Harris, Denard

P�AMA / EY6REDGE & FILL I ' ",'" NU. 74487 A B C D
GENERAL PERMIT Previous permit# — r
Phew [-]Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality „�, - r r j; // v.
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC (� 7 H � I ��.'
, 1-2RUles attached. `
Applicant Name I .j (rrr) `r't (_(y t Project Location: County _
Address %`" 1 G V ta) { (NE I Street Address/ State Road/ Lot #(s)
City �r j t ' i f /1 T 1/ State M ZIP - "� r F:
Phone #
Authorized Agent
Affected El CW
AEC(s): ❑OEA
❑ PWs
ORW: yes /!"')
;*W ,PII _.L.1k ❑PTS
❑HHF ❑IH ❑UBA El N/A
PNA yes / no
Subdivision
City�ZIP tx
Phone# O River Basin `t��,/,J'>P
Adj. Wtr. Body (nat lman Junkn)
Closest Maj. Wtr. Body
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Agent or plica tPrinted Name
Signature •* Please read compliance statementon backof permit'ra"
Application Fee(s) Check #

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to //wr [..mots ekq.v )1d R k is s
— (Ndr�e of Pro rt Owner
property located at 45 L 5414%,- W4 n4-, �ro >zrn Rd plA-ye (� ��-
(Address, Lot, Block, Road, etc.)
on in -To jNSki,, jr -('R,4✓2,I CO N.C.
(Waterbody) (City own and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Ct'J O o'F C jZ 11 `f11
6
W'/-G (dare 5
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waiv the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement. �E�EIVE�j
I do not wish to waive the 15' setback requirement. MAY 0
6 2019
(Property Owner Information) (Adjacent Property Owner Infordit
I �, HD ciry
Signature I
SA r 1 F al42R K j4lel<Arr
Print or Type Name
Maing Address
'309,Jo Oh �� o13612 -131i
City/ ate/Zip
757- �6$- i590
Telephone Number
Jf/i -3 IX e7l9
✓)rloreAteod C,dr_ /�C
City"tate/Zip T
;t,5;t - 72— - 0 3 ( 7
Telephone Number
Date
Date
(Revised 611812012)

I hereby certify that I own property adjacent to / q'.) 's
/' (fume of Pro rrtyy Qwrler)
property located at 1 85 S,%I � � /�9M-S ;7412yr Lg / WW- oL W
(Address, Lot, Block, Road, etc.)
on CIi l'v F0o'T Ck4iK:: in rwa 51.1S' • 024Ve k? (50 N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAINING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
c L
�� f
�43�Rr
,A\c,*
V 13 Fo o eYZ G l�
u
0
?':!� A
135-
2�
WAIVER SECTION
�bhec� f�rrs
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me.laEjpEIVED
wish to' waive the setback, you must initial the appropriate blank below.)
V i do wish to waive the 15' setback requirement. MAY 06 2019
I do not wish to waive the 15' setback requirement.
DCM-MHD CITY
(Property Owner Information) (Adjacent Property Owner l4ormation)
Signature
µAyNAP-OV
Prior Type Name
-�n4 r��N�JEI S r
M fling 4ddresrs �C ZgSJ 7
e�P L^� 4
City/State/Zip J'
9,SJ.-72'-oat%
Telephone Number
Date
ra.w
or
City/State2ip
aI 0- 6oI —!�00"3
Telephone Number
F010
0
7 zs9,
(Revised 611812012)

Proposal � - - proposal NO,,
FROM � ° '- ' Sheet No.
VI��Q� jir� C iT"1— - A 8 SS7 Date
Ar�> —7,2.5— 3 yis
- - - Je Performed At
��Frop/ascxl Submitted i'a � t( ��1__.._
Name1.-1�—✓—rc—Nj-1 Street 'TgS srt� r'rV=' �'f' `�T�•!
Street
/ PLC Y City
}�AAm_S.—��h SfafeSL__
/ .$ Date of Pla
city 5
state Architeggt G r C�
Telephone , b '1'o:S U 1% 'j'71— / 5007L Q Gr MPR A
We hereby propose to Furnish dll the materials and perform all'the labor necessary For the completion of
ofeLi- — (✓ .I 35 Z- r Az ' CeT-
Sf1L"( t L
.--
S rr4 15 r 49 L 1
u C-S 'T d �' C£IJ rE25 ftTfAGMiEp
All mdteriol is guaranteed 'to be as specified, and the above work to be performed in accordance with the dre:••
and specifications submitted for' a6ove work and completed in a substantial. workmanlike manner for the sui&
"TN►r`r6S-A "TA4i)0-'rW-•1A F\Vi✓ HOT-4D-e-Sb Dollarsf$1a1600
with payments to 6e made as follows:
Any alteration or deviation from above specifications involving extra costs, will be executed, only upon written orders, and
become an extra charge over. and above the estimate -'All agreements contingent upon strikes, accidents or delays beyond 1
control. S>wner to carry Ere, tornado and other necessa insurance upon above work. Workmen's Copfprµa'fv=d P,rt,l
Liability Insurance on above work to be taken out 6y t 11 VV tLD
(7n91 MAY 0 6 2019
Respectfully ^•t^^s''"'
Per
Note— Tbls, proposal may be withdrawn by us if not accepted within days
DCM-MHD CITY
ACCEPTANCE OF PROPOSAL
The' above prices, specifications and conditions are satisfactory and are hereby. accepted. You are authorized to, do the wa'1
specified. Payment will be made as outlined above.
LITHO 1H �:.