74083_Herbert L. Betts_20191024

CAMA/ ❑' DREDGE & FILL - .p # to 4 Z 3 a No. 74083
GENERAL PERMIT Previous permit# A Bf C D
A'New ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued A' /A.
As authorized by the State of North Carolina,Department of Environmental Quality i
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC J ' • j
Rules attached. j
Applicant Name f/c- 3EZT L. ' a-T--r> Project Location: County /., A,-1�:a 1 ,_.),
Address /e7—9 A l'/ - 4' 4 9 Street Address/State Road/Lot#(s)b• c ,Z / 9 / D
City ,1 t 3 4r- State,&) G ZIP 2 7=10 L-' / , a 1'y-- /..-r..,AU
Phone# (2<2) `r V3- 5 `'(a E-Mail Subdivision
Authorized Agent 54, L 4 h City 4 '-i%%0 2A ZIP 2 e-7
Affected ❑CW I EW C TA ❑ES ❑PTS Phone# ( ) River Basin 7" AA,7`-' w
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body 71.'0 r' f='- i; (nat an /unkn)
❑ PWS:
ORW: yes / no PNA yes / a� Closest Maj.Wtr. Body
Type of Project/Activity/ = ) k , v-n 7
(Scale:/ =3D )
Pier(dock)length
Fixed Platform(s)1-'t-) 7 f I ` / 1 i 1 .),>�. r
Floating Platform(s) /PA_?•i 1 y--� I s:ei�)t
Finger pier(s) ` .1 �'
Groin length
number
Bulkhead/Riprap lengthr., , :.
"
avg distance offshore ( /,V X <!
max distance offshore ��,
, . , : _
Basin,channel
i 1 l
.-7
eity 1P1Z
cubic yards X
Boat ramp ` I
Boathouse/Boatlift I
Beach Bulldozing _ '•.)` I
Other - 3 1'' ti1/tr ,N i, t I
`�'°, _ fI
Shoreline Length v v � 1
1
SAV: not sure yes no ( r,._ri S x::, t �,.-._._.._
Moratorium: n/a yes f�
i Photos: yes no .r c •?I ,lige,i 5 -
i Waiver Attached: yes
Ia'1
A building permit may be required by: 13E-eh7 t'rr e/J • . []-See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions /►Fi 'C.''"'4*~/f P''-Oc>5-c S -"/df'(a i-i ,c.) r tom"" 1)-. ' . /1 I n y i/t-i *- -,
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'i- `, 1- S", t,41 / C' j, +i e' 71-)d L,F" (,4'1-4 c C'?--y I
/ _7 4) F-4-2.G.d -r-- 'S r 7s-, ,—a-t 0 LA",)- rmt . l
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Ageint\or A arinted e Permit Officer's Printed Name
Signature **Please read compliance statement on back of permit** Signature
Application Fee(s) Check# Issuing Date Expiration Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 's
,�j� / (Name of Property Owner)
property located at /&7 /' �� (/.
(Address, Lot, Block, Road, etc.)
on , in , 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 DRAWING OF PROPOSED DEVELOPMENT
.441
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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 waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
7-)7
Signature Signature* •
l /r 4 /0, lZt >)(/
Print or Type Name Print or Type4lame
/?) Aii)1C
Mailing Address MAiling Address
S2
City/State/Zip Cit State/Zip Y
e A ea Li, (4'
Telephone Number/email address Telephone Number/email address - C-c'' 1
I(- / �
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY 0 NER STATEM ENT /
I hereby certify that I own property adjacent to L4. ,/ / f5/,/,5 's
of Pro a f (Name p rtywner)
property located at 1 6 % A7 IL
/� ( dress, L.ot, Block oad tOy
on /a7( �j�j‘A , in c //'L W , N.C.
own and or(
Caun
(Wate�dy) (City/T ty)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
G I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
j
,Ag\14 7----
i „._ ,\''
t)1
I �
..---- fikA A,i , vir
WAIVER SECTION '
\ I
I understand that a pier, dock, mooring pilings, boat ramp,\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 waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prop 0 Inf mati (Adjacent Property Owner Information)
2 C
1/ ,,,s Z /, XX; cl- ----e./.44 2,el-44--) ,.//aL4-1--
t G , Ignat / i/ 97/,S
Print or Type Name Print or Type Warne
Mai; . res,7, // /6_,/ Mailing Address
City/St /Zip City/State/Zip
/ ,DC,9,r ,,C, ,
T4 epho e Nu ber/email address Telephone Number email address
-,���- `�_42f J .� 7� - 7L //7o
Date / Date*
(Revised Aug. 2014)
`Valid for one calendar year after signature*

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1 ' LLB-14

NC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant: ul 2 E)z r . . CI-7 5
Date: 2 0— a�e 7i3
General Permit#: —7 y- A 4? 3 3
Describe below the HABITAT disturbances for the application. All values should match he name,and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft FINAL Sq. Ft. j TOTAL Feet FINAL Feet
(Applied for. (Anticipatedfinal j (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
Habitat Name Choose One includes any Excludes any total includes Excludes any
anticipated restoration any anticipated restoration and/or
restoration or and/or tern p restoration or temp impact
temp impacts) impact amount) temp impacts) amount)
2_eq--r-� Dredge❑ Fill❑ Both ❑ Other 12t. 0 Ire . - 14e, 2
Dredge❑ Fill❑ Both ❑ Other ❑ -
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
I I
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
j 1
Dredge❑ Fill❑ Both ❑ Other ❑
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Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
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Dredge❑ Fill❑ Both ❑ Other ❑