74096_Howard Gerald Heath_20191104

#' iCAMA /,DREDGE & FILL 4' (04g3 9 No. 74096 A C D
GENERAL PERMIT Previous permit# is/ ''}-
. 0% ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued i 14--
• 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 I 41 • / f
/ , ©Rules attached.
Applicant Name�c,a✓,n�p Cn-7r R1 1-0 �c.'1 L7't1 Project Location: County G^ ' ,c) •
' Address /2 ' , -i, i I,.; f }!.-1= Street Address/State Road/Lot#(s) 0Fr= wiz 17 _-1
City Z.:0-f'F State i,/C.. ZIP -7 5-,_- C / . �/geNi 4,;� M' •
cPhone# ( ) j 2.3 - '2- E-Mail Subdivision _/3/ 4 '140
f Authorized Agent �v7,r-;;T - LIP e� ,. City /4--r-+-J ZIP 7-7 s"
r IIICW X EW IOTA ,®ES )2 PTS Phone# ( ) River Basin Z C r r C)
Affected ❑OEA ❑HHF ❑IH El N/A
AEC(s): Adj.Wtr. Body -v U '✓ Y� .�n,0)/man /unkn)
❑ PWS: ❑UBA
ti ORW: yes / no PNA yes / no
Closest Maj.Wtr. Body ''' ' , J-!L 4
Type of Project/Activity
(Scale: / - '2.d )
Pier(dock)length
ir
rr
i' Fixed Platform(s)
i I- i, r 0 k.'r/
Floating Platform(s) """ I " — r i 4 J
Finger pier(s) J
i
3 Groin length ' 1
number X! '1-! /� t"/ I ) Iv)
ii., ----- 1,--Bulkhead/Riprap length ^ri �" I /
avg distance offshore 1 G/ /.. i , .� i
i. � , /T j °I
max distance offshore _.D ' G f`. I- i
Basin,channel ' I I I
I
cubic yards J ._ i-__--
G ' I
r Boat ramp : j
Boathouse/Boatlift �_ ` [7'7~ ' .0
f. .__. I 1 ' /rl<y"4i.c . -. �I�
_
_ ... 1i4a 4.A.r
Beach Bulldozing i
i
Other _ -'I _11116k.
. i I
—' f
I
ill
N
Shoreline Length > i `/�-- \ !:'f1 C . ,y i r Ar 1 \
' SAV: not sure yes no _ ........ ........—_. { • ; rx:`d�
a Moratorium: n/a yes 1-1 72yp L �2 u�
Photos: yes r.-rrn — — —
1
Waiver Attached: yes s I I I I
A building permit may be required by: . ]See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions 5'_ '+7--%7 ---'i_-:
1
Agentlor Applican Printed Name Permit Officer's Printed Name
fI'
i , .' -ftl 4;J I -/-7__,, gi- __, _
. Signature **Please read compliance statement on back of permit** gnature j -
P.,a 14/C 1/ . )— •X•z1'Y ce i/<,✓.:_. ,2:4; ., c-)/i 14. A/4k. /-! z— z,
.t Application Fee(s) Check# Issuing Date Expiration Date
{. Y

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT
I hereby certify that I own property adjacent to 0
t�.Y'1 rr I-Le64 's
(� (Na of Property Owner)
property located at a*( Iteeki 1 Tn(1 P r)V t?�
Pa (Address, Lot, Block, Road, etc.)
on t`(� I l �0 �/��. , in , N.C.
(Waterbody) (City/Town and/or County)
The appl. ant has described to me, as shown below, the development proposed at the above
Iocatio
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)
Lrs)d sulk head
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 .sh 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)
SigInf�fire Signature
ff 0%Diat L G-eeald. 4 Z3dm.-n.h).Maras r u..
Print or T ae Print or Type Name
la 'pe m
c{row t2717taxMe/ w R-
Mailing Ac�clress Mailing Address
�J d� /i:;'GNn-o,vo, WI 237,3 3
City/State/Zip t City/State/Zip
a51- 9 a3-03 D,t� goo- 307-62s-to MacmArs441Q✓e,ezen.0e±
Telephone Number/email address Telephone Number/email address
5 ear?
Date Dale*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

Scan05142019.jpg Page 1 of 1
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to hVri rzl Cerajel gen is
/n1 (Natme Ppperty Owner)
property located at lag tt aek) tt1I(o e. "-_um
l v
n , (Address, Lots Blocks Road,etc.),
on' 2 tY j (7 i�4 �e-l�, in OcCH1 N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as,shown below, the development proposed at-the above
Ioca pn.
V 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)
8ctik 7 .
RiverS d e.
wpIVER 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 vyish to waive the setback,you-must Initial the appropriate blank below.).
, al I do wish to waive the 15'setback requirement.
I do not wish t waive the 15'setback requirement.
(Property Owner Information) (A -acent Property owner Information)
Si Signature*
J re n-t 6-erald. tr1,
�p.
tfint Print or Type Name
1 Ky r ialmale al Ath , ?,r?ve...
Maltby A ss Mailing Address
Jf" yPC a '—Q3 City/State/bp
ip
Telephone Numberl&mei.address Telepho: N Or/email address
5 15( 11
Date _ r Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*
https://mail.google.com/mail/u/0/ 5/15/2019

NC Division of Coastal Mgt, Habitat impact Computer Sheet
Applicant: {.�awA' - 4 efz,e-r,4 / / r7-�'
Date: ¢ o✓E�"'t3 cue 74.2 '
General Permit#: i
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. TOTAL Feet FINAL Feet
(Applied for. (Anticipatedfinal (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
Habitat Name Choose One includes any Excludes 3nv total includes Excludes any
anticipated restoration any anticipated restoration and/or
restoration or and/or tern p restoration or temp impact
temp impacts) impact am cunt) temp impacts) amount)
5;.loi2e"Z-/.-J e Dredge❑ Fill❑ Both ❑ Other
bl �„{,j 1 Dredge❑ Fill❑ Both ❑ Other }� e�2 6
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
• 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 �
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑