75403_Carl B. Pennington_20191106

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❑CAMA/ ❑DREDGE & FILL /' _ No. 75403 A B% C D
GENERAL PERMIT Previous permit# i
>Z 1 ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued h! /Q_
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC .
0 Rules attached.
Applicant Name Project Location: County
Address . Street Address/State Road/Lot#(s)
City State ' ZIP , '
Phone#( ) E-Mail Subdivision -1
Authorized Agent t ! City jr=.t:.,,- ZIP 1 -7 - 'v
Affected ❑CW 4EW A PTA ❑ES ❑PTS Phone# ( ) River Basin
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): ❑ PWS: Adj.Wtr. Body' ;..> /r:,e.- Z (flat/man /unkn)
ORW: yes / no PNA yes %no Closest Maj.Wtr. Body ./.-- ��'7�
Type of Project/Activity 2 c , /2 x , • f/3'=> , r- \ .,
(Scale: , - _,D )
Pier(dock)length/L. ' x .T;
Fixed Platform(s)
FloatingPlatform(s)
l ( C ! // e-- 4n 1 r r") ,Pr 4/4 k .,.
Finger pier(s) ! 4--
Groin length k ' Z' r ' { . .� Ilki.
number II I
r-Z I
Bulkhead/Riprap length / 1 I • N
avg distance offshore i j(171 rr T b
max distance offshore I ( >,,y y�
C'
Basin,channel j
{
'cubic yards •, - • — I
Boat ramp I � /
� I
Boathouse/Boatlift
.......-._....--
Beach Bulldozing �' ';1 2/0-
� _-- i
Other ,
,
�- ) Cr
ii
Shoreline Len h ,/o D
SAV: not sure yes no f _ ?Pt, �� ,
ew.40
Moratorium: n/a yes no I 1
Photos: yes l I ( ■
1
Waiver Attached: yes -ig-) , : .,_
A building permit may be required by: r (1/, c--F 7.0 /R.-See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) '
Notes/Special Conditions (-( '--)-1-4 t---- Y) L f) k-1`-/
r
14 )i .i_5 /
Age 12 ph Pri am Permit Officer's Printed Name
Signature **Please re compliance statement on back of permit Signature
Application Fee(s) Check# Issuing Date Expiration Date a.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Ca N/ '. -PeA0/1);qb T e% 's
property located at // S 0/Cv ?an)I i - aced Cof Property Owner)/
—� (Address,L- Block, Road, etc.)
on -6M4 1tc6 }.nek , in pe 4 L
(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
--6 ‘e1--,Yetirr , X(e / . -t° 46,_.-e_ Cijelp_ori
ek.6h)Q- /o p/ &15 140 Ae-41 ,e,A0 /04y
IA i
iiiill -6t'(-- 1/tL i211/f/d>LQ. CP-6 412421: 1 i
jx4" ' - (&,M
"J7(411 1/42/1167
iat/G ilitejl"At,
- el4 11°-s
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.
(Pro erty Own r Informati n) /� (Adjacent Property Owner Information)
S&wture /
l--tt'l g. q/Al i' p jpk -/� Signature
*
Print or Type Nape ` Print or Type Nam e
T S /S- G/'-kPGvii(-tri d
Address�' 1� �� ' Mailing Address
'� �� 1.•, J 7�
City/State/Zip City/State/Zip
cc - A 7 -/p`2 ')
Telephone Number/email address Telephone Number/email address
//' S- Il
Date
Date*
`Valid for one calendar year after signature* (Revised Aug. 2014)

NC Division of Ccastai Mgt. Habitat Impact Computer- Sheet
•
Applicant: C(or / tN^•ems �•,.
Date: //, 6
General Permit#: 7S Ye 3 /7
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. (Anticipatedfinel li (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
Habitat Name Choose One includes any Excludes any total includes Excludes any
anticipated restoraticn any anticipated restoration and/or
restoration or and/or ten p restoration or temp impact
temp impacts) impact anoint) temp impacts) amount)
OP**•• 41.1-1" Dredge❑ Fill❑ Both ❑ Other R' /.1 /-2�
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