74094_Charles Worth Lewis_20191104

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I e 'i CAMA/ 50REDGE & FILL Ib (0 4 05 No. 74094 A -B` C D
GENERAL PERMIT Previous permit# 1-,/ `-'
>G rNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued ni /A-.
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 ,_,,22 /i
1.Rules attached.
1 Applicant Name `,L1,-sc, M"5 .�© 171 4-6.,- 1 ' Project Location: County f,5_--, „r„ ,1 -, /,_) .
Address c 1.-0 /'-.o vi.! Tt J 1- i;✓ T'J . Street Address/State Road/Lot#(s) ,51 1� ,D)z 1 .:,,)4
F , City: J,,.+ram „ v, State N ZIP > 1 ) ) D , ) , 1
Phone#( -- - ;_-7- -_�j(„E-Mail Subdivision ---j--a4._,, !A , - ' ,l
Authorized Agent .fit t--,-2, Tt i)A‘.1 r City : --e_/L,;;:; >>e A ZIP -)`/ )y.
Affected ❑CW Q EW ,KPTA ' 9ES )Z PTS Phone# ( ) River Basin-71-Q_- ra(,, I< -)
❑OEA ❑HHF ❑IH ❑UBA ' ❑N/A -'
AEC(s): Adj.Wtr. Body f/a t 4 , --i L.IrTz- (nat %nan /unkn)
❑ PWS:
ORW: yes / no PNA yes `no, Closest Maj.Wtr. Body , �r/ , Z i) �1 a t:Y..
Type of Project/Activity / _I - 7,— ( -.0-/4/v F-) L '2. ,p ?,4> i/D 1.,,A ,,v44_,. Q r
I , 1 i) ,, t � - (Scale: / ! 3D / )
Pier(dock)length
h
Fixed Platform(s) i I 1 'i
Floating Platform(s) - _
v 1 41'7 L /4-) ✓1t:7` -4_ 1.,• -
Finger pier(s) LLLLLL? - , E-- '
Groin length I I
i I1 1
s number
Bulkhead/Riprap"length / t/D f 1
1
avg distance offshore /7) " I I 11
I 1 . . ti
max distance offshore ,
i
Basin,channel P°'Llt\I
cubic yards t �-
I
Boat ramp I e. -7n-
Boathouse/Boatlift . / VI) I ©r I
Beach Bulldozing i i I
Other
'
.
t
1
+ I 4 f I
i Shoreline Length ----.,7 1 Q �i 11 ` 6-� 1 �r i ,
SAV: not sure yes no
'^PzUn i� CD
Q I
Moratorium: n/a yes ��.1 J ! � }j
Photos: yes 0' YJ V.� f ---
Waiver Attached: yes no g i v.✓I IS 1 I 1 1 1
A building permit may be required by: ,-ry1. T z',), . I I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions 15 Y/->-1 ,. -i (� t'-`-t•,) L�- , �) -
Agent plicant Printed Name Permit Officer's Printed Name
`=tip -.�
Sign ur a read compliance statement on back of permit** Signature
Application Fee(s) Check# Issuing Date Expiration Date

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: (_ r)(4 )--/e S Oti51,Sj-'
Address of Property: / `� .Z L(i,� 1J �_ f� clo]A iVC aalV);?, / )-(c
tfi
(Lot or Street#, Street or Road, City&County)
Agent's Name #: /) t ti os( Mailing Address: C )s kr. /11,04 31V
Agent's phone #: Z v-z ; Z Z`' t?t J.' /)a9/-),,/0 /!(, NS i
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http://www.nccoastalmanagement.net/web/cm/staff-listinq or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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) (Riparian Property Owner information)
Signature Signature
C11(9ric( C l,rt ,).+./ 1,4). k 6,ir:JAi
Print or Type Namef Print or Type Name J
/S5 5ok/ Tri t2y L�L�,J
Mailing Address _ Mailing Address
City/State/Zifi City/State/Zip
9in) 1('10 /9C
elephone Number/Email Address Telephone Number/Email Address
Date Date
(Revised Aug. 2014)

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2373 NC Hwy 304 [phone]
Bayboro, NC 28515 `- -\,, i, Fax: [phone]
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Rock, Sand &Topsoil • Custom Bulldozer&Backhoe Services • Clearing • Grading • Rock Bulkheads • Demolition

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: c_iii--:,ii , . f,-,,-
Address of Property: / ' r:
(Lot or Street it, Street or Road, city&County)
_,...,
Agent's Name#: ), -,,,' "." : --i,, -, ; Mailing Address:
Agent's phone#7. ' ---'
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
i
`I I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management
(DCM) in writing within 18 days of receipt of this notice. Contact information for 0CM offices is
available at ,: ,,.,,•=,---,-,,sir:.-...71,'Ilte, -_1.; 1,;',',;1; ,::(r :afr-i'istiori or by calling 1-8813-4RCOAST.
No response Is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.
'V I do not wish to waive the 15' setback requirement.
-..-
alislawe
(Property 07;1 Information)
zi (Riparian Property Owner Information)
/
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Signature Sgnariii.e
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Print or Type Name Print or Type Name
-) - 1 , ':' L. /
Mailing Address - ' Mailing Address
/ /,f 7 . : ,•• , , L i 7 „ ,r_/'
City/State/Zip City/State/Zip
Telephone Number/Email Address , ' Telephone Number!Email Address
Date Date
(Revised Aug_ 2014)

25- -
Ver..
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: (47;
Address of Property: I ri 71) _
(Lot or Street#, Street or Road, City&County)
Agents Name #: . Mailing Address ; •
._‘
Agent s phone #: , 7
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at pttc://v/ww.ncroastairnartqffement.net/i,vabirmistaff-listing or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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) (Riparian Property Owner Information)
Signanire Signature
/ • •
4) 1 //- , ;.! • /-1/• I /
Print or Type Name Print or Type Name
le,"/
Mailing Address Mailing Address
- • •
, • ,„ / .
City/State/Zip City/Statelip
Telephone Number I Email Address Telephone Number/Email Address
./f/
Date Date
(Revised Aug 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: (AArlcS /'Ji r/ L CLi)i S
Address of Property: IS0 Lt'W,.1 /, 4,'I0I a / NC 27 / (�r'Pv t01 f
(Lot or Street#, Street or Road, City&County)
10)- 5 L. (J)US'-
Agent's Name#: (fit,S/1 A.) 7 r N�a�P Mailing Address: 7?1' 3 tiC. //L y
Agent's phone #: <_AZ_) ')" ,V/�j V�� , , L 57 5—
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available athttp://www.nccoastalmanagement.net/web/cm/staff-listinq or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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) (Riparian Property Owner Information)
•
Signature Signature
Print or Type Name Print or Type Name
C JN 1,7 / l Tit /5 5 510;/e y iZc
Mailing Address Mailing Address
City/State/Zip I City/State/Zip
2�.
Telephone Number/Email Address Telephone Number/Email Address
/1 /‘ ' 1
Date Date
(Revised Aug. 2014)

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O• o Construction & Trucking Co., Inc. - --
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2373 NC Hwy 304 [phone]
Bayboro, NC 28515 t,\ /i Fax: [phone]
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Rock, Sand &Topsoil • Custom Bulldozer&Backhoe Services • Clearing • Grading • Rock Bulkheads • Demolition

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: (12,1 '_ Ll'-w'j
1
Address of Property: /F) /eco j 7(1 NC Z'? /pH
cLot or Street#, Street or Road, City&County)
"Tl iv,aSV- (01.)1 F N,,c 4,4s
Agent's Name #: i'S ii t rAJ1iy Mailing Address: (7s?3 N'C ��'� s��y
Agent's phone #:/Z S Z)Z Zr)- tit aiy 4,,--0 /,)C JS/T.
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http://www.nccoastalmana_gement.net/web/cm/staff-listing or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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) (Riparian Property Owner Information)
Signature Signature
�/�a1/t f /A)/ / ����,s li( 104CC L (27.0 rr i�
n"nt or Type Name Print or Type Name
Mailing Address Meling Address
City/State/Zip City/State/Zip'
Telephone Number/Email Address Telephone Number/Email Address
2. /
Date Date
(Revised Aug. 2014)

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!,u TURNAGE �_.:
.O•o Construction & Trucking Co., Inc. 4 r
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2373 NC Hwy 304 [phone]
Bayboro, NC 28515 t,1 /1 Fax: [phone]
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Chit I e S I)/if/h Le t./i f
Mailing Address: 7/ if t (or;A i 3 //)A ( /Lt/.
l4JiA;/er Li,/1( , Nr_ S 9v
Phone Number: ( 7) �� � s S s
Email Address:
I certify that I have authorized AJ$r' (",>N / / !- )..S7/,z/
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 10 gl)pfiv
Cx f cJ Cti1i oli'()nil4-! it,or 1 l t, ':!�
at my property located at /
in %Sc al oft)r-t County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
(-1 f•/-I / 1X Lc-<
Print or Type Name
Title
�n I /1 / ,)/2ri
Date
This certification is valid through I I

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Beaufort County, NC GPIN:6598-77-1990 PROP_DESC I ACRE WILLIAM B MBL 65980066
GPINLONG.6598-77-1990 THOMPSON PIN_I:14028418
NAME! LEWIS CHARLFS WORTH LAND VAL 141179 DATE 5/24/2018
Disclamer: BLDG_VAL:3000 DB_PG:1960/00842
NAME2 TOT_VAt 144179 STAMPS 94.00
railnhle and wflh auamann«.«presxlnrimplicl.€ am pubhshd,m
dJ,,,,,,ne isr o.i,,,„,.��. �i.,�d ir���in..J�4o cans...a ADD RI:6640 COUNTY HOME TAXABLE VA:144179 SALE_PRICE:47000.00
igain_,`«d nor
abovid n be mbmm�ed�a me aa.;w« �;.«nrnan,n, ROAD DEFR_VAL:0 REIDI 21420
pmlessionals.11 avary of F3 !i+n end the Websi,e Provide,div:leim all
�P.,,>;biiipa�d raning,Mm��a�,m�wnhinm,mi,.. ,.im.Ih.: CITY:WINTERVILLE PREV_ASSES:143775
sr,agm«rMi l3neIaCnunc endits Assignsshell he 141 herml«s1'rtm,all STATE NC ACRES:0.74
�a dein,s_dau,eg«.,r�ndgm�n�.eneing n„��t mine..nrc.,nnry Jain ADDR2 PROP—
ADDR-.180 LEWIS RD
bamlwmcagamapsaxn
q 2II��a 1 Oct/16/2019 ZIP•28590 TOWNSHIP:14
A 180 0 I Scale 1:970

NC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant G,L1A1-cE5 G,'o2z7?-4 4L,SrJ
Date: ¢ /4V. Zo
General Permit tt: -q 171.
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 I FINAL Feet
(Applied for. (Anticipatedfinal (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
Habitat Name includes any Excludes anv total includes Excludes any
Choose One
anticipated I restoraticn any anticipated restoration and/or
restoration or and/or tem p restoration or temp impact
temp impacts) impact am cunt) temp impacts) amount)
Z _ I
Dredge❑ Flip Both ❑ Other ❑ f, 4-or Ff- 1l,V
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑ •
Dredge❑ Fill❑ Both ❑ Other ❑
• Dredge❑ Fill❑ Both ❑ Other ❑
I it
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
I '
Dredge❑ Fill❑ Both ❑ Other ❑ i
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
I � '
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑