75312_Judith Raburn_20191210

SD# bi- Q 4 3 No. 75312
eCAMA/
Q DREDGE & FILL q g C D
GENERAL PERMIT Previous permit# / ..
>' ONew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued ,L- a
As authorized by the State of North Carolina,Department of Environmental Quality /- // 1
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 67f/, O
l Rules attached.
Applicant Name Ju�i 7 L RA 6u r vt Project Location: County / a /)
Address / `/0 Rr L, ki , 1 Street Address/State Road/Lot#(s) /` CI re,J ,. / et
City /Je l 1/ '(in State/V( ZIP .2,,/U
E. Phone#(a-C.?) 9`/.:-607041 E-Mail J"`l bwhCd/,Icy. c.•-' Subdivision
Authorized Agent A/,if City 1 ;A...fee ZIP 7 f/O Q
feCW I [EW ETA ❑ES ❑PTS Phone# ()S2. ) gY.�G ur. River Basin T. `/ �.h
Affected
AEC(s): ❑OEA ❑HHF ❑IH El ❑N/A Adj.Wtr. Body AIL-r^- r,k,, / (nat 6nan unkn)
❑ PWS: D j�
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body &' r'y-' M ''�'"
Type of Project/Activity Al, ,. -/ ,_.n lE ,` _(-%4i /✓„ i'/ 1+1l.. de- e / , ,, /Jrz,, )4, —-7'At
(Scale: / i = 1 ' ' )
Pier(dock)length 7
Fixed Platform(s) / ' )� /�11 ( __1� �II� ■�I
Floating Platform(s)
f
Finger pier(s)
Groin length uivi 1111 .411
number ■■■■■ ■■■1MRl■■ ■■■■■■■ ■■■■■//r■■
�-- 1.--�_ ■■■ice ■■ ■■ ■■ n�■■■Bulkhead/Riprap length �
avg distance offshore {, • , 5-
max distance offshoreNil' { � b
Basin,channel A e. he/
.mot, r I /, ■■ ►■1 i !i •
1 I I I ill ill '
cubic yards /00FA ��+'
Boat ramp I, urn;
111111111111/41111/4
lI1IIIIlIlHE!iI r. Boathouse/Boatlift I _-.....mliii
- f ..L.-„ fimlu !_. _._..uuinii .._
Other Beach Bulldozing I !I � � �' I i 11111111
1111111111I
■■■■ ti �i.!;>►/l ��'i ■■ ■■■■■■■■H��■■/■■'.�' `
■ PiiM ■ a■■ ■ ii■■■•■■■ %•ii2■■■■■■
Shoreline Length :-%�4. )Pl iI
I ,E. iiuii
4HI
;
SAV: not sure yes no ii1111
�.
Moratorium: n/a yes no !, III
Photos: i yes, no r —
1 jlr' . I IT, i I
Waiver Attached: yes o ' o
A building permit may be required by: 17(4- . 1✓1 See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) /// /
a
Notes/Special Conditions ,f'�, 3 2 07/4 � fix,/ e{ j f fed ', f�-( //� cif e `"' ''Z
1i / , f ,re'!.
Agent or Applicant Pr' ed Name �_ PermitOffi er' Printed Name_ Z
S. nature **Please read compliance statement on back of permit** Signature
u
0,2:
Application Fee(s) Check# Issuing Date Expiration Date
1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to \)u p i.T• 1-1 Q(.; R tv 's
(Name of Property Owner)
r.• property located at C '}0 [A t oi.)I.?, - - c(Address, Lot, Block,,$oad, etc,) (3 C L (4 A I) E N
on Y)0 6?-6 � ( VEV� , in P�N ?E oininuNc71 OF
, N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location. /
t/ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Ind' ' ual proposing development ust fill in description below or attach a site drawing)
,; crufuL
Q - - \ c —t
/I (,1)/t i ilia° 0G--
p itl_.K__ . 1\,)
.i ' P11 9eUVIrl
N I
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 Prope Owner Information)
ti\ai7.1-z" X /, z. ,--
Si tune -� Signature*
U D +rt N ` Ot'B u R N (fit � U_ ((IV) i9
U Rm Gri .o iv 6:, U
Print or Ty e Name Print or Type Name
v`�
14-0 iAiS t N sc) ( D I) '9id;� , ta-
M iling Address Mailing Address
LI-IPNE- \1 ‘• C DiE) D Rolrc '.IIc, ,Vc,R7571
City/State€ City/State/Zip / h`t�, 6�,,,k
p
Tele hone Number/email address Telephone Number/email address
( I - D7- (Ut It-,7-,)Ci9
.."` Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ,tn;-tr it t 0 o c Ivy 's
c_, (Name of Property Owner)
property located at l 4 Q It A 0 o'er o [ 0 t) D
(Address, Lot, Block, Road, etc.) e C-L t-1 A\i
^) c c ;ry CrN.C.
on u�lC� u 1 � ER-, , in c� -� � � MMuty ,
(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
(Individual proposing development must fill 'n description below or attach a site drawing)
ti 1
>, irk. ?,A
, ____ ,) �� r�.
\�� / 1 „T
ri , i-f
R;Ai f
-gust;
WAIVER SECTION
I understandkiha a pier, do k, 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, yoou 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.
(Prod rty Owner Information) (Ad' cent Property 0 ner Information)
P 1
P • 'iv Zo_A- /cm&
i, ,
Si at r ] nature �t --I Y L o (-1
Print or Type Name Print or Type Name
( Lk-o Rt ABLN N l?o4'D Sq. NC 45 Jul
Mailing Address Mp►ling Address
cL!-1 1VEN� R� a"/ S ICE LAN t �) ( r / O
City/State/Zip, C►ttyy/State/Zip
q43-6-Loo IvD1RRt3L:gt4E0.1Atioc,c_OM 252 -?t - ki; % 7C
Telephone umber/email address Telephone Number/email address
�..• (l - V 1 - D0 C'f - t2 - C2. - 11
Date "Date*
(Revised Aug. 2014)
`Valid for one calendar year after signature*

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NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: J I i 7 L v i u rYI
Date: D 10
General Permit*: 75
Describe below the HABITAT disturbances for the application. All values should match be Marne,and units of measurement
found in your Habitat code sheet
TOTAL Sq. Ft FINAL Sq. Ft. TOTAL Feet FINAL Feet
(Applied for. (Anticipatednlal (Applied for. (Anticipated final
DISTURB TYPE Disturbance total ! disturbance. Disturbance disturbance.
Habitat Name includes any Excludes 3rr+ total includes Excludes any
Choose One
anticipated restoration any anticipated ! restoration and/or
restoration or and/or temp restoration or temp impact
temp impacts) j impact amcuat) :emp impacts) amount)
3
IL t✓0��, Dredge Er Fill❑ Both ❑ Other ❑ 7Cr-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 ❑
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 ❑ ( l