Clegg, Philip

®❑CAMA / ❑ DREDGE & FILL No. 75907 A B C D
GENERAL PERMIT Previous permit#
gNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources C©
ommission in an area of environmental concern pursuint to LSA NCAC E
Rules attached.
Applicant Nam2me._, j, �-`y _ _ Project Location: County
Address tk' 1"/I
) ,Y ` I� (i Street Address/ State, Road/ Lot #(s)
State ZIP— -,,) ,
Phone # ( I)_'9
Authorized Agent
UOW
UiW
❑PTA: LIES ❑PTS -. -'_-
Affected
❑OEA
f7HHF
❑IH UUBA UN/A
AEC(s):
Ll PWS:
ORW:
yes /no
PNA
yes / no
Type of Project/ Activity ' !
Pier (dock) length
Fixed Platform(s) T1/
Floating Platform(s).."�
Finger pier(s) _
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore
Basin, channel /
cubic
Boat ramp
Boathouse/
Beach Bulldozing if -�
__-I
Other i
Shoreline Length
SAV: not sure yes 'no —
Moratorium: n/a yes ;no/;)
Photos: yes no
Waiver. Attached:_ -yes no
A building permit may be required by: _
( Note Local Planning jurisdiction) N!
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check#
.i.j :'I
City '
r
Phone( )4
Adj. Wtr. Body,__
Closest Maj. Wtr.
(Scale: )
❑ See note on back regarding River Basin rules.
1l
Permit Officer's Printed Name
Signature
o
Issuing Date Expiration Date

0,,th
CAMA / ❑DREDGE & FILL jN�\\ �" No. 75907 Ag D
ENERAL PERMIT 1 ��\�\Previous permit#
ew ❑❑Complete Reissue ❑Partial Reissue /,� Date prev'ous permit issued
rued by the State of North Carolina, Department of Environmental Quality �('//� / / )
and the Coastal R rces ommission in a area of environmental concern pursuant to 1 SA NCAC l/
\ i 1� Jl F k- T Rules att ed.
I)l Applicant ame ' Project Location: County
Ci r i State—MZIP_-Ct I
Phone # -Mail
Authorized Agent �[T
Affected ElOE I1H Es ❑ P
TS
❑ A ❑ HHF d IH A El N/A
AEC(s):
❑ PWS:
ORW: yes 1CL PNA yes
Type of Project/ Activity
Pier (dock) length
i
Fixed Platform(s) -
Floating Platform(s)
Groin length --
.-�--
number
- -- -
Bulkhead/ Riprap length
1 _
avg distance offshore
max distance offshore
Basin, channel
= t
cubic yards
Boat ramp
Boathouse/ Boatlift -
-
Beach Bulldozing
ii/ 1111W.10
iIli
�I- tom.
f— ----I
Shoreline Length J
SAV: not sure yes
Moratorium: n/a yes n
Photos: yes
Waiver Attached: y�1 no --..-- ----'/-J)
A building permit maybe/required by: tn-F
( Note Local Planning Jurisdiction) n j f f / /
Agent or Applicant Printed Name
(Scale: — )
I
Signature . * ease read compliance statement on back of permit" Signatignat re
�) 1c�, IICIq�1q
implication Fee(s) Check# Issuing Date E

I hereby certify that I own property adjacent to // r5L�.-LZIM91 It's
amoe Property wner)
property located at 17 o I (�lu�T
on m�n� yJq� (Address, Lot, BIpI�}�jRgad, e )
cofi//"`) , in hFklfiltTi?, t71 --, N.C.
Waterbo y) (Cityrrown 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 in description below or attach a site drawing)
)
`:Ifs" r; - .✓' _
I;)Pv` iRlr1i�V; i!^l ",a 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.)
CC t./ I do wish to waive the 15'. setback requirement.
Date
I do not wish to waive the 15' setback requirement.
(Adjacent
Signature* l—,-�
Print or Typ
Mailing Address ^ C%US
City/statelzip
Telephone Number/email address
Date* z- z
(Revised Aug. 2014)
*Valid for one calendar year after signature*

I hereby certify that 1 own property adjacent to
property located at 9 17 old
I
on %% CDC 66 (Addres1s, Lot, BI A . ,g G , e ,ZZ7� N.C.
Waterbo y) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location/
L- 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)
f: J
-)A,v J JR14� It's- WAIVER SECTION Vim)RI understand that aier, dock, mooring pilings, boat ramp, breakwater, boathouse, lif( or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If you w' h to waive the setback, you must initial the appropriate blank below.)
Ado wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement,
(Property Owner Infornation) (Adjacent Property Owner Information)
Si nature*
D/ 07HY /"L 171� U)S
Print or Type Name
0%
-)DG4
� �?y 1
.3
Date
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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I hereby certify that I own property adjacent to JU11111Z ( 's
r' me o Property wner)
property located at g 1 % old ( USA
on,(rlcvly r" /'iP in /F�IHhTrI- _t`"C71 , N.C.
Waterbo y) (CltPf own and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatio
n.
VC 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)
Ok c
Y
�yr�41k/F7i, J.i.
j)V(5 Ip/j/hp C h�4jaWAIVER SECTION IO�lf4f� I understand that a ier, dock, mooring pilings, boat ramp, breakwater, boathouse, li or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If you w. h to waive the setback, you must initial the appropriate blank below.)
r// I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property, ,Owner Inforn)atlon) (Adjacent Property Owner information)
Signature*
012.0-7}iQ /"(. 17AV1S
Print or Type Nam
v -7 MoAlerVIT-u) 7)k-
Mailing Address
i'�li6V1t_Le AIC, ?SFTO/
City/state/Zlp
Bag-zxo-Ic(o`7
Telephone Number/email address
9,1,4 l.3. d-019
Date*
(Revised Aug. 2014)
"Valid for one calendar year after signature*

I hereby certify that 1 own property adjacent to dip )b
� s
t / e o Property wner)
property
y'l�ocated�jat� 1f7 0�� (FtG(SKrL+� '/ d �F
on lYt���`] "1� (Address, Lot, B QGIfR ..q d, f5 [ u , N.C.
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 in description below or attach a site drawing)
r l�vr
f
WAIVERSECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwate , 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.)
L� I do wish to waive the 15' setback requirement.
Date
I do not wish to waive the 15' setback requirement.
(Adjacent Fope ty Owner jnfo Ion
Signature*
Print or
Mailing Address
q/Fb!tc,N1 City/State/Zip
Telephone Number/email address
Date* 7�"T
(Revised Aug. 2014)
*Valid for one calendar year after signature*

I hereby certify that I own property adjacent to �/ /////// c// (��tY)� 's
/ ( dame o Property wner)
property located at g i g old (AUS� r
�q�� I (Address, Lot, BI�G� Rgad, e ) /�
on /rl Irl'"1 /.�oA in 111iHA712, a , N.C.
Waterbo y) r" (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I 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)
1J; (ffffh'lrl�t�,{
jjjj/
9 II11w V�' � C yr
00
Dami 1pllthp (.-0eJ'0-WAIVERSECTION I61)���
I understand that a Ijler, dock, mooing pilings, boat ramp, breakwater, boathouse, li or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If you w' h to waive the setback, you must Initial the appropriate blank below.)
r// I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Adjacent Property Owner information)
Signature*
aiot2o7Hy I't'j . 1`�!� UtS
Print or Type Name
6—'7 Ni0A/7v'IF-W Lk.
MaRing Address
N6vt«F, Nt: 28Fl6l
City/State/Zip
Sag -zso-lc&9
Telephone Number/email address
--ly /.3 . a i9
Date*
(Revised Aug. 2014)
'Valid for one calendar year after signature`

I hereby certify that I own property adjacent to
property located at �` i L/ o i"
I
on /rlCPJV' War % riN'" , in hHNHA"iiZ. f U7/ , N.C.
terbo y) . "(City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
f/ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must till in description below or attach a site drawing)
P i { aK
- -
�._r . f .
t. 'V' `"' I�L'il.!�i f WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwate , boathouse, IifC 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.)
t/ I do wish to waive the 15' setback requirement.
flafy
I do not wish to waive the 15' setback requirement.
(Adjacent
e
ature' I 'r '
ig Address A/ f � J ! V ` %
Telephone Number/email address
24-/y
Date* I
(Revised Aug. 2014)
*Valid for one calendar year after signature*