Loading...
HomeMy WebLinkAbout75429_Judith Edwards_20200218 ii- •XCAMA/ E DREDGE & FILL W5 1 qLo. No. 75429 A B', C D GENERAL PERMIT MKS Previous permit# n! IA ��- = New C Modification El Complete Reissue ❑Partial Reissue Date previous permit issued N '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 ) N • / I LI`-) . KI Rules attached. Applicant Name./.i o ,-r ,_4 -E p wA`x 05 Project Location: County Be a..1�o-rz--c F,} . Address i= D. 13 o x 2 Street Address/State Road/Lot#(s) City i3 A r-i-\ State nl G ZIP 2 'Roil •}-i q Ha a u 5 moo,ti, r- LA of E- Phone # (;{7,..)9 2 3-3 S J I E-Mail Subdivision j- A r!Qy s `ao 1 rJ T' Authorized Agent r- ' A - City . A-r-f-I ZIP 2-76' .6 Affected i:CW ❑EW APTA ❑ES PTS Phone# ( )-- _ _ River Basin PAMI..I -rl -2:OEA ❑HHF El IN ❑UBA CI N/A AEC(s): Adj.Wtr. Body BA--i-I Gam-E--1c� Chat man /unkn) = PWS: ORW: yes / no.% PNA yes) no f NJ L i fl Closest Maj.Wtr. Body PA All LA( cD " u 1 v E_ Type of Project/Activity - /3S o rP 42AP io L.,.A1 7(..�' or tw )S/o,- Fsl'P/1-it--/-'t- / .5-,D a x- 1/s(' RL-I� e . ::y o T ,P 41 P u P 7 v (Scale: ) : s- 3 ) Pier(dock)length f-f•4 Fw tC Y r k-'� • ! 1 44, ,+„T1.J C� ,R1'P R�' Ei11•siti ki Fixed Platform(s) i r3c` .t,pM m ` vi t --1) Floating Platform(s) ; hnt y�,4s,e4 Finger pier(s) I —.j o 1�J /7/I p16'p j 6., ea* t� Q Qom'_ Groin length I i +•�.� number i �� + . n - r a,, -'•±• / glt l•Srl+-1 4 ?,ca _ _-..._ 1 j tC_, ? L Bulkhea -Rips ngth 30pAA. " 1.1 — avg distance offshore /0• 5 q.., P°rt rvvi sr jit1 max distance offshore /0 ' 1... 12. j 1 4, Basin,channel RAIri W -S cubic yards I —. -, Boat ramp . ! CD t•v,set 1 S " • Prty, Boathouse/Boatlift i 1/ `1 t6 0'1 i i Beach Bulldozing I r r -. /_S fj f ;s r Q T...v, ; Other _-1t—+ b.�.-r fl 4.-�2 ._ D P.• i I ,C)r'- l E71 r5 5r b f•-' r�.SCAP" .�-�-r e 1.-r— • Shoreline Length ? 7— , 1 SAV: not sure yes no + — Moratorium: n/a yes ` 1 ' Photos: yes _ r' ✓ G7Co" o'.f/ I ' Waiver Attached: yes P/t. i oz I • A building permit may be required by:?„w,L/ D-f )j 4 c . N See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) Notes/Special Conditions c,-r /-; 1 - A4,-)7-.4-+ p-/t YJ :;A W r•-1 IA) ' -tom 5 • p.-) r-e-a-',,o -5 c.4J2--faF M e.A- 7- -7 /3€ ipri- / 1. i z. 17 L,v' -r7-1- ' P i2.4.)p. 'TPw A. 2,7 73177Y'1,- _ - /,r/6 (,,,.�, P' i.^ram ri f /'t A C.b+ t-0 • ✓ p /J c '` G )( J u of r l'! H H. 4-d Wa c. cJ L , J,,, ,,-,-,/ Agent or Applicant Printed Name Permit icer s Printed Name x ,� N• II ar i�(� Signs re **Please read compliance statement on back of permit** Signature•= o1c ��L O '&4O 1`i Fcal e,-hn 2u 2_il /"6-- .a ti 1-,Lc- 2 v 2.tl Application Fee(s) Check# Issuing Date Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian landowner(s). The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief,certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: Tar-Pamlico River Basin Buffer Rules I I Other: Neuse River Basin Buffer Rules If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-648 I) or the Wilmington Regional Office(910-796-72 15)for more information on how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ I-888-4RCOAST 252-946-6481 Fax: 252-247-3330 Fax: 252-948-0478 (Serves:Carteret,Craven, Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde, North of New River Inlet-and Pamlico Tyrrell and Washington Counties) Counties) Elizabeth City District Wilmington District 401 S. Griffin St. 127 Cardinal Drive Ext. Ste. 300 Wilmington, NC 28405-3845 Elizabeth City, NC 27909 910-796-7215 252-264-3901 Fax: 910-395-3964 Fax: 252-264-3723 (Serves: Brunswick, New Hanover, (Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet- Dare,Gates, Pasquotank and Perquimans and Pender Counties) Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 TOWN OF BATH copy BATH, NORTH CAROLINA DATE F4., 7 Z°Z v BOOK NO. PERMIT FEE Ss O `` PERMIT No. APPLICATION FOR: BUILDING PERMIT( ) ZONING COMPLIANCE CERTIFICATE ( fr-j' Name & License No. Address: Phone No.: OWNER t & ( L4) Cf Ei tiAtil) LI ICI Ha► s l'�-l� (IA) sZ -q ZJ 337/ CONTRACTOR - i cw. 6 o n .-t et DESIGNER (.✓ Js '4 nrtt� SURVEYOR / 0 !V E ELECTRICAL PLUMBING TYPE OF IMPROVEMENT 8�- 1 K ke«d NEW ( ) ADDITION ( ) ALTERATION: INSIDE ( ) REPAIR: INSIDE ( ) MOVE ( ) OUTSIDE(✓f OUTSIDE ( ) LOCATE ( ) Lot No. Block No. Building located at O ff t,d yi (ei4, &) C between and Streets. Building to be used as . Type Construction Number of off street parking spaces . Contains rooms and bath(s). Total square feet of building . Electric Service . Type of heat . No. of plumbing fixtures . Foundation block caps 4"( ) 8"( ). Corner bracing: Plywood ( ) other . Insulation: Floor Walls . , Ceiling . Windows: Storm ( )Thermal ( ). How many exterior doors. . Water Heater: Gas ( ) Electric( ) Other Roof Ventilation: Gable ( ) Eaves ( ) Louvers ( ) Other . Ventilation crawl space, number of feet apart . Height of crawlspace under house: 18"( ) 24"( ) Other . Zone . Water and Sewer Tap: Paid ( ) N/A ( ) Size water tap Size sewer tap: . Total Estimated Cost Flood elevation BUILDING INSPEL I ION DEPARTMENT COMMENTS: --P,P � tv("Lk, A 77 t-C.,{64 - PL4 is oR 7 ems& R P4 it_IZE,oc. 4 ._ o f L X/177u6 31144 ao A VAga6/ mF A-647 (-IAL5 Gv rL u 564o 7z, 47ct$vita. cv,,,6 Ta_jU7604 — lv660, co",C Ef� fz//' .zAP Ei AQS60 CO0v5 77Lcuxr4A/ (a) 6Doi-CeC./.4-AuC E Gv (T D 4) OF Lj47�F• ,ni Ca A)$rncc C-77 s.J ! )(L t— I ,4 .i 6,c.E4o $/ G/ A4 A /2€1° GENERAL COMMENTS: },-C c\c ap(J O CL --D (A er\ ,o1l,kke4aJr CITY LICENSE NUMBER: Contractor/ _) Electrician Plumber/Heating Application approved by: The owner of this building and the undersigned agree to conform to all applicable laws of the Town of Bath, North Carolina. rl Signature of Applicant 'Effective 8/10/04, there is a $50.00 filing fee for all permits, including zoning compliance application. Any construction that requires installation of water or wastewater services may: A) Be installed by owners, contactors or B) Be installed by Town of Bath Utilities Department All components must be compatible with existing water/wastewater materials, including Myers pumps. Bath Utilities Department must inspect all construction prior to services becoming operational. Inspection fee is $100.00. • ' •-"" • • .., . ;A7-, - - ' '• A < ri; i( DVICL.qi9 '"••• .•• - _ , . . _ . • .; ';‘• , .7} . \ • "tx - • - • , • •I' ''irArt•-% r,:;"11/19": • 4 .• •\ 2 ;'- _- _ ;Tr.D '• 1„: , • '4" • ‘:3/4 - - - ` ts; A • • ,•A• :.j,• 01"; . ' I *. ) ("0 ..17; ; 191jr;. 1".0fi 't;) ;:," .., ;24,•'. ;L'tt. 1 • r r•-•, `.;-; • 40;11 2,.q.1\12:1\17' •.. • . T . ".•"*.t.)!.3- ,.);) 0,1 ; I • •• .,-rt 1.3), 1)11(.`, j y.:;CiPr cO ; . _ . „ _, LK HE-611 AP(' L r cA op/ j i (3L / ) N< E-o IAJAA Os ct 919 ,m301/ s /'0irtir LP\ NC, NL le.°g V 5-7 ` q23- 3371 +v ” � d3 Q u \ANC iS poi N7 i- � N ��• , , - , + y _ v LS _ _ N � R c � �5 �.\ m— (1)C ) & VA 1Z N G& c 6. c M 0 6 �� %, poodEN /joLCK HcAII \ 4wG1`Og 0 PiE-it To i N71-y ow'4E4 6 iNT?-t- c veif k- ..,,c v , L,AL i) tid tu 0 0 A A-w/i) )3/ --3 gi%/6r-g--ts 2v7O \ 0 l STATISM/It / t hereby sty that I own property to�wd'_ Ed ww r15 C-iwol a property located et Lf V 9 fi f lei'r+ La n c "e of PrO joLwnKl 1 i bo�aL' r{t. f-I. / 8ecsw-�o�t Cou,, ,N.C. on (wsgsrttoth►1 tCItylTown andror Counter) "..._ The applicant has described to me, as shown below, the development proposed at the above I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing devetppment must*6 Osigeninfon below or attach a sib drawing) it is my plan to have a rip-rap bulkhead built on the east/Back creek side of my property.The bulkhead will be adjoining the Peele/Crofton property line and bulkhead.It will be constructed of broken concrete slabs as a foundation with rocks on top of the concrete.This portion of the project will be approximately 165 feet long and willrequire at the removal o the of several trees.The tree roots will not be removed as they will be required to continue The wooden bulkhead at the point will need minor repairs,but the structure will remain as is to allow for a'nursey area'for sea life,birds, etc. The existing rock rip-rap bulkhead on Bath Creek will be extended to the pier which is jointly owned by Roberts and Edwards. Some additional rocks will be placed on the older section of the bulkhead because has some rocks have sunk in the mud or fallen area will t of place.Over the years,much beexcavated so that new filter cloth can be puU^rP��^d the land side of the bulkhead.That fill dirt and sod grass will be installed. maiiims 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 riparianaccess uneicw.less waived by me. (If you •sh to waive the setback, you must Initial the appropriate blank I do wish to waive the 15' setback requirement. miummiimmir I do not wish to waive the 15' setback requirement. Ainimiliummim (Property Owner Information) (Adjacent Property Owner Information) v aL)Ili -FL [ t' 0."`,,kk_ i rul urc' y 5 V S fir\ ` ...RA-d;��, H. rr� t✓Gg ,-d or Type Name, S fi Print Print or Type Name 1 (.J ; S O ►�t • l-1 y a c Ma li Addre cD MailingAddress !Z t d ,� c t C1\ ��i�. �_-~ L City at .p City/State/Zip - l Co l�' c' ;� Z S 2 - g x -33 71 Telephone Number/email address Telephone Number/email address 1<q r.w.w a -1-t - 2-L" • hale* Date 2014) (Revised Aug. "Valid for one calendar year after signature* ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Tw0(1 f'4 it t7,1,,,),,,15 C���dr� I s property located at 4/ ci (46^''vdl y S /�U//, f- (Name of Property Owner) (Address, Lot, Block, Road, etc. on li C✓ e e(L , in I ,,.-'� / fa t u. cam,,f Cu (Waterbody) 7 , •N.C. (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. 17 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) It is my plan to have a rip-rap bulkhead built on the east/Back Creek side of my property. The bulkhead will be adjoining the Peele/Crofton property line and bulkhead. It will be constructed of broken concrete slabs as a foundation with rocks on top of the concrete. This portion of the project will be approximately 165 feet long and will require the removal of several trees. The tree roots will not be removed as they will be required to continue to stabilize the bank. The wooden bulkhead at the point will need minor repairs, but the structure will remain as is to allow for a 'nursey area'for sea life, birds, etc. The existing rock rip-rap bulkhead on Bath Creek will be extended to the pier which is jointly owned by Roberts and Edwards. Some additional rocks will be placed on the older section of the bulkhead because some rocks have sunk in the mud or fallen out of place. Over the years, much erosion has occurred on the land side of the bulkhead. That area will be excavated so that new filter cloth can be put in place and fill dirt and sod grass will be installed. I understand that a pier, dock, mooringIION 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 w x. do wish to waive the 15' setback requirement. Xl T I do not wish to waive the 15' setback requirement. NIIINIONINkfirAPPtteilkTtD (Property Owner Information) (Adjacent Property Owner Informs 'on) 1-1 5»cNureSignature* u..af, � ti L d("tiov 5 66GE./6- L, Teo Print or Tye Name 6-/z -r -j-R /1 .O Z Print or Type Name Mailing ailin M�ru°>'� / Ct4l? L � Mailing Address City/Stat-, yt LZ. 7 3�r# A)c Z.7 Fo Z 5-2- - � Z 3 - 3 3 �/ City/State/Zip Telephone Number/email address SZ Y23 6ac 9e rb.gryy®s„��i,�� Telephone Numbeer/email address Date Fc 6 rua 7 _it .2 LZU — A.c>'K I 2, e 7 Date* *Valid for one calendar year after signature* (Revised Aug. 2014) . . 1 • V)7ri!"Lr AI '.?. fi:3 V.P0 li 1.1•3-:-•,(-)fic-; 11.e. slAri!:7, I;'-':.5:I,-1,0 A ' • . .....,. __ _2::_,.., ... ......:, _ ,--,:. ' ''" -: 1 • i ---, t•./.11 ';',.;...!C•1 V.P:.;.1(r)1(14 ' .4..-r. ..s,..t ,e...7,•:-.1--„0,"). ... . ( \ . ..) t4 -- i , - ; :, . .: ''. ,,.• e., , . ' -1 . ',• • ;0 i'... '‘).Y....t..'11fi 1'0'0 i .-,...i.::):: 1-10r/6 li*frfill4) . .! ip i'..e,i •:).:. L..:;?(,,cioi 1•0;fjc!,(4,_21 ivr,-0-2, wo, -.A lie 1 rAnrie. i,=. , ,. -,i- i:. 13-...:` •Z'qh i't ;-,..,.(.;,ik .'..i ,-;;-;-:..,:. ,--(..;- . it' , --.."" , :. , r — -- F.: 1.-, ::),4 e-;ft' I `.r.); ... '1,:le . . kqr•'\r5:.11,1 to c 0.....tivs'A! Wk-it''...% :Ati.1-1...c.:.4,c,, t:t ',V.i- le,f_votAt3/46. ..-;r4t) 1;;...-at'...-.10/, '. .. ,,•-• :, ,-,,, 21.,..!. :( , ,1-1 r.) ..1-1,-.kel ' A •&in‘,:re.: •) *LP; .)•••.)(Uit.l'i,_,-. 14411 ii Icgri(.4 ,'XIO, VM 11 . .1*-. 2 . ..) .7 ;: 0• i , i.,' IJU'itPI•C.) ..21!..,.: i -if .9,:41,0-; ...“-a; -.:-1 ..r.`--f,...,-i-hi f.t-lio-;v3 ,.., ,..1.1.; 4ninic,ihs.Er *P-,iisrl'Ir ,crzir-.. E'-'21 111%4 4.1')I0-.1 cc r-, 1{.. -1.74, *...irt ,•,-; .I-c.,."., 'P'%11 '' -i•:'1 i r,.;.);c, ilivi istt i.tIshrlt!ol -F, :..)V.,;11`•-• ‘ i!ICii:lilt!1:114,. •"..; I .r.f : :AI. ir.7;v=!.,.. .,-) !-.-,...r-r it_si i ,.,t.,),u.,., , ii,•V Ilf.il,pf,r,1 t i r:9-0,..sy" 4-01..q., ; .:: 7 li;,1 .;.:!i,,q,- ,..),': f- c-: i I. '. 'J IniU'D ,2f,, if, .)(,,,,;:,, ir. ri.:)tx-vv.-Fry; - - 7 tq :i1.1:i '-* ''..- , )1'7*`.411,‘!9;!.1:l' ' 6 led bc,i 1.o,,..1. t',' .', ;11. 'Ai leit: 4(11 01 1.)3,41‘.!,i-,)(3 0 !! ': :4'9.. (. ,.. ';(....‘ t...:1 P i...... .. "..-..•,li: '4)0 i !Wit-.!.Y4r...' f.'", i' - .. . 1".ii ii -'''i/, if.: -.3•,L it, ri(30..,:7- : •,a ,iil fl 1 •)-i::r1 ; ' - !II,' - 1...,;''.. !,:n' :. • , '*, Z*.i'V...' ,! u ;1,-0-. ..)-- - • on .!..,,...-, _itTi t.)f!•5, ...,f,i •1..-• • t3 FrI •'.; - . r lilt .(% , t : 4 t ,'r-sty,:•',f_,L i'. -• ftertoit -.)( ,i ‘13,•;' :+; ' 3 I fl.", '/ .)•1_;•tii ,••••311 : •-•f 'fl:.• 10:•+---:VF •-• ' 1;:‘.• 1.4tr. lg.',i : -•c:cH!, . f-,tr ?r•....).-1,; .0,- ,...,-; . •sit::.,.:--„ -- -; ‘. 1-,,, ._•.t-,'14 .r,.S_' • 4.4...4 1:*41 i.''i.51-.=I-i-!:i 4.:.% I- i.c •.rd 1 ; .l...r: '•;_•:.Irr•.:‘ii-1(...., flatt."-s!'!•..:-.• ;.i il tr, ,,. •:•,‘! • 4 . '....:.!!•• .. '.. 1"..1 ;:e.' i ' ii-7 .:1 bO'S.?/f .--i-t VC? q:i\inh!.,.`• .af. .'IJ.; i.42.- r. . 1. .' '';::::1' ''''(.' ...I'..... .. - .--'...'t;G.'. '...1,• r,IL. ' ,,ttirn fI t:.A,.., ',. .. ic:1 : -:•-• '“,'1 2.-Vlit"' '('`..1 'el- -s:''i. t,.i ! is. i!.11 i ..0.' ir3y. ::i• fl",-;iii, 1..,.. 1 1--,.1:'• - t-...,,, : ; , . .,; .,' .'.:-. ..P t,r, '`' ts:v:i .'...1E 'c. ..3/.;•:-...;)..f.ci,7 .- ,. , .. _ ... r .., - J... . •:', A.,5rneItt 3t .:4..t.: ., . .- s 'A -.•.' .' ,. .. liCli410,VaN`J;:f"lc,440.t.44.44 -i.:-* !:- 11 '-oar:L6.- 1 l.: .qc '!...•4 -•,c3:- -1:10:11: iflo. cr,---1-1', -4,, - v/C. .., - i •:,.., ,, 7't Isi. * ' !. ..,-; 4....'-'6.1-", *7''' lit.7*.... .. -------------1 .: ,...**r 7.1-• '3\ !'l .'',C' A A '''s.,,,..'7,.;„-v;:". : 1 • -:' - , ) •\ '1-\ %,'V 0,4...4 '`u N — • - -----•-•,----- - •••••-' E. ',.. 0. .1"31 '4, !cl+ :, T'''' V'S; ' t N '.-'t S.- ..-.1-:r'..A -A:.t ..•.:-';:Z.:..LCI- C..,.T#.!r'...':.. -..-.5e. . '.., :. .:b.:Is ...A)A tr....g *,.,.. '.-7'i,".* a.:1'• :. ... ,.... . ,....j::\ ',f. `,••• 1,..., `:;.: t•1T ..-• '' -I. (,....... _ •i ,., ')1Cfk..•''''i..0./ .-it..'. - ..,•;:.•1- '''.... " .i.5'.1 17-....:?•-__.-- . -- --- _.. - __ . . .. ".i'• '', •,-4:i'.11 11 ". t...A. 5•.. :2.0,1,,1.,..i... ttEr(•,-.1" ..,..1•:,• ,,,....1,.; , . • ,r ..••••V: e '5' ---A • •,•• , - •-. • .,,,,,t...,,,, ':,,::!,.• ,.- ,....t., -E.:. -1 - i , , • ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to J 4 L fr} r Lc�c✓p.; cn ,s llJJ , pd�`� (Name of PropertyOwner) property located at `1 I c( L&VC �/ 5 4,& f / kl L Z 7 S, ,4 1 (Address, Lot, Block, Rod, etc. on CA-L- ( C K e (L , in /3(•,,t G, / 6e,1,,, ca:l` CO(,K f- , N.C. (Waterbody) (City/Town and/or Count 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 ro p posing development must fill in descrip tion below or attach a site drawing) It is my plan to have a rip-rap bulkhead built on the east/Back Creek side of my property.The bulkhead will be adjoining the Peele/Crofton property line and bulkhead. It will be constructed of broken concrete slabs as a foundation with rocks on top of the concrete. This portion of the project will be approximately 165 feet long and will require the removal of several trees.The tree roots will not be removed as they will be required to continue to stabilize the bank. The wooden bulkhead at the point will need minor repairs, but the structure will remain as is to allow for a 'nursey area'for sea life, birds, etc. The existing rock rip-rap bulkhead on Bath Creek will be extended to the pier which is jointly owned by Roberts and Edwards, Some additional rocks will be placed on the older section of the bulkhead because some rocks have sunk in the mud or fallen out of place. Over the years, much erosion has occurred on the land side of the bulkhead.That area will be excavated so that new filter cloth can be put in place and fill dirt and sod grass will be installed. NEVERIMON 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 beiQw.) TIONIFOIMUMNISININON- I do wish to waive the 15' setback requirement. SintatOingilliNfit I do not wish to waive the 15' setback requirement. N (Property Owner Information) (Adjace perty n r I mation) )C-c .1-tZ eq• ( C LLC4L - tcrl trt e ,S ignul t rep` 11 1.-- -,,A1 cti rc�� �arfrll1/11: �r-- Print or Type Name Print or Type pame ,� / /k d 1� rYjc Z �f Z / /•t9-K1 P 411�- f iV Gam_ Mailing Address Ma AdJr s .3c,(-41^� t'c 27KL / /X C z78.513 City/State/Zip ZY City/St.t- ip Telephone Number/email address Telephone N e mail address F� � rutc� y � i�L(1 Dale / — --- I)ate" (Revised Aug. 2014) *Valid for one calendar year after signature* • . . , . .. ' • 134::ilf‘47-,CAT •.1.2:)/1 (.it, • ' -.. •3 i.., ' .. .1 k ' , t r'r: r,*,,i.- ' irlii 1;,--'n ',it:.-iir. i l .......... • - , ••••: N.,••,..fl...$)., : •••••••-•Pl! •.,E.,P•rr:'3%,.. pt• :',„t. • ' - • ....• ..#4 . A•• • ..I , .. . 1 .‘ I . ' _il•ii, '.- .25,. 7-3 ; r'itEnz.•1 vP . c.,'.?-_-1 ...... ..._______ . .. _ . .... . _ _ . __.. ..... _.. f_ ;r• . . •tt .P.: ,-.-pt4J . 2,' i ,?, : .“-...,..ti, ' ... ),i --'• `:'' •ir • .. '.•5 - — . . ;'1,,-,•c -=':i ,.- ',-,i ; , •• , ;,-„;. :•/.4 ,-•••‘.1.':;•:01",/,' '..: ; ,. -•'; ,-,.! :,14r,'A ,--.. •1 .; ,itri -..,,.-•. .F.:I r1Clitt.- 'i r;-... • ''.i ::,, fic :•.•'*;'v •:' 1 9‘.1- i 1 . , !• -.,;:tc.• .1 •,-- , •:1 g.r.r..l'izte,l'J''.' f.e./Fri a --- ----- ' - 1-,- 1',IrtC.„-,:.,"-',Vrnr.:1. ij :;,.-.Y iCir-.,:‘"1 :1,. ; i.)`;','":''.f....:'..-.' : ,0.(iii 0 i#(...,'•f 1:-.. :;:,;"....7.,Alt ,1•.-. !, ;r4, 1,7, ....i..rts": 4,t • .-.. ..r.-..,,,:,.,,, -•,... ' ,, -,,,,,.ftil ,r,totilrii,:%•,•: t1 .1. r.:::14......'.!•:''.',A,..1 Ii.y.:Vic,i.:*stIV`; . 4,-;':1 ...,- - - 1._ '.'• . '... kIli."v?.',',,, af. •0 j.1711.! tp e"!i-l.H(..; .;1 Ili i i. 11,S..... 0)CW-ic, I , 1,. , , ',^6:-.•.(.0,11t.,,:: ,id 'i .• , 5---•; -! pci i .,.• ' ; ' -7,..v:eR.i .. -•!i,:i..)k.I',?-e-)ri• ,.:',/qf ;.'it-,';h6',id Iiilk; -/ ''. ':-1.317 -•,,' (;i- ;f7q .-;. ";•1, •.. , - :-.•: ,.) ,-,i,..14 fl•• ;.,4-Wi,'•••.• i,,:•,i, b•a•li 6ire:O.' •:',;',.• -1; .•'.",i •• - -,ci?(•.•I I -si... •••.'..,...-• -/1 t: 4' .<,•.-rwi :;::‘''.. : '-'• ' V:?-21r1.1 f.,,:II -,6-1 !I •14,t-,:ii: g,•1,1i 5-!I iilif .. .. . ' ,t-• . ,,,,i+.15 :'-',.,.'•,',.. •;,. :-..nr.,..,..)1 ),-. ,.;,-,-,.. . ,.i Ply:, . .. ... ,44ii5•',..; ;': •,, 11 t,t1 4 .1;•.1P-;1.t•:, 9f4!-. .•',••I i,',,: li,,1 ,0‘.,11,i ,. .s •••. 1,,•;k• ,.-f-,.-- i}.. .r4f!,.!1, ' . ,t7,0,,4, .,.,i: ' . .ci ,,,l( v?,; jr)i; . i;).1. V 1^.., •"., if 6.1 1: ' 4.'!-(''),-;U'l '''... -. . '' i.4.- !,')':7, . ttl:j '1,' C:1 .'0'8, .ies''', - ...i. , :i .;•-...., ..;,,,,, , :, tr .., t- ..,—..•••te. •Iij :I '•—. 1..! '.• 1,...' .. if ", 0 . !:...)`; 7. ,-2 .?^,',.:.,..i1.3 1.,E-,,--,-• • - .,-.. "- -.. .•- ' . : ! ,•:- ..... ---..,., . 1 ^R., i •-,- • •!; ..• .. • , •-,t ..}, Arl; '..• : -• .; ,. • .•••• .1 ,- '44.:•• •• :. V. 1N'; ( •;i. ,'•• 1.,,Ii '.."")1(‘= -!-.• ' V •• •:, ..,• l'''. • 4 ;.. .i• -.).4.-iri :,,,v l'.'..','•.:-Av- lib I •. . r‘.,),,p • , ;>l'i J. . ut- ,-:-.,,y- ,4-)1,.,..; .Li. 4; r-. -,, 1 -T:-%1 •': :-.. . n: ".:.f", ,, , '.) .i ;..'.f 1 t;---3'.'..! -). ..,• :!9,,,:f.,,,, ....,:,-- : .:, ' ,. ,-- ..:.-..i , '. .: .,:..;.„ -i ,,!.-, -Ay, ,' , ' ' •-; ,,f-,, :Ii-.. In; :: ',P.1p,i ; ''',_1 11.1 , .1d gr'' t'll.:',.': 1 •I i ,',,, •. •.-..: . .,!', 4.,,-,:, t:,...): ', • ••s.v, .,::);:,,,;t•,7' ,,, "y"ii .iidif.1%., .: ...'1!",!,' ;!(...:\••• 'Y .', .;''',.:-' 4' •••.--'kkz.' 'if!I; , ... -.„- •,,•• ;!. ,•. * .,...4.-: -_,•,- r , i, - •, .r„•:•,;•... ,„..: .p,,Jv e,) ' ..--.. "'Ik' ''''':'•' :":. it.11, y ‘r' t...: -:,.. .. . . ,• !-•.1,:-'14-!•,'/..:;.". 'i.r:,__d. -,': Is . " ; •••... ., ,-,1 -4 ,v t:', • ; --; ; * .. -',..0447 .r7(.•iigfrl•ilf.• •••••••• -i„,, ,v-v. ..i.;-, ---1.: -:,•."Z.-:?=•.: ...!.-,,t, ,...T.-4-'71--..r.,,,, i..-. ',tiff), '-.?•-:!": - 1 ; ,- !-- 1 • ' ''''.' . '. i.' - - \.‘ : - • .'., '4.\ , ..!,.k11, 'Xi' .%',••; in. •,... • N . .. ....b. •.".'•:•1 n::f,..... 'sr, - .4...‘.-.,„ 4.i..44.,,,NS.,...S...- S'ilt•SIA,,A1.1;•-.r.•,it.:5,,I.: • N r . `... ,i'..%,-. .-....4 . C......s ...Y . r,,,, ; .:it,•• .;.,,t,...*•,,-,n‘r......,,, ..NA. ci? ft.•Z ,:.. _,- ,• i\ —1, -.---....---, .. ,, - ...;:. ...... _,..\., .., :--, .,. . ... . -.s. _ ...-• ,.. : --. . . -,-, - ,. , ... ..•;. „.,T-._.,..,..-NN,..,..^,.,......_ ..., Nti.,•,, ..,-;\ . .) , .. - ,.. - ..„,.. -ft-.14-r-• -.w.,,,k--%,...- ,..-y.-.4..„......__ . . , -- . - - --- •. -- --- - i'7:-. )')i.. •• z l'.."= `-'1 .11:%`.... e-,f,;',', .•- , 11,3't•"s•* ', , _ —" . . ' •••J ft. . !,:.• • . . i-t,,.,,i i. ,:•-•,... ,, . ,,.....•• .. 1,.4, ,* , K:. , •-• - • ..' . .. ., • .., . . . . . Judith H. Edwards 66-71 419 Handy's Point Lane 8660 P.O. Box 2 5 NC 27808 Date s / 2O� 2 52-2-923-3371 Pay to the Order of oZf1YL `` 1410 $ D. OP Sabena* STATE EMPLOYEES' CREDIT UNION Doflaa NORTH CAROLINA (888)732.8562 OR(919)857-2150 WWW.NCSE U.O G For Li __—___- : 25307049i: 86060L68390 8660 NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant Sit °v Date: 1 43 rc'-57,J-c A y Z o Zv 1 General Permit#: -7 S a ' 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. (Anticipated Final (Applied for. (Anticipated final DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. Habitat Name Choose One includes any Excludes any total includes Excludes any • anticipated restoration any anticipated restoration and/or restoration or and/or letup restoration or temp impact temp impacts) impact ameuntL temp impacts) amount) .3 o 1y-04,‘ Dredge❑ Fill Both ❑ Other ❑ 3,voa F} 3,coo"F-t- - Dredge El Fill❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ • Dredge❑ Fill❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ Dredge 0 Fill❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both 0 Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ • Dredge❑ Fill❑ Both ❑ Other ❑ 1