74605D - Battle

CAMA / ❑ DREDGE & I FIL NO. 74605 A B C ej
EliGENERAL PERK41T Previous permit #
New Modification El Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality /�J j
and the Coastal Resources Commission in an area of environmental concern pursuant to 1 SA NCAC o
❑'-Rules attached.
Applicant Name � I y Project Location: County l� 94—
Address ¢>rJ r° Lb Street Address/ State oad/ Lot #(s)
City �r i' State rJ(.iZIP ��� O 2 OGA-N/` /%VC .
Phone # ( 0 1 '" 9S 'E-Mail �/k' ! (, :r;. Subdivision
Authorized Agent C,-F...' -0 (r I "S -("at a'q'City v / ZIP
ElCw EW XPTA ❑ ES ❑ PTS Phone # ( River Basin
Affected
❑ OEA fHHF ❑1JH ❑ USA ❑ N/A
AEC(s): El PWS: Adj. Wtr. Body hiy/ w nat an /unkn)
ORW: yes /t�7o PNA no Closest Maj. Wtr. Body r✓ ✓� %� OV /✓
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Agent or Appli t Pr' t d Name
Signatu Please r d compliance statement on back of permit"
Application Fee(s) Check #
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Per i er's Printed Name
Signat /e
//' 20
Issuing Date Expiration Date

Thomas Tackle & Seafood Shop
14210 Hwy 50 • Surf City, NC 28445
[phone]
Ship To: Date
Address
Town
Salesman Delivery Date
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Thank you for your business!

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �-r i1 �,'� s
(Name of Property Owner)
property located at gG 3 �- o •1.. ,,ter (��¢
(Address, Lot, BI ck, ad, etc.)
on aL W , in , N.C.
(Waterbody) (City/Town arid/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
y I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
Si tune !
Print or Type Nam
►l' Ad Tess ,
City/State2ip
AJC- -2 Fyn/1—
Telephone Number
qm 3 Yq' � y
fv L.
Maili g Addr s
City tate/Z 1 L)
. � 7
Telephone Alymber, _
Date -�� f/ � Date
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to s
(Name of Property Owner)
property located at 903
(Address, Lot, Block , oaq, tc.)
on C- , in /- C_ , N.C.
(Waterbody) (City/Town d/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
7 1 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)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.)
y// I do wish to waive the 16' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Ovynpr Information)
Slgila Y%M,t '�o f)A )
Print or Tye Name
(f
1 illi,, .7��,5 �o��p dPd
Mailing A�%
City/State/dip
n1. ( -
Telephorie Number
Date
(Adjac t Property O ner Information)
C�
Signature
�-a r a
Print or Typ VNarne
7y' /a d / 1/
Mailing Addre s / ` /
City/st te/Zip
Ia o23a -
Telephone Number
Date
(Revised 611812012)

Relief Request Questions
Project Name:
Date: 513 i I I I r
Name of dredging company: TO p 5- '�
Provide an address/Lat.Lon. with an aerial image
L ,-4 3 y I 31sg , i��-7-7.55d `14,
Describe the project:
o Footprint area (estimated ft�
o Dredge Volume (estimated yards
o Current Depth at �4
o Proposed final depth after dredging (NLW)
Has Work started already?
o When did the work start?
o Cause of delay?
How long is needed to complete the work?
'�- w Z-t V- S
What is the method of dredging?
'�)Uc.Ve� �-O
What is the sediment type?
5C�-"\A
Any history of dredge relief on this or former permits?
-- A-) \ ue of
Can a turbidity curtain be used in the area?
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***All moratoria relief requests are a one-time occurrence, and each project will
individually

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Shoal To Be Removed - 30 Feet Inside of
Orange Bouy. Shoal Present Along Length of
-Channel - Approx 60 Feet. Channel is 40 Feet
Wide.

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: _J QaM Q s Ba--+ri
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
D L C�c-5 Lu
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cc
es. nCL
CIn MGrY iS
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at ,
County.
I furthermore certify that 1 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
Print or Type Name
Title
9 /
Date
This certification is valid through I l

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