74226D - Cotton

—� CAMA / ❑ DREDGE & FILL NO. 74226 A B C
GENERAL PERMIT Previous permit#
XNew' ❑Modification []Complete Reissue ❑Partial Reissue Date previous permit issued
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 21112
j
❑Rules attached
Applicant Name r����r�i✓ �U7/�P�/
Address / a 7 /
City Su Cqq. 17 ii State N c zip 2 7YY5
Phone # E-Mail
Authorized Agent 1P 2 t .,
❑ CW
J""'
XPTA ❑ ES ❑ PTS
Affected
AEC(s):
❑ OEA
❑ HHF
❑ IH ❑ USA ❑ N/A
❑ PWS:
ORW:
yes /(�o J
PNA
�J/ no
Project Location: County iCND C /?
Street Address/ State Road/ Lot #(s),3O � OG%=
L
Subdivision C"Ue Oi -
city�fiahol ��� zip 7 yy�
Phone # ( ) River Basin Lt 4, -le ah't
/J
Adj. Wtr. Body C/1 erg t man /unkn)
Closest Maj. Wtr. Body 4,�/ G✓A/ -
� � r
pier
�in length
number
head/ Riprap length
avg distance offshore
max distance offshore
in, channel
Bulldozingr
.-
reline Length
not sure yes
.... ..
I -
0
NEESE
ENE
MEN
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P
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A
Agent or Applicar
Sign ure �` ,Pease read compliance statement on back of permit
7t,,�Q K `' *i-/JZ
Application Fee(s) Check #
Pj2 'o- G✓, L.,s er
PermitOfficer's Printed Name
nQ
ignature
a i � 12Z is
Issuing Date Expi tion Date

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORMA
Date #--9-19
Name of Property Owner Applying for Permit:
Mailing Address:
'- 0 9 e yam, -�
I certify that I have authorized (agent) E;7 ne4 ,Y1 .0, -a-, to act on my
behaK for the purpose of applying for and obtaining all CAMA Permits necessary to
install or cronstreet (activity) _ I-L,. c Ham? L d oc!L
at (my property located at) .'-� p q 01 d e F ®i' 14
t+cu,nP 5 f"010, C, 1 7-
This certification is valid thre (date) _ f �� 2 C i 9
9. /
Property Owner Signature
Date

ADJACEPNT ' RIPAR AN PRONE RTY O-W N WER S TI ATSWUNT
(FORA. P -Iz�GO�'C-FfC IBC}74 -Y 3O A HC US—)
I hereby cerfit- that I own property adjacent to A f la n 's
i t� T- V� is� i�Q�E• L�r V Y?�5��
�u y-3,5=�if�:,?
pYlocated ai t
(La , Blood Road;
on {V Kpn Cr3 i, lLi-�(_' S c:c- CP"c'�' l: ).C.
(WeZer body Tc m and/or Comntj)
PplicanLss phone ff. 91 s I 'a - 7 '-f 17 lE���g � d���: '� t� � `1 : J"t' S �,
t; L. fv�r--
He has described to me, as shov.m below, the d. velopmem. he is proposing at that location, md, f
have no objections to his proposal. I underst-and t� E a pi&mooring pilings 1 boafl-Ift I boatihouse
must be set back a minimum distance of amen feet (i S} my area of sp an ancess tniess
warred by me. (-Tr you r ish to h 8'-e the setbeck, you m ink tile app --o p iate b;
below.) d
I do not wsh to wai e
f"""I dg wish towaivre sae setback recluireement.
INDJOR DRA 7WP G OF PROPOSED DEVEL€3PMEE—NT.
(To be filled ire by hndividval proposing development)
=� ov Sv
Jj
j � a
1
{
(Iniormatiou for Proper—E, Owner er Appib'ing
for Permit)
-211`S
Mailing Address
-.'v-I clC ZS y
GIlt/Isiah%lip
i elephone - j�
s� Date
(Riparian Property Owner Tr, {! Zion)
signature
Pr.-m-t or Type Ntame
I I a J, / `l fP ->--,
Telephone 'Number
2- ram- a,fll�
J�LL

ADJACENT RTPARI NL PROPERTY OWNER STATEMENT
(FOR A PIER/1VI00RUVGPLU7VGS1B0A7LJFl/B0A7H0USZ)
I hereby certify that I own property adjacent to AJ CC-jkn 's
Lot 'F3 5ed on.1L ffame of Property Owner)
property located at 324 Ott too- )4- Loo
(Lot, BIock, l
etc.)
on N i y rn Cf't,e in HAM 12 5 VMd R, tcl.w' Co) N.C.
(R'aterbody) 1 (Town and/or County)
Applicant's phone #: 919- $i 8 7 f 7 Mailing Address: 7087 7 M 5( -
6U;7( `�, JV C_ Z &'for
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatliit / boathouse
must be set back a minimum distance of fifteen feet (15) from my area of riparian access unless
waived by n1e. (If you Nvish to waive the setback, you must initial the appropriate blank
below.) 9V
I do not wish to waive
I do wish to waive that setback requirement.
DESCR=ON AND/OR DRAWING OF PROPOSED DEVELOPAMN'T:
(To be filled in by individual proposing development)
(Ir_formation for Property
for Permit)
q0$-7 74-h S-�,
Mailing Address City/State/Zip
gilt=9141-7
Tel one Number
Signature Date
(Riparian Pro me formation)
Signature
etc C, 0
Print or Type Name
Telephone Number
!2 120 �?
Date

Dan Received
Dare De sired
Check From Nam)
Nam) of P—H Nolder
Vendor
Check Number
amounCI»clt
t
Pe —It NumbenV—~ts
Receipt or ReiurxWea located
Columnl
Ceiumn3
Ceiumn3
CalumrN
CokmnS
Cohen"
Column?
ColumM
C01~9
4123/2019
AN, Cott,
t

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CC