74251D - Hudson

4 X,CAMA / �:] DREDGE & FILL No. 74251 A B C 0
GENERAL PERMIT Previous permit #
)((I,ew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
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 I SA NCAC 07H, j 2 <Dy
❑ Rules attached.
Applicant Name M I Y-ey 1AL'V50y
Address 3& D 3 Gt-jm-ro w IZD
City EAR i T F V I LL F State A/C ZIP Z'9 3 I Z
Phone # ( 110 ) 30%- 77 7'9 E-Mail imq huJ-son 4 ntSM.eom
Authorized Agent jiL !Z.
Affected ❑ CW 'KEW KPTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes / no
Project Location: County 9 Izu.'Jf w I c K
Street Address/ State Road/ Lot #(s)
1
5caTi.AAJ D JTFtC ET
Subdivision UJ A
City-Ocf=_AN =sLIE- BEAcM ZIP 48409
Phone# (91o)443-48112 River Basin LurAgerc
Adj. Wtr. Body C AWA L. (nat maon /unkn)
Closest Maj. Wtr. Body A I W W
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AgentorA
Oicant Printed Name
TJ
Signature' "Please read compliance statement on back of permit"
Application Fee(s)
Check #
T/LER M GwizF
Permit Office%r's P 'nted Name
/
�/ / t c
Signature
5�8 /Zo 1q 9b 2 Dig
Issuing Date E iration Date

N FOR CAMIA PERMIT AP
Name of Property Owner Requesting Permit:
Mailing Address: G `?
_ L��, I%eX' 3 i Z
Phone Number: e) l G r 3w y-? 7 7 :7
Email Address: 97G1 h
I certify that I have authorized m�
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 --,/ --S l- v
C
in / �v C%< County.
I furthermore certify that I am authorized to gran._. j do in fact grant permission to
Division of Coastal Management staff, the Local Pe m+t Officer and their agents to enter
in connection with evr_,Jating information related to this
on the aforementioned lands
permit application.
Property Owner Information:
ignature
Print or Type Name
Title
Date
This certification is valid through I 1_-. .

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Micyru
(N r 'Property Owner)
property located at � � rJC.o}HG1nr1 S�
(Address, Lot, Block, Roo,", etc.)
on cancui in ccfaa 1:sk 19eac h N.C.
(Waterbody) (City/Tcwn 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.
hcrt
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, 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 apprC�lriate blank below.)
�_ I do wish to waive the 15' setback requirement.
1 09- I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Sin ure
Print or Type Name J
10 L-)-7 �=r
Mailing Address
SJ, x V)t,t, NC �OK4(.Z
City%Sta�e��pf�
Telephone Number / email address
Date
(Adjacent Property Owner Information)
Ulm
Signature "
Robert L Alexander
Print or Tyre Fame
3654 Cedar Hill Drive,
Mailing Addr& s
Fayetteville, N C 28312
City/State/Zip
910_269-1722
Telephone Number/email address
April 11, 2019
Date*
*Valid for one calendar year after signature*
(Revised Aug. 2014)

CERTIFIED MAIL - RETURN RECEIPT_Rr' ,,QUESTED
!0:11 0"QUA -04110MI'M 1:4re 102 Ila LO-L131 to] Hillfflil W
Narne of Property Owner. M It i(, L-f
Address of Property,
(Lest or Street #, Street or Road, Cit, County)
Agent's Name NkS Mailing Ad 's,
Agent*s phone #: fob - 'A (4
I hereby certify that I own property adjacent to the above refemoced ptoperty. The individual
applying for this permit has described to me as shown on the attzx.hed drawing_the development
they are proposing. A description or drawing.,with dimensions
-n --t be Provtdf,0 with this letter
hate no ohict to Thi,, propo,,al, h"11, C 10.11o3l, Ic 0II, proposal
I f Yo
lave objections to what is being proposed. you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice- Contact information for DCM offices is
available at)it�www,nccoastairr)aria qg
,qeiiietit.netlweb,lcttilstaft-listJ or by calling 1-888-4RCOAST.
No resL!onse Is considered the some as no obLection it you have been notified by Certified Mail,
WAIVER SECTION
}understand that a pier. dock, mooring pilings, boat ramp, breokv4nter, boathouse, or lift must
J.
beset back a minimum distance of 15'frorn my area of ripa62 ;cress unless waived by me. (if
you wish to waive the ietback, you must initial the approprOl 'ank helow,)
I do wish to waive the 15' setback requiremen',
I do not wish to waive the 15' 'setback requirer,wvt
(Property Owner information)
Signalurc
Print or Type Name
iar P,operty 07, In7frmation)
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Mailing Address Addras7-
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Cityl,statelZip
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Telephone Number / Ernail Address
Ti — Ad i
Telephon her mat dres,,, i0,
(Revised Aug. 2014)

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