72883D - Prince

� CAMA / 1 DREDGE & FILL
GENERAL PERMIT
y 4ew ❑Modification ❑Complete Reissue ❑Partial Reissue
No. 72883
A B C
Previous permit #
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 15A NCAC / /7. Ara
❑ Rules attached.
Applicant Name W /Z IAI G Project Location: County NZ W yA�✓OI�E�('
Address
City
Phone #
State PC ZIP'2 g f //
Authorized Agent A4/Jt
Affected ❑ CW ❑ EW ❑ PTA )(ES Xj PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes /r PNA 4j!j?/ no
Street Address/ State Road/ Lot #(s)
Subdivision
City
Phone # (
`..519/Vz---
ZIP
River Basin \ -lP
N
Adj. Wtr. Body, AI- X nat)man /unkn)
Closest Maj. Wtr. Body / l') W
I�.0 11 . -1 -Zi
r
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■�
r�■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■1■i��_
�il�■l"©_Ilhw■'■■■■■■■■■NONE
!■■■■■■■■e/ii�!'!!r/I■.����\I�VI�I©111■■■■■■■■■
■MMUMwEi!■ ■■ ■■
E�Iri'il!■■■■■ ■■ ■■
mown == = ■■ ■■ M OROMAR200■
■■ ■Ea!!■ \■ no NEON ■■N '!%in, OEM
MEMO MM05MUR ROME
■7i�■■■■■■■■■■■■■■■■■■■■■■■t!■
■■■■!li
- � ■t■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■Nil '
. .. ..All■ ..
Agent or Ap licant Pr' tI ;dJame
a r * Please read compliance statement on bac of permit
Application Feels) Check #
L"BDQ � � %�i�Sa ✓
Permit Officer's Printed Name
Signature
IssbSng Date " Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: c t f ��-� r ✓t �-f,
Mailing Address: tt .
WiLM Inrc,TcN AIC 29g11
Phone Number: I! 3y g s 3 -5,-q
Email Address: CY-I rice_ �Ma I J Conn
certify that I have authorized I kc W H i Tc ► S I qx) ATU r2� U t
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: &S7-xtA'I 0Yy or
at my property located at \5 1 S M NU CRC r; L IV , W I LM I N4-11r& Z9 1 ,
in � W �OlyfytT, County.
/ furthermore certify that / 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
I Print or'Type Name
d 04--f oLuvler S
Title
3/ �`� 1 / I q
Date
This certification is valid through / I
C. r
MAC222019 1
ny
RECEIVED
MAR 2 2 2019
DCM WILMINGTON, NC

r
ADJACENT RIPARIAN PROPERT/Y, OWNER STATEMENT
I hereby certify that I own property adjacent to QC QGUI � �'��l C � 's
(Name of Property Owner)
property located at 1 S 0r4V1( i / 4;2
t �Address, Lot, Block, Road, etc.)
on0Off e C., in , N.0
(Waterbody) (City/Town and/or unty)
The applicant has described to me, as shown below, the development proposed at the above location.
V 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
i-ee.� P
Signature
Print or Ty e Name
11, 1l vi �Ce v�
Mailing Ad ress o o L Z0 C /
City/State/Zi qlq - �,,,/ CS
t -
Telephone Number
Date
Owner Information)
..u�nu�ui e n
/��,3r�� > e F4-, �+�L
Prin or Type Name
l ( Gam-. I-V
MaI7ing Address A)
City/State/Zip
Telephone Number
3 .- 2,1 — A o i q
Date RECEIVED
(Revised 611812012)
DCM WILMINGTON, NC

r
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �J , ( L. M ► LrLdLEI s
r „ i I-% , (Name of Property Owner)
property located at
ree
(Ad r s, Lpt, Blo k, Road, etc.)
on in e_w v ( (U Q-)Llvk ✓l , N.C.
(Waterbody) (City/Town 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.
T
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.)
1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adj#cent Property Oyvpertlnformation)
Signature
l ,U c, ( L C L44 CP
Print or Type Name
Mailing Ad&ee s
Cityistatz
35q
Telephone Number
Date
Sign re
Prin# o_r_Tj Pe N�e f
� Ey�
g A dress /+
,N !mil_
City/s te/Zip j
Telephone Number
4 — ZZ —1 9 RECEIVED
Date
9
Revised 6/18/201'1� Z019
'-ACM WILMINGTON, NC

•tip f 11�, � , •` w �'� "�.�1 j ' 1 � t•,,
,
1 � h
NT
• �` �r"�1 '7. �� �1�f� l�..r� �r. ',ki � �•� .,{+'�r 1 , x},t• !;v, (��'% ;'I�\ er� t�' � ,� �R+,�, ti� did, � ` � � n :.�.- �, ��'r�4t � '" ��j '
t ��• e. _ � 'a ti ar � i � .��: .1s Ms�^�'"q�rti . �, a'"- �' +' I �4:s 'r , � +-.� r I.�. ' � tW.
4
�• � •4. � lsl ! s+ Y Li, f � � M Sy��i�+ Arrr� aM 1.,1�A''l1. _ ��,
~,.,�� •+ .' ",'.;jay , M � r � ' �• "ri .{ ��'+` , '` ., ,'• a �'� +'r�` � y
i'e _ � r .\� / r.. ��.�.} w :{,� .,�YL. ���,, .� 1 sits !�1 `'1Q 1 i, �. A�FI, �.s �. � nP<° o.,�e.�'f• t B��•
aF � r .0 ♦ � ` �
�, `, i�. • . 9 !✓ •' i � � Rom.. , s ' � �97 '� y.G„r,�, Y'S.i'1 � t S.t1 � ,� R'
4.1
/ r
j'+ �. `1 'Sy ��:' y Y!�} 2'1­ 7
� \ I �� _ � a V;ta } � '�(� � is >. �� n "•; 1�'�" ��k � r��?Y�e :�ir :s/f'��j' �� r r� _
1 k • 1 ' ( J.�(yjjy' y� �' '.
� • ,. V - r {lT.i � , �� . `l / � _. a.. j I y Y`ih: ' 'L'. v^ �H' :t �� !�r � t ! �. Y,"+" +`�,. i'' +�� � '�� 1 � .
• � , � 1 `.`< � � )>''� '�' .w �, '� •.r��a • a � ,' rl ' ;' if�j� i4' iR� �(�; � ; �J,'�{� "i�3rh�,;�t! cr .k' �e,�►� / ...,� `;�,, '�+- _
\. '\ r - + ` .\. r rT � .t.�.r 'sl ., �P��m'�yq,;vr ''t + 1 � !•' •- -
.vy ��,,1' r s�$'',r ; _" _ I ., i ���, * .y,. �x y. ','� =e aI''•���� r' r . i�y,j�e�L�� r; „ ^ —
\�..Ar
•i'` ..sR. �r..\. ':;\� 'f i � I ��7..�M� tF .� V=�•i� �'i r14`lA��'� � �r�Y:,-L�c'^_�$�'- �..-�- �r.._.£" \., �. ,. - ., ..
Or-
AhL
til I i r I �! � s � � � / - �� t��llr !,•� ' j � Jr�`t! �1�y.;,• � „
., � _ � .r - � •. e � / 1 � , ` f1 S :isr�. a '�iF„ _'�� •�r f
- i�. `„� � ' �•"' ,� / ; :tea ~'t.l._ :.,, � i�,� �,,'�`'Ct��, `t , �'�='�4�"'
'1� /// i1 I ,` 7. ♦ •rig.
/ tp�..J - \ /,•. 1 j-Swt, 1"�fi.,
`�-'� "�Yii �'► i

a

n w o
totr Are, x
kfDE 519E R7�-iJ A d E
Yv I T f 4944le g ),07 �; S
`1V 51 A(IUQUO
00fUS ` D� WMlrvMV'
2�sc« Q.-,,tAt) VI WA
2.�� T4 ZrB
12
Y �
-Tbp OF
174V w I CE'
LLt
U
cc
YC� �
\S 7 SCR i 04c'j (�q Ev< tit
low iormr\1( PAC 2gy Ii
m
0
mpw

/J/y' /�// ?�, ,�,•'a' .:T'`��1��� �►i0t1d�1 �� ��LIIiJC `�
YYwrf x'
o
v
n m
z n
m
aL
l ogU J; L,i v)M/n lddld
353 Ij o4
A7'JI 1'1 A''

Date Received
Date Deposdfed Check From LName
Name of Perm
Permit Holder
Vendor
Check Number
aChackmount
Permit Number/Comments
R— t or Refund/Rea/located
Columnl
Column2 Column3
Column8
Columns
Column8
Column7
Col-8
Column9
4/1 1
Si nature B,,Id,no Solution C
William and Shodev Prince
F
106d
60
P#7 8 3
WIct 0157