74804D - Healy

-,CAMA / DREDGE & FILL NO. 74804 A B C
GENERAL PERMIT Previous permit# /
lew uModification ❑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 15A NCAC 0. -7H • ' / 0 (::>
❑ Rules attached.
Applicant Name y. %J ti Z - 4 h Ct\L'N Project Location: County 1, _,' • . t&—
Address N O — ( r — S 19e, h/ Q.. Street Address/ State Road/ Lot #(s)
City h,al-\ x_ J (I (-Ac to State NC_ ZIP :�l% `�b';— P'A_J
Phone # (?') hlv "11 E-Mail ahc 4jy �4 Py��N (�,,,Subclivision
Authorized Agent Ivy u�
Affected ❑ CW EW ElPTA �ES I/PTS
AEC(s): ❑ OEA HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes C�> PNA yes /49
City CAat. nErJ n t h C H ZIP ') 0`U)'
Phone # ( ) River Basin ( _" 6-
Adj. Wtr. Body ,. ^� (nat nkn)
Closest Maj. Wtr. Body— A/
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Agent or Applicant Printed P1ame
Signature "Please read compliance statement on back of permit"
o✓
2
Applica ' Feels)- Check #
�T �J C „A , PermitOfficer e
Signature
Ih-Z Zo2.y s zi/L�Z�
Issuing date Expiration Date

I hereby certify that I own property adjacent to 410 S to
//��
(Name
property located at //b �/D f1 P-Ag J
(Address, Lot, Block, Ro
oni`�d� L . in I-,SkDO
(Wat+erbodyr) COr
The applicant has described to me, as shown below, the development
1 have no objection to this proposal.
! have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVE
(lncmdual proposkV development mast fill in descdptlon below or
l� CANAL
11a D UDN5 PR
Ky-
IVrN'�l, ` WA4'
L U n WAIVER SE10
CTION
understand that a pier, dock, mooring pilings, boat ramp, breakwater,
must be set back a minimum distance of 15' from my area of riparian a
me. (If you wish to waive the setback, you must initial the appropriate 1:
-N I do wish to waive me 16 setback requirenmrrt.
I do not wish to waive the 16 setback requirement.
Owner
-r>
Print or Type Name
/It) G�JDr'1 V/rf i�T
Marling Address G G
_W
Telephone M /email addmss
Wand for one calendar year after signature•
(Adjacent Property
S fw-r
� '7 =
Telephone N mW�/�
8 q-Vt24
,s
Dwner)
B . N.C.
County)
Dosed at the above
a site drawing)
10 5 L-T)
Pf VkA r-_
house, lift, or groin
s unless waived by
below.)
ner Information?
address
(Revised Aug. 2014)

Name of Property Owner Requesting Permit:
Mailing Address: 110 LIOn
Phone Number.
Email Address:
140110 RLO&A N L 12rf(,Z
- 704- 64 77
r
I certify that I have authorized n✓\ T,- ',r L CA I'D
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining al
necessary for the following proposed development: REMoVt
at my property located at PA
in f3VNA'SVAIC-t. County. j
LAMA permits
I furthermore certify that l 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 inforniation related to this
permit application.
owne
rrtle
Zo ZD
Date
This certification is valid through I I

I hereby certify that I own property adjacent to
(Name
�}1�114[, � IF(Address, Lot, Blck ooa
on
(WaW�y) (C any
The applicant im desc abed to me, as shown below, the development
I location.
I have no objection to this proposal.
. f
I have objections to this proposal.
rS
Owner)
N.C.
County)
goosed at the above
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or a�ach a site drawing)
OW A C.
VINYL � WAq,
I understand that a pier,, ocic, mooring pilings, boat ramp, breakwater,
must be set back a minimum distance of 16 from my area of riparian e
me. �(If you wish to waive the setback, you must Initial the appropriate C
I do wish to waive the 16 setback requirement.
I do not wish to waive the 15' setback requirement.
}
or Type Name
Mailing A Tess
Air,
cay/ at p
(6— 7PG
Telephonq Number/email address
I /� T3.�w
Date
t° �-p
Jan e_
house, lift, or groin
s unless waived by
below.)
(Adjacent Property Ow7r 1 ormation)
lO
'Valid for one calendar year after signature'
Signature
* ` s'
ei
Print Qf Type Name 5
Telephone Numberlemi3d address
Date*
(Revised Aug. ,
Y�
M14)
M14)

Dart Ra.Wvad
Dafe DeaoaifadI Chock From Nam-
Name o1 Permlt Holder
YW War
Check Number
ount
Permk Number1commenn
Receipt w RefunNReallocatad
O.F—f
Column2
Column)
Com"M
COMM6
CokanM
Co9am7
CohmuM
Column9
1/22/2020
Allied Marine Contractors LLC
Jeffrey Riecken
First Citizens Bank
8615
$ 200.00
GP $74875D
JD tcL 10940
1/22=20
JerTy EnneC da Ennett Marine Consbuclic
Billy Tart
Coastal Bank and Trust
2688
$ 600.00
GP i74874D
JD rct 10939
1/22/2020
H5 Constnu8on LLC
Austin Healy
BUT
2457
8 400.00
GP i74804D
BB rct. 8806