69366D - Beale

CAMA / DREDGE & FILL ca �% S�'" A B C D
EN ERAL PERMIT Previous permit #
New -Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As auth rized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
+ , Rules attached
Applicant Name Anil r�� I.i h
Address 1�� t< 5 w j I I j G� VIS011 Vlive
City (/1 State_.N& ZIP IUOG
Phone # ( ) E-Mail
Authorized Agent nit h L GL ! j AA" ru
Affected ❑ CW >(EW >6 PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / f " ' PNA yes / no
X
Project Location: County Me U vj t(L f t y V (i�
Street Address/ State Road/ Lot #(s) 2 (�
I,VAAA1AA(X V
Subdivision
City 1An fS Lf J�( zip 2 b
one # ( IC 2Qt UUTO River Basin a f?'t7I'
Adj. Wtr. Body C ha pI it. n man unkn
Closest Maj. Wtr. Body At t ty
ky
Type of Project/ Activity V x l 3l lii • j' !r1 S(( a,L( ( (7Y1 P-4
Scale:
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) _
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshc
max distance offs
Basin, channel /
cubic
Boat ramp
Boathouse/
Beach
Other
.iZA NE WIN"■■■■ I■� �i ►. 1�■■■�■wll�I�I�■■■
■/i . ',t��:�7i■t:4iy!■■■■Ilr�■■■■■�11�1r31'(;a rr, �i�ii�r4�■■■
r
Name
Tea
se read compliance statement on back of permit
4Zot go2q
Application Fee(s) Check #
oal / irZLZ( A _�X40 fS
Permit Officer's n e
Signature
Issuing D Expiration'Date

Rem
.;914rZ4
322 Sa..4
A!p �er SOW
Div Fe Ole
320 (may- N 4 R1�
rJ/JG, Ilµf �Qd�rJJ
272E Nadi 23rd Sheet
wknin W, NC 2E401
phone [phone]
fax [phone]
dunanmarineioc.com
q)
DUNCA E
MAMN
CONTRACTORS, INC
A giantamong a►rpiM-`
)4JAi
RMVED
CLCM W lLI'hl`I'NGTON, NC
AUG 0 2 217

AG=WNT
ADrTACI � CtCGI"�ro
If6ijk6ALTI0N/WArJBR FORM
Name of 1 acan Marine e Contractors, Iric.
Address i v" %vr`� i9iG�G ,, d �✓ r'�Gi
I hereby t to the above referenced propex'ty.
The indiN describctd to me as sho"m on the
attached roposing. A description or drawing,
writh dimensions, should be proNgnea xvim tuns letter.
IWTUL HERE
_ i have. no objections to this proposal.
If you have objections to what is being proposed, please write the Uvision
of Coastal Management, 127 Cardinal Drive Extension, Wilmington, AC
28405 or call 910-796-721S within I4 days of receipt of this notice. No
response is considered the scarce as no objection if you have been noised
by CerL{fied Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, brealnvater, boathouse, lift or
sandbags must he set back a minimum distance or 15' frotn iny, area of riparian
access unless waived 1�y me. (if you wish to waive the setback, you must initial
the appropriate }dank below.)
IMTIAL HERE
t do wish to w-aive the 1 ' tcetbark requirement.
or
1WTUL HERE
1 c
PRINT NA F.F.
1 do not Aish to waive the I5' setback requiremrrtt.
Tr: YPIWYNE NC►bSDER
RECEIVED
sVt,,,•fdc-01CM WILMINGTON, NC
0 2 n17

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying fr
Address of Property where wol
I hereby certify that I own p:
The individual applying for t
attached drawing the develops
with dimensions, should be pr
INITIAL HERE
X I have no
tIC
_/ .-,
pro e
kc-'� V 4-pno�� p �.
i on the
drawing,
If you have objections to wt Division
of Coastal Management, 1: ton, NC
28405 or call 910-796-721; ice. No
response is considered the same as no objection if you have been notified
by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or
sandbags 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.)
INITIAL HERE
____ I do wish to waive the 15' setback requirement.
or
INITIAL HERE
X I do not wish to waive the 15' setback requirement.
-4 U��
-26-1
SIGNATURE . / DATE
33
PRINT NAME TELEPHONE NUI
- G 776
RECEIVED
DCM WILMINGTON, NC
AUG 0 2 2017

NCDENR
North Carolina Departnieril of Environment and Natural Resources
Division of Coastal Management
t'e:ttao F Eas'cy. C-cvemor Charles S. Janes, DirectOr Vii Nam s'a. Povi it , `tvetar;
Authorized Agent Consent Agreement
is hereby authorized to act on my behalf
• (prentecr A'nmr Cf AQnrnj
m orCer to obtain any LAMA pennit(s) required for the property listed below. The authorization is limited to the
seecific activities described to the attached sketch
LOCATION OF PROJECT:
ve-
VJ
2�y} 8 o
PROPERTY OWNER MAILING ADDRESS: �3i3 ��11iGmsc�n�r�ve -�
t�G1e i ah �'+C 'Z7 Io0 8 PHONE NO
AUTHORIZED AGENT MAILING ADDRESS:
PHONE NO
Signature of Property Owner
Signature of Authorized Agent
127 Cartrinal Give Exi .1, Dirrigico Milli .iao'nw 7E4G5•2N5
Ph. -Me 310.7%-72151 FA.( 910.395.1%4 i tnlemet erwi nccaast.amia mement net
A^. ";uJt i .�IjYY:4'^RV : �+n efat:•rr, A:'art t..4'6.Cfr' - �`=: "-, ri• Y}. i++l � f i'�: r'P,.i �:ars::nrz C�
RECEIVED
DCM WILMINGTON, NC
AUG 0 2 2017

WIRO
Date Received Date Deposited Check from Name Name of Permit Holder Vendor Check Number Check amount Permit Number/Comments Receipt or Refund/Reallocated
8/7/2017 Duncan Marine Contractors Inc. Ann Beale Branch Banking & Trust 8029 $200.00'I GP 69366D CS rct. 4751 D