74292D - Trotman

CAMA / DREDGE & FILL
GENERAL PERMIT
XNew Modification LiComplete Reissue ❑Partial Reissue
No. 74292 A B IC
Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality �/ n
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 00 �Iy ✓n
�� / ff ,�[ P Rules attached.
Applicant Name U/�ld%n, /D(/ Iteywo Project Location: County Nn" e
Address jQ I �0 %�(; dC Street Address/ State Road/ Lot #(s)
City W 1 knl o9A State NC ZIP a V/ f / S~
Phone # ( ) E-Mail
Authorized Agent r T'
Affected ❑ CW ❑EW ❑ PTA )6ES {OPTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes / no
Subdivision
City
ZIP
la
Phone # ( ) River Basin 14,7. ti-la
Adj. Wtr. Body g s /fie nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity T41SGi IAS`�ff A41&41 in A411 e W t�•f'/5���1
V 6
Pier (dock) length
Fixed Platforms) - DS 'f +� Fp
I
Floating Platform(s)
Finger piers)
Groin length
number
Bulkhead 'praplength
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
PROPERTY LWE EXTEN
TO CENTER OF SMUGURS
CREEK CANAL
� EIP
♦
♦
\
Ti
e: /Vjs
Beach Bulldozing . ��♦ ` ` _
A ♦ \
Other
N6- 600-A - �' ♦♦°9
Shoreline Length 2 80 + 6� /,h �� `♦
SAV: notsure yes /L�J/`Q)[' p EIP
Moratorium: n/a yes ® (•Y / ( f/l '
Photos: yes /:� PAY UNE EXTENDS
� I �, ljLc To CENTER OF BFdDGERS CREEK CANAL
Waiver Attached: yes 6 //II — L, -L
A building permit may be required by: / M- A ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) G' a L
Notes/ Special Conditions r /Ps �/"OV3' /f/ �j' az[
/IDl�ll/, .�C �/ . D n. %Li; c �il'i�'�h'1 !✓��5 bye 0,w AzJ t- �� NA �!/�i�.� �✓G �%fnel
Agent or AoRlicant PrintedName
Signature *Please read cory)'pliance statement on back of permit
qm_P
Application Fee(s) Check #
Permit Officer's Printed Name
Signature
Issuing Male Expiration Date
l

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that 1 own property adjacent to
Zi"D s
property located at /,2 f�p�n f- Z2 j2' (Name of Property Owner)
on Q �, �/'toP (Address, Lot, Block Road, etc.)
in Zv/N.C.
(Waterbody) (City/T n 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.
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 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)
,Si sinature
Print or Ty -Name
/az/ O/'/9/J
M itin,9 Address
City/Statelzp
Telephone Number/email address
Date
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
_�'L Ova
Si gture* YL� A �
�V t�l1l�C �P
Print or Ty Nam
1r7 uolrlf V.
Mai/i g ddress /
fU� G J C on�E l i
Date*
address
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
i hereby certify that I own property adjacent to ILl/it«Qf7 s
(Name of Property Owner)
property located at /,% / �O//I f
%� (Address, Lot, Block Road, etc.)
on in
61 (Waterbody) (City/T n 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.
l have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing developmentm►isifill in description below orattach a site drawing)
CL��aexPpl
WAIVER SECTION
1 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 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)
ignahrre
.%f/ /�o�rna/J l.>J��lilHi 7l!-yTJJii�'
Print or'Pe Nam
12/
Mailin Address
ZDZi r719/7 /Ve -2 P�///
City/State
Telephone um¢er/email address
//4'
Date
'Valid for one calendar year after signature"
,,, roperOwner Information)
Signature
Erg
Print or Type Name
3-2`i A4rtRS14 antDRw
Mailing Address
City/State/Zip
_ 1(a Z - 3S' 15 ell awe. rn.,c 6e-e-Q
Telephone N mber/email 6ddress
2 ZO
Date*
(Revised Aug. 2014)

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
i
Date
Name of Property Owner Applying for Permit:
Mailing Address:
/.)- / /a,"T V de-
L.' %L, A9.,ry h Ta ^-/ A/ G Y//
4//"1/OPpiN
I certify that I have authorized (agent) '7-/11 i /0i/2Pml 11`74gl'v �� to act on my
behalf; for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) J9VI- �&/,/g4 e
at (my property located at) / 2-/ A."V /? 2 (,J/L/M i2-,/T ,- -- - r✓ ey c-
This certification is valid thru (date) X 3/ 11,q
Property Owner Signature
Date

SURVEY REFERENCE_
Section— Map Book— 9
Subdivision— BAYSHORE ESTATES — KOONCE DMSION
Page— 14
Lot— Deed Book— 1175
Page— 1392
ECM
N
�— -- Y oRE pRNE
17
PN Cf
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NOTES
VICINITY MAP NOT TO SCALE
1. IRON PIPES AT ALL CORNERS
2. NO ENCROACHMENTS T
3. A PORTION OF THIS LOT LIES WITE{IN O
A 100 YEAR FLOOD HAZARD AREA
4_ AREA BY ELECTRONIC COMPLq-ATION
IS 32,733.32 sq It = 0.751 ACRES +/—
ABOVE MARSH LINE ECM
LOT 192 O d`
1, �!
i
/
Opt •�B F
i cT E`
i
jp003TV1
/ ElP
S 50'58'41' E
RsEO \\ 41.93' CHORD
`\
PROPERTY LINE EXTENDS �O`��2 pRNE EIP
TO CENTER OF BRIGGERS >t� E G�Va
CREEK
CANAL 55 �5
�d
+
EIP
`o
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\ h
o
\ Q
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y
Din {'I(i
qS�\ _N
IDECK ( r
\
6u /,ell\
F \.
�P EIP
{���a' ` n40PEHTY LINE EXTENDS
TO CENTER OF BRIDGERS CREEK CANAL
MAP OF SURVEY
for
..WILLIAM HOL T TROTMAN

Dam Re Wvsd
Data Deposited
Check From Name
Name of Pwmft Holder
Vendor
Check Number
Check
amount
Pelt Numb -Comments
Recel for RalundlReolbcated
Column!
Column2
Column3
COIUmM
Column5
Column8
Column?
Column8
Column9
L --
511U2019
Pipm M
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