71746D - McCarthy

�AA1► I I I►� P �URRI Cat IJV
CAMA / DREDGE & FILL r� NQ 71746
t�i,oRE�i/c;< A B C
GENERAL PERMIT Previous permit#
> New 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 C `7 H IS O O
❑ Rules attached.
Applicant Name
MC CAR i I ly
Project Location: County F?L( N ^w1c K
Address 70 3
Or_5T
;2 8TH S'r.
Street Address/ State Road/ Lot #(s) 12,10
City L_omrCRTo
y
State VC ZIP2735f 1-11VEKVIEw DqRyC. V ICJ
Phone#(rllo)774-405?
E-Mail
Subdivision N%A
Authorized Agent
ewA/y
i?,As17 Rr PAuv 1NE BEN-oN
City �',F(A -O'r'TE ZIP 2 ?470
❑ CW
XEW
XPTA El ES ❑PTS
A6cm—T Phone # (rl to ) 5qd - 44 24 River Basin ,_I.+MP r R
Affected
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body S'NAw v-r-rr Rrvr_ Tz na /man /unkn)
❑ PWS:
ORW: yes / � j
PNA
yes / no
Closest Maj. Wtr. Body %� f W w
Type of Project/ Activity REPLActr Pir-p IDocyl is F/ciLITv --o Pizr_ — r—X15TIIVG
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Moratorium: n/a yes
Photos: yes
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A building permit may be required by: RRLk,y t w-CY- C,=5 A(TY ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions 0 L( 5 no A Nr> AL L OT A c R LOCAL � S T A i c - A 4 Il
I'rC RAL R CiuL M io45 /APPLY
Agent or Applicant Printed Name
i
Signature * Please'head compliance statement on back of permit"
N'fA N/A
Application Fee(s) Check #
I`i�G2 MC CLANRC
Permit Officer's Printed Name
Signature
I q 2of? �l 2� 2�19
Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 5 %y%�Q
Mailing Address: 71) ►its 2 SA
,turn r=irs.c 4C 0� e359
Phone Number: ?/0
Email Address: ��� r cc r A/ f- //r,'ek. L�v�✓1
I certify that I have authorized .L7" Lj/ Wit%
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: I / . ,-lea-It no
at my property located at /, qL) Ziefg
in Z i L fl Sry i c1c County.
l furthermore certify that I 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:
G
Signature
ZL'l
C Nrvi S "Z
Print or Type Name
(QW Al Jg=
Title
Date
This certification is valid through _,�_ l_/ _/ Z2

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to is
(Name of Property Owner)
property located at L,2 q 19 / t v'G✓I/ �) V ?e,
(Address, Lot, Block o ,etc.
on �� 1 ✓.� , in S� , 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.
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)
Signqure
n
Print or Type Name
743 W. 8 I S
Mailipg Address
City/State/Zip
91027v- olcv�'
Telephone Nu er
„1517
Date
(Adjacent Property Owner Information)
Main!=Add'& .
City/State/Zip
Telephone Num er
///. -i-r 3
Date
(Revised 611812012)

Brunswick county (316 Uata Viewer
214NB 008
214NB007 1302
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214NB OQ .1298
Nib 214NB 005
f 1294
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88
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214NB004 0
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214NB003
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214NB002 C13
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214NB001
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214N E02 0
ti
214NE 019 = r
214N E 022
10/31/2018, 1:03:12 PM
■ Addresses — US Hwy Minor D Parcel
Roads — NC Hwy Parcels
Interstate — State Road � 1 Condo
1:625
0 0.005 0.01 0.02 mi
0 0.0075 0.015 0.03 km
Brunswick County GIS
Brunswick County GIS
Brunswick County GIS I