67132D - Bishop

J CAMA / El DREDGE &FILL ?X +'
1 A B
aENERAL PERMIT Previous permit#
)New ::]Modification El Complete Reissue El Partial Reissue Date previous permit issued
-ized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
m '_'.' U
N f�� I t()N S gles attached.
t Name i 1 / Project Location: County l Q
w AAA V1 + 1ok 40 V, 4u Street Address/ Stat Road/ Lot #(s)
1���1� '7 "�i''•^ State /VG ZIP -�ZS`� t i� Gt �w'� o rs
(111D S� r 1 E-Mail Subdivision
edAgent %Uv�ti C►^^ (%c` City -fX ZIP
❑ CW );6EW ,EJaTA ❑ ES ❑ PTS Phone # ( "�� '&iver Basin
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ WA
Adj. Wtr. Bodt
❑ PWS:
yes / no PNA yes no
Closest Maj. Wtr. Body "n vv
Project/ Activity i -' — t=- I J /
ck) length _ _ ? . i
itform(s) (O0
Porm(s)
ie )
ngth
-nber
i/ Riprap gth
I distance ofhhore
x distance offshore
cannel
sic yards
e Length
kttached
o G1[ r?
(Scale: ! .
+e
rig permit may be required by:
Local Planning jurisdiction)
❑ See note on back regarding River Basin n

NC Division of Coastal .Mgt. Habitat IMP211CIE %ou"ov"'u's
Applicant:
Date:.
HABITAT disturbances for the application.
Describe below the H
in
Habitat cFe sheet.
H
measurement found your
All values should match the name, and uhits of Mw
FINAL Sq. .
.TOTATOTA
-j--Flaluni
T. TAL Feet
L Feet
FIN
F
TOTALS q. -Ft.
I
(App led for.
i
d final
(Anticipated
(Anfjclpa�ed final
t cip t
0
lied f r.
(Applied for.
t .
pp
5 rbance
Disturbance
Di
(AM
dist,
,
r ce total
Disturban
TYPE
DISTURB TYPE includes
s y
iincludes any
a
disturbance.
b
x s
Excludes any
noludes
total includes
total
a tic
'joated
any anticipated
any
I
Exc
E
resi
r
Habitat Name Choose One te -
anticipated
anticipated
ration
esto i n
resto
e Mp
temp"
a ndfor ternp
restoration or
restoration
re, Ora �r
tem
t
restoration or
and/or
a +%
M
fAmn iftir)acts)
aril
IA
Dredge f-1 Fill 0 Both ❑
Dredge ❑
Fill El
Both 0
Other [I
Dredge ❑
Fill 0
Both n
Other
Dredge El
Fill n
Both El
Other ❑
Dredge 11
Fill[-]
Both n
Other 0
Dredge E]
Fill n
Both 171
Other ❑
Dredge El
Fil I E]
Both ET
Other

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date I
Name of Property Owner Applying for Permit:
L-OCA e It Dana �,'540R
Mailing Address:
If 73 G ti ed w, C!(- f rz pre 5 3)r
I certify that I have authorized (agent) oaSta 1to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) ✓1 e_ 4/ P-' e(`
at (my property located at) N 7 3 Chad�v c1C 5Aor-c5 1) r fury /V(- 2gK6
This certification is valid thru (date) t Joc,i 20 l
7.1
Property Owner Signature Date

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:/c1� ie l t Dana 5,5b,92
Address of Property: 413 Lyad w- -rX 5hyre5 Or- f7,1rad 5 �erl%l C�15/ow
(Lot or Street #, Street or Road, City & County)
Applicant phone #: /� I n l k l c'� Mailing Address: H 7cK 54ore5
iA,--td5
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
/ I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangement.neticontact_dcm.htm or by calling 1-888-4RCOAST. 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, or lift 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.)
/2 I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Print or Type Name
473 L .-dtiy:;t4 ShertS Mailing Address
Address
(Riparian Property Owner Information)
J�-4""V `:
gAnatJ
S ERK\I L . }aN NiT
Print or Type Name II
Mailing Address

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Dun; C l a R;o op
Address of Property: V `73 Cher J w, c 1< Shores' 0' 5„ -fCcd 5 Fr:-ry 0.,5l0 w
(Lot or Street #, Street or Road, City & County)
Applicant phone #:
-75 7-562-- 112e(c
Mailing Address: q 73 c S6E its
5!1 c':d s
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
_ I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastaimangement.neticontact-dcm.htm or by calling 1-888-4RCOAST. 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, or lift 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)
aj)
Signature
Pun 1 (51
Print or Type Name
(Riparian Property Owner Information)
Sifhature
-To NN L_ 1-1Alp T)�,i T F
Print or Type Name
4 7 3 -L SI,
Mailing Address
2/lG E, EMr/-y L�-)
Mailing Address

EW DOCK WILL BE ROUGHLN
SJZE MAINTAINING A "T" SHAI
THE EXISTING BOAT LIFT. REP)
STORM DAMAGE.
25 ft
Dl��aTANCE TO T6Oft
Pf OPERTY LINE ti
90 ft
x SSft
DISTANCE TO
PROPERTY LINE
0
y
16
Ilk

i
25 ft
DISTANCE TO f"
{� PROPERTY LINE
85 ft
DISTANCE TO
PROPIRTY LINE
ob
r f}
i
NEW DOCK WILL BE ROUGH
SIZE MAINTAINING A "T" SH
THE EXISTING BOAT LIFT. RE
STORM DAMAGE.
V„
i i a
i }
F
I
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