67117D - Brown

ICAMA / ❑ DREDGE & FILL
aPEN ERAL PERMIT / Previous permit #
(;�lew ❑Modification ❑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 I SA NCAC
A (I� � ❑Rules ttached.
Name �7 J Project Location: County 1`..�
ONO Street Address/ State Road/ Lot #(s)
State ZIP �`i�1 `'' ` (_ G �r;O (� 4
(A O) `�� ri lL 51 U E-Mail Subdivision �—
ad Agent
�Vz
��j
❑ Cw;1'11TA
❑ ES ElPTS
❑ OEA
HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
yes / & ) PNA yes /(no
Project/ Activity
:k) length V1 X 1 b
tform(s) IC
I �
Platform(s)
igth _
nber
I/ RiPrap
;e/ Boatlift j) Y l S
Length
not sure yes o
um: n/a yes
yes
(h
stached: Ge no
1�
Ci C A( ZIP '�!n t u
ne AJOW# (�Ib )b-1i River Basin%✓1�i/
I
Adj. Wtr. Body c( nat
Closest Maj. Wtr. Body 161 AZ
l"/( �_Wf S Av\
C",
(Scale:, _1
ig permit may be required by: ' UW __11 O 1 (4Lti, I
.ocal Planning Jurisdiction) n ��
_Ail I-,
-lI __1n -

NC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant: g qw L-1 Permit ##: 6 7 f I
Date:
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremenl
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp .
impact amount)
TOTAL Feet
(Applied for..
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL feet
(Anticipated fina
disturbance.
Excludes any
restoration and/c
temp impact
amount)
(�
Dredge ❑ Fill ❑ Both ❑ Other
� `
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
j
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑. Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both 0 Other ❑

1Q:82 From.
Wic"F.EM".ew mor
?� To:aga9666
NOM cWaft DapWvrAmof End erd NNftWp4mourm
Ohl" of con"
4=MK VAN
Au1iftI ! Aqm* Consmft A�eoMoeat
in ader� - an„ C� is► au�hori�ed � apam�(sj ft*mirmd for on pvpoay wed below Ths
specs iC miss described in do tMachad Mmb*l.
wcnWma of nAoEMT:
PROPEI!'1'Y OWMM MUL Mi Ate:
1;1_�Kv
, .!�iauj h
z 5?q�-717'
/So g� S',(aO.e (,-k

18 16 10:16a Gt-e: Hoiden 6429906 p.2
I)TYISION UY COASTAL N1A NA.t ~rovnj `1`
ADJACENT 1UPAWAN PRoprRTY 0WKGn STAT�.i-ik i�l l
Name or PropertyCwper: ��►a-dr'° :—��U�a.11�- -- -.-
Addressafproparty: _ L4QC,).� �r.�s_a..�.�.,i.1 �-- •�r1,,,,��f.�.:S._r....��.._...
(Lot or street #, street or Rond, City &
.Applicant's phone #._�1 t U ^ S �� . -71
1 Jieraby eort'i that I own property adjacont to the above rderoaccd propotty. The i '—[iV dtutl nFplY ng for this permit
lrus described to me as shown on file attaoi:ed drawing tho devo[opment they aro pxoposirrl; r er .r , ion df cl�a�►,i;�
Ste' i�Sr7R.�2mYe� 1ri. t4_ otter,,
hFiva no o*Ctions to this proposal, Shave ouje'tions to this proposal.
Xtyou have objections to what It being proposed, you Most uotio fnc Divlsioa at Coastal Maa;<gaLaent jZ1CiY1j
in rvs-iting tivitlrih 10 dayx of receipt of this notice. Correspottdertce should bo malled to 121 Cartiir,vl �rlwo V4►ilm1rr; tnri, NC 2$405 3845xjCyl t e[rrc,9dntatives cau also be contacted sat (910) 7I6-17211.5. No respowm is
cousicl�ittt t$� me Rs nh PclFo�� if ou have Boer a $ed h e tiPed M
'4'41•k MI R SECT-T0',f
I uncierstattd that a pier, dock, mooring pilings, breakwater, boath wse, or hft trtwa be net barZ. a nrist%r,urn tiislancra of
1 a' from my aroA ofri eriFtn. rte(-cxs unless waived bq noc, (tC yea v a3h to waive. the��Cfi+stcic, you ±a�yyt inatin[ tl�
appropriate blank ucloiv.)
a- --'• t--• . ,- --- 1 JO wish to waive the I V set back requirement.
_ —_ 1 do not wish to waive the 15' set back requirement,
E`Pro�,�cty 4tivner Xrs%rmatlon)
��-
°riot '��• "1'y{re ante
?- 0 G� �
Mailing Address-
City/State/zip
Mparian,1'rop"er•ty Osynez• Information)
Sig;2fifure f
Wolfam C. COX, 1V
??ri;rt or Ty[;c+ NaarF-•---_____.,
MflilingAdrk= '--

18 16 111s 16a Greg Holden 8429906 p.3
CI>vtTI,FIED MAIL —RETURN Rif`,CE1-rT RE z FSTr,D
DMSTON OF COASTAL DVL,NAGRiVUMT
ADJACENT RIPARIAN PROPERTY ONVYER STATZi1r PNT
Address of Property: — H9 C. �- s � S'� • } d ' 6 r•.l c' :_ _
(Lot or street i , street or Rood, City R Court , )
Applicant's phcsitc� U ^ a til' 4- 1 y1-1 Mailing Address: a$ S ;'t�� eo:.,
I hereby certify, *At Y own property adjacent to the abov-. refercucCnd property, 111c individual appl_Ang for this peralit
has described to Me as shown on iite attached dmwin the doyclopment thcvy arc progos tlg, A tLe Cri ti n t�dM,vintr,
nth dyxnension:.t,�mu,t b�-P.x4 �ricitxi ti�;ith ti��tter. ,
I have no objections to this proposal. � _ r h9vc objei corns to this proposal.
If you have objections to what is being; proposed, You must uotlfy the Divivion r4 Coust-tj Managerneat (I)CM)
iu writing within 10 days of receipt of this notice. Correspondence ihtotild be rrtailed it 127 C'.ird►nal _Drive Ext.
N'pUMiugton, N 2g40:5-3845. DC NI rcpre;entativcs can also be ealztactcd at if'I0j 796-7215, INb rspouse is
considered the sime ak no ON Cli0n ifvou have been notified by Certliicc3 Mail,
WAIVEp, SECTION
I undcrstaud that a frier, dcrck, moodag pilings, breakwater
15' ;front My area of riparian access unless waived by role.
appropriate blank below.)
boathouse, or lift must he set back:, miniinum diMnee of
(ifyou wish to waive the Setback, you llnu3t iritiai thU
` '. t' l do wish to waive tit-. 15' set back requi.rcmeiit.
--_ 1 du Qot wish to waive tire 15' set back requirement-
T�'roperty (:hvuer Information) );?rixn fro TfOwner InfOzmadon)
Sigtnah�re
Print or.Typv, Nzinie
1�-!_off-75,
mailingAddrew,-�-4 "�— —A - Z- 2- Z
City 1 Statq 17m
!!�P%'�
Mai.lingAddress - ---'

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