67111D - Barnes

❑ DREDGE & FILL 671,11
A B
a E N E RAL P7olina,
R M I T Previous permit #
lNew []Modification Complete Reissue El Partial Reissue Date previous permit issued
•ized by the State of North Ca Department of Environment and Natural Resources
;oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �/ ,
t ules attached.
Name �� �C�NLV j `i , Project Location: County
Street Address/ State Road/ Lot #(s) �Q
UO)
6
:d Agent
❑ CW
❑ EW �FPTA ❑ ES PTS
OEA
❑ HHF H ❑ URA ❑ N/A
❑ PWS:
yes /no
PNA no
6e'/
Project/ Activity
�
:k) length 4W x 10)4
tform(s)
f 413H�
%atform(s) k t
er(s)
igth
nber
I/ Riprap length
distance offshore
( distance offshore
annel +---.
is yards
p
;e/ Boatlift
illdozing
Length L`
notsure yes o
im: n/a yes
yes
ttached: yes no
ig permit may be required by:
.ocal Planning jurisdiction) /11
Subdivision mmr
�j
CityVi- ZIP
Phone # ( ) River Basin
Adj. Wtr. Body r �..
Closest Maj. Wtr. Body elv�v -
C
(Scale:
t � �

NC division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: J)"y` Permit
Date:
Describe below the HABITAT disturbances_for the application. All values should tch_the name,_and _units_ofineasuremE
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 f
disturbance.
Excludes any
restoration an
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
a
-
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 ❑ Other ❑ .
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

✓CAMA / DREDGE & FILL
9ENERAL PERMIT
New Modification Complete Reissue Partial Reissue
N? 63K
Previous permit #
Date previous permit issued
authorized by the State of North Carolina, Department of Environment and Natural Resources
d the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 7 k' ,
-,'Rules attached.
plic2nt Narneix Project Location: County z
dress Street Address/ State Road/ Lot # s
3 �-t L �. StateNC ZIP `} '✓�" WA"U-tlJl.H-K PD.
one # l` 1t C Fnz'# ( _) c �ir��tvt lt_ - I�Mbdivision c^r & _
_.- --
thorized Agen ' lyt '� t City L ZIP__ I-
ffected 17J CW El EW PTA mfi O ITS Phone # (_) River Basin
,EC(s): COMAHII ❑ IH ❑ UM WA Adj. Wtr. Body_ Z. AQ /man
❑ IWI: ❑FC: --
RW: es ? PNA Closest Maj. Wtr. Body
y io yev ! no Cnt.Habb.. yes no
Fype of Project/ Activity ili j lidTE� orlc4
1�"�♦&TV
It
r�u.
. i
: i►J:i�adji�i
Finger pier(s)
■
■
!i■■I
Groin length
>r'
.�
e!N/,
AT
MIX"-
`
AIR
..
�_
,
number■�
Bulkhead/ Riprap length
UM
1
max distance offshore
Basin. channel
ONE
40
Boat rwnp
w z:•.
�.;;.,�■�■
/:."Ji'Z'
� lid■■■
""
■
Beach
BulldozingOther
9
+IL
iM4R.
._
� ■�
■
#�
1;
i
Ian
KIM
.-
-..
Shoreline Lengt1h Ei
SAV-. riot sure yes /1-4
Sandbags: not sure AW *i t
rVa yes rt:;r
Photos:
■■■■■■:+IllMoratorium:
■
:
�ii■ii,j7,
r
.ri
i
�i■■■■■
■
■
yes
Waiver, Attached: yes
A building permit may be required by: f 0-awsAN i be. '(0 , ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions j�dt (6m 0 M rAY% 0V_-,J • j D E} LflC L � fy Pit'
• ct'J(1Ve i 4lt
vC v-- LW 2. 9UPT &'ninz2l-n i3Y 7 xs /'1�P�r►'i7-

North Carolina Department of Environment and Natural Reso
Division of Coastal Management
Beverly Eaves Perdue Braxton C. Davis
Governor Director
AGENT AUTHORIZATION FORM
Date: / l
Name of Property Owner Applying for Permit:
Owner's Mailing Address:
Phone Number (10 ) .51 ? -'3Y 3,0
Name of Authorized Agent
Agent's Mailing Address:
�iy / r�-�.� Cvr'�7�✓ ,
Phone Number a0
I certify that I have authorized the agent listed above to act on my behalf. for the purp
for and obtaining all CAMA Permits necessary to install or construct the following (ad
For my property located atS�
This certification is valid thru (dace)
Property Owner Signature Date

&Q"&ElfT WARS, b PROPERT1 2MM>MER 116JEAKNT
jNum of Property Qwneir1
property r,4d at �-�- �. r� # 3 �Y�1 �+�#c�.�a �9a _ C-OLAA�A A.1� `84/51
(Addraw Lot, 81 ock. Road. 4v—) 06
on _ h' f t7tr .� 2�1t��'►,sn � p'."JIrS ✓10< Cc . N C
IWsbr odT1 {Cay/Town andlor Cotait►)
The aWX-a,-d hU descnbW t:, Me 21 beiorr, tt* Jev#i0pMM1 tWOLIr ra 2' ,"# about *CZLCY^
� — I r1awe no otio, cNcr tc 4t s Vopo&af
DESCRIPTION AMWOR DRAWING OF PR'DPOSEti DEVELOPMENT
.1bu oiduat prop osiraV eawa#*pm*m muss fitl in de"rrttbor, a~ or attach a site drawmVI
i ur+dbrstwO OW, a prey. clack mow" p&Vs b+FtdM:rv*W boatnimm lift, or gross• mW be se, bac* a
rnowrrcrrr, d+sgtarce of to from my arin cO ripar.an ate utftss wareed by mv iM yw wish to w•a"
rl,e selb&ck you must Irvit F 0-e a� OWSta bkom Imo? 'J
f " 4- t d w ,h tQ wtbr 61•rA '5 .'�bCM rat
Ail* I do not wos to wane Me s 5' Wb ack regwrar t
iPropWy Owner Inionnoien)
P'itf� 6r
1"r patty €4mer 9ntorm4tionj
'Atf �\ l

Tm
- tld►r�ss, LAM, Mach. Roam etc.,...
�iMntht�yra ..
d # ,To wr, n�° 6w Gttvn jrt
r'a d 7N Q as Mc JS *#%**n tam t * dO~ WW4N =00"O A tt* �t .
-!n,'o st!aae pr_,tst�,ri
too* IN*I-lcrg to Nit
CRN►Ct k aft DRAW04G of PROPOSED VEVFLO .hIT
govokpAwt nwat Irw an
n.>rum SEto
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tp dog, mcarinv c ttoak *.r t _ rtt or gMvn MW bs w urrt a 1M*s1nT+ti 7 "� tt+i►iL$! of IT 1y1 My Q'yyR p( "G/(� ARM �J' OO" *WOO by RAC' Of, j'W wlh in 4M11te1t

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