66546D - Breeden

CAMA / El DREDGE &FILL �(v � JPLJN _ A B I
Previous permit
IENERAL PERMIT
Vew ❑Modification ❑Complete Reissue []Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources ` n
3astal Resources Commission in an area of environmental concern pursuant to I SA NCAC i� ❑v Rules attached.
Name Project Location: County L(�k'�VY� S W/
PStreet Address/ State Road/ Lot #(s)
NQ Y 1 V �\` State V zip
( �) n 5' t i U E-Mail W �' bit'�' (W' Subdivision
i -
:d Agent Vr i�7� c��� city i , ZIP .�
,! �� S I I1 L- \,AAA'
❑ CVII PTA A ES i rs Phone # (, U ) �� d` `y River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body C-k V1 R n)at
El PWS: Closest Maj. Wtr. Body
yes / not PNA yes / no
Project/ Activity O'n vC t G�Nil� a
"(iYVV �q c; (� � -kk 5� 1 �1 �1��n^��� i"U �� Ih
=k)length
itform(s)
d/ Riprap length SU`
distance offshore 31
uc distance offshore
Attached:
V
no
0
y n
ling permit may be required by: aWo 0� �-1 �CVNtu
Local Planning lurisdiction)
yes
yes
es
❑ See note on back regarding River Basin i

r, r ,/"� ,�o� NC Division of Coastal Mgt. Habitat Impact Coml
Applicant: W t � � t VVA � '_et �
Date: 0 5/o_/t
Describe below the HABITAT disturbances for the application.
All values should match the name, and units of measurement found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FIP
(Applied for.
(Anticipated final
(Applied for.
(Ar
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disl
Habitat Name
Choose One
includes any
anticipated
Excludes any
restoration
total includes
any anticipated
Ex(
res
restoration or
and/or temp
restoration or
ten
temp impacts)
impact amount
_temp impacts)
am
Dredge ❑ Fill Both ❑ Other ❑
l C)
6 s o
Dredge ❑ Fill Both ❑ Other ❑
( 000
000
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both 0 Other ❑

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to h), /h & t B r e e JC 1% 's
(Name of Property Owner)
property located at
(Address, Lot, Blo kII, fR�oad, etc.)
on Canal in i0/f1 �PQe�- N.C.
(Waterbody) (City/Town and/or County) ,�
Agent's Name #: &re go [Irt Mailing Address: S ite N 1Mnt= f'
Agent's phone #: 91i5
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal. „� 6Q bk
-------------------------------------------------- rju _"-`-�,-! 5 s`----------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
/q 'e w Q.. L�t
Lao
?, :s
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 http://wvrw.nccoastaimanapement.net/web1cm1staff iistinq or by calling 1-888-4RCOAST.
No response is considered the same as no obiection if you have been notified by Certified Mail.
(Pro erty Owner Information)
Signature / 0il%JrJ
am Y 6 eeden
Print or Type Name
Po ,Boy .2-7,1
Mailing Ad/dress
11i of ur%-,1- X G
Print or Type me
17q
� �4l
City/StatelZip
`ty/State/Zip

-GEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to Wtlt'ratn 8 ra4E C?% 's
/- J (Name of Property Owner)
(Address, Lot, Bi K oad, etc.)
on GHQ nth in Holdeo &xnQ , N.C.
(Waterbody) j (City/Town and/or County)
Agents Name #: ire °t�t1 Mailing Address: 15d2 S&e dAramry
Agent's phone #: 916 - 10 ^ 1 SIO �.1 ccA� AJC
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal. 0 15 ' -.4;4-}, back
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must flit in description below or attach a site drawing)
`s
�
?!�• , � roe Q
ff you have objections to what is being proposed, you must notify the Division of Coastal Management
MCM) in writing witfiin 10 days of receipt of this notice. Contact information for DCM offices is
available at a*%llurwurreccr�asfar"mar?aoer?�er ei' re � ' :a - or by calling/-888.4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
(Pro rty Owner Information)
Signature 11
toll%tar!7n Breeden Jr
Print or Type Name
A Box o7
Mailing Ad//dress
citylstaftop
Riparian Property Omer Inform ion)
Signature
Print or Type Name
L? Z D k-
Mailing Address
CiiylStateOp

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