67242D - Gibson

CAMA / ❑ DREDGE & FILL ILb,-
A B
PENERAL PERMIT ( Previous permit #
New '—Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources 6 ^ to Jr t ` n
oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC uL U t"'� �� J �(
1^ ❑ Rules attac ed.
Name � JY`\{ �j t �S r 1 ` Project Location: County O, V
Street Address/ State Road/ Lot #(s)
State ZIP ; b Vti
ail Subdivision
-�
�d Agent SO' M IN1yy O�v lk fC�i�t/yV �� a /�� V� f_'l1�lL' ZIP
❑ CW Ew XPTA 1�ES XPTS Phone # (��U ) ' 4 �1 River Basin
❑ OEA r ❑� HHF ❑ IH �❑`UBA � ❑ N/A Adj. Wtr. Body A ' (nat
❑ PWS:
fes / no PNA yes /�i'o, Closest Maj. Wtr. Body
Activity
k) length
�V -7 ' �I
dorms) % Z
'latform(s)_
gth
fiber
Riprap lengthC_�
distance offshore
distance offshoge��, j
Lnnel
c yards
e/ oatl�`t S j
Ildozing
x 0
Length j O I
—{•-
jAl
it
_Y
.7 F ' 7
not sure yes 'ono) .. �
im: n/a yes no'
Yes
ached: ye no /
3 permit may be required by: CW
Dcal Planning Jurisdiction)
---­ ----- ,! . 1 x-711 1 _ It %A 1 .. 11 141
❑ See note on back regarding River Basin ru

MC Division of Coastal Mgt. Habitat 1..mPact Computer Sheet
Applicant: Cj.I�St� Permit:
Date:
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied..for.
Disturbance total
includes any
anticipated
restoration or
tempimpacts)
FINAL Sq. Ft
(Antcpated final
disturbance.
ExpMdesany
restoration
and/or temp
impact amoun
TOTAL Feet
(Applied tor..
Disturbance
total includes
any anticipated
restoration or
temp impacts.)
FINAL Feet
(Anticipatedfinal
disturbance.
Excludes any
restoration and/or
temp impact
amount)
V
Dredge ❑ Fill Both ❑ Other ❑
C7
V V
Dredge ❑
Fill Both ❑ Other ❑
d p
( fl .0
Q (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 Q Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑

.A�..._.m
WDENK
North Carolina Department of Environment and ;`Natural Resour,--es
Division of Coastal Management
ael F. Easley, Govemor Charles S. Jones, Director
Authorized agent Consent Agreement
!y iiiliam G. Ross Jr.. Secre!ary
tx" M rh t I Ilama n is hereby authorized to act on my behalf
;Printed Name of Agent)
er to obtain any CAMA permit(s) required for the property listed below. The authorization is limited to the
1c activities described in the attached sketch.
kT€ON OF PROJECT:
'ERTY OWNER MAILING ADDRESS:
S c)Cri1t�5 C[i i�.
y Z -7
PHONE NO.
CAR€ZED AGENT MAILING ADDRESS:
43c"Ck'I '-s k+ 5
PHONE NO. fife, _L1 3 " 49
ure of Properly Owner:
�✓ r
ure of Authorized Agent:
,,I, h " . , i

127 Durham St. Derek Gibson 001.1pg
Name of -Individual Applying For Permit: i
Address of Propertjv; (117 blic ho M 1-134 RIO W eA
(Lot or` S,"dt #,,.-Street or Road)
6>riunwi�k'
(City and County)
I hereby certify that I own property adjacent to the aboi-v'e-referenced property.. The individual
applying for this. permit has described to nio.as shown on the attached drawing the developmen . t1hey
are proposing. A description or drawing, with dimentionisshould be provided with this letter.
1 have no_objections to' this -pr9pow.
If you have objections to what is *b6bg proposed, please write- the I)ivision of Coastal
M*11112gemep4 127 CVdjual Drive Extension, NVIlirlinton-, NC 28405 or call 9.10-305-3900
withiti 10,dAyscif-rOceipt,ofthis.iiotict. No retp—onse-is:considered the same us no . opiection if
you. have bee' notified by Certified Mail:
WAIVERSECTION
I understand that a pier, dock, mooring pilings, breakwatee,-boat
lioute or-lboat lift -must be set
lick a minimum distance of 151 from my area of riparian access - unless waived by . mc 'Wyou
wish to waive the setback,.you-must -must initial the nppFop*;te'b1ank below.-)
I do wish to wail the 15' setback requitement.
1 %& not wish to waive the 15' setback repirement.
-7Dq ­�7G -S78'l
Telephone Nu m*ber with Area
S:`.camishells,nparianproperty.frm
WA .
i A.
NCDENR
Code

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: bece-k (1 ko %A
Address of Property: I0-7 Dvr rlQ M -St-
(Lot or Street #, Street or Road)
r3-each N (- a
(City and County)
I hereby certify that I own pFoperty adjacent to the above -referenced property. The individt
applying for this permit has escribed to me as shown on the attached drawing the development th
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coast
Management, 127 Cardinal Drive Extension, Wilmington, NC 23405 or call 910-395-391
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be s
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (Ify(
wish to waive the setback, you must initial the appropriate blank below.)
Blw— I do wish to waive the 15' setback requirement.
Ad" I do not wish to waive the 15' setback requirement.
Sign Name Date
rl)
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