66599D - Greif

ICAMA / ❑ DREDGE & FILL j' Q
3.ENERAL PERMIT Previous permit #
fNew El Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources ` G
.oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ` j�
tt ❑ Rules attached.
t Name C V Project Location: County
1 f"� �� Sit ✓� d\! �� Street Address/ State Road/ Lot #(s)
CN''(",k,))S State�J ZIP� j '`. �_�C.
Subdivision
ed Agent
❑ CW
XEW
PTA
❑ OEA
❑ HHF
❑ 1H
❑ PWS:
yes / to)
PNA
yes / no
' Project/I Activity
1 V� S )
:k)length
►tform(s)
Platform(s) b
ngth /
nber
f/ Riprap len
distance offshore
x distance bffshore
,
cannel
sic ds
ip
se/ oadi
ame 3 XI
❑ ES ❑ PTS
❑ URA ❑ N/A
City f �C1� ��G{( ZIP q S�
Phone # ( ��- River Basin L t' VA
Adj. Wtr. Body C a Vx A' (nat
Closest Maj. Wtr. Body M U-/V
' L
X�C a ,P �k r-� f Vy\ , r F' � C�i f��\Gl U(
Length J U i
not sure yes no
i
um: n/a yes
yes }a�
atached: `Y no %
ig permit may be required by: 1 UW j(�, G I� `'L'► ht G((
_ocal Planning jurisdiction)
(Scale: 1' =
❑ See note on back regarding River Basin rn

NC Division of Coastal Mgt. Habitat Impact Coml
Applicant:
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.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FIB
(Applied for.
(Anticipated final
(Applied for.
(An
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disl
Habitat Name
Choose One
includes any
Excludes any
total includes
Ex<
anticipated
restoration
any anticipated
res
restoration or
and/or temp
restoration or
ten
temp im acts
impact amount)
temp impacts
am
Dredge ❑ Fill ❑ Both ❑ Other
?j H I
� l
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

/06/2016/WED
01.00 PM
P, 001
A DJAC R)pAMAN PROPERTY OWNER STATEMVU
I bmby cerdfx that.I ownpmperty 4aceat to �
.(Name of Prop" ownrr)
propccty lvcsted at 131
N71T—
(I.a2tBlock Road, etc.)
on ZZT �/. WA1940y-�Ce�S iu �O"O&N x hel/ NC.
(T(ms And/or County)
Appuc=rs phone f! 7b �92 7S55D iaug AAdrt= 2 ! Z ►.., ¢�� t�e ✓
Hoc tins descried io nat, as shown below, the dwol,pp�t � is propos;u�g at that ioc�iaan, aud, I
have xto objections tv his praposaL I wudersEsnd out a pier/mooring pegs / boaft / boathmno
umstbe set buck a miz== distance cffifteanfeet (Ij� fn= Syr azea of npa= accm unless
waavcd by xnc• (UY'DU wish to WO&O the settrick, pan auu9# inrtiaa the appropriate bl ;k
beWw.)
IA229t wish to waive
I —do wish to Nma that sciback aeq*exneni
DES ION AWOR DA&WING OF PROPOSED DEMOP ':
(To be filled in by lndTvldkat proposing demdop mcmt)
SSeE A 777AGL/i--j) PP —A wit.i -
(Xaformatie u for Prop" O AmfybB ( ya,� proper(, O�uer Ii+foxma4on)
for I'txmfij
214 7 SA *110Y L% U� R 0
Muffin Addtrzs - -
C" 'p
70 B9Z 75"
4,4 �h, 1*3
� � fry Si�natnre
Piriak oar'Y`ype N�ae
*qga- ego

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIEI?IMOOB YG PIZWGSIBOATLnMBOATHOOSE)
I hereby certify that I own property adjacent to
%� (Name of Property Owner)
property located at 13 / 0 4- Pa ! AJ
.(Lot, Bloc/k� Road, etc-)
�a
on 89 � Q�c�E s , in
Mat"body) ,
Applicant's phone #• 708 % Z 7.55
(Town and/or County)
N.C.
Mailing Address: Zl V Z && N o -_Ce— Pic
o�,v �L, us NC 2;a�,
He has described to me, as shown below, the development he is proposing at that Iodation, and, l
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15D 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 not wish to waive
I do wish to waive that setback -requirement_
.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
Mailing Address
ca4/4C-L,0s
NO, 29031
(Riparian Property Owner Information)
Signature
City/4tate/Zip
Prin+

North - - >
Canal JI
[71
W4
1 WO floating dock
2'1
� 1 t----IUPJ
23ft boat
12' v
;k Extension —
Ramp H Existing Dock

Canal
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b
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( Extension
;amp
1
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w
0
N
O
North --
'i WO floating dock
9
it
�j R E)dsting Dock
- - -----......... Ir
\'23fit boat