63208D - Pitts

CAMA / DDREDGE & FILL
!ENERAL PERMIT
❑ ❑ C lete Reissue
i ( /v /G
Previous permit #
slew Modification omp ❑Partial Reissue Date previous permit issued ' t
zed by the State of North Carolina, Department of Environment and Natural Resources
:)astal Resources Commission in an area of environmental concern pursuant to 15A NCAC 1 ❑ Rules attached.
N&nm
t Project Location: County/Street Address/ State Road/ Lot #(s)
30� Fax # (_) Subdivision ZIP
City �(/LY ZIP
.d Agent
❑ C'W i ❑ EW ❑ PTA ❑ ES El PTS Phone # ( ) River Basin
EA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body I nat
❑ PWS: El Closest Maj. Wtr. Body
FC: ' L'�r 6 � �
yes / no PNA yes / no Crit.Hab. yes / no
�\ 4
:k) length_
1(s)
ier(s)
ngth
mber
d/ Riprap k
g distance (
ax distance
hannel
3ulldozing
ne Length f`,}
igs: r
)rium:
(Scale: JLA�
- Attached:
ding permit may be required by:
❑ See note on back regarding River Basin

VC Division of Coastal Mgt. Habitat impact Computer Sheet
,pplicant: ��� Permit #.
)ate:
lescribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremei
)und in your Habitat code sheet.
labitat 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 amoun
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated fir
disturbance.
Excludes any
restoration anc
temp impact
amount)
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 ❑
YL
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both 0 Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

Receipts for
Certified Mail
(Staple Here)
Date
-32., . ear
Adjacent Property Owner
Mailing Address 1 �.f �f "�
D % r 1_ -� __ N C �[ / / 0 /
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, J� / have applied for a CAMA Minor
Property Owner
Permit on my property at 39--260° 0a'h i Lz L in Brunswick
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 336 Y3/i�S� or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Donna F. Coleman
Local Permit Officer for the Town of Oak Island
4601 E. Oak Island Dr.
Oak Island, NC 28465
Sincerely,
x�- k LLAL-
Property Owner
0 7 e -.�f-A V"LS W 1, J
Mailing Address
i.v-S _ Q.C_arlt�]

Receipts for
Certified Mail
(Staple Here)
lt�
Date /
K I rn PA tNLIN C.
Adjacent Property Owner
Mailing Address
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, Kt i h f , 4--f-r-have applied for a CAMA Minor
Property Owner
Permit on my property at 3R a ? w . `3e0,C , �-, ') C , in Brunswick
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 33(,- ?3 I - 4 4 SS ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Donna F. Coleman
Local Permit Officer for the Town of Oak Island
4601 E. Oak Island Dr.
Oak Island, NC 28465
Sincerely,
- �% P
Property Owner
300) clkf".10t v k s`� UJ-
Mailing Address