66548D - Richardson

CAMA / ❑ DREDGE & FILL �(L /� J %�
ieN ERAL PERMIT ` ` �� / `� Previous permit # A B
�ew El Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources L
)astal Resource& -Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
NaMS6-A Project Location: County � -yl, -
r
u Street Address/ State Road/ Lot #(s)
State�ZIP
lA E-Mail Subdivision
dAgent 1 Cityc ` �,' ZIPO'1
❑ CW A ❑ ES ❑ PITS Phone # ( ) River Basin
❑ OEA HHF IH ❑ USA ❑ N/A Adj. Wtr. Body v�[,\
1-1 PWS:
es fl no PNA yes % �no~" Closest Maj. Wtr. Body
Project/ Activity
<) length
form(s)
'latform(s)
gth
fiber
� Riprap length_
distance offshore
distance offshor
Lnnel 7
c yards /
P
Boatlif f Y
Ildozing
Length W j V
not sure yes nn,
Am: n/a yes
y no
ttached: res no
g permit fa?be required by:
.oval Planning jurisdiction)
(Scale: It J
❑ See note on back regarding River Basin ru

Itr_tDivisjon of Coastal Mgt. Habitat Impact Computer Sheet
pplicant: Permit #. (l c5 16
ate:
U
=scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
ibitat 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 final
disturbance.
Excludes any
restoration and/or
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

NCDENR
North Carolina Department of Environment and
Division of Coastal Management
ly Eaves Perdue Braxton C. Davis
nor Director
Natural Resources
Dee Freeme
Secretai
AGENT AUTHORIZATION FORM
Date: 12- —/l
of Property Owner Applying for Permit: Name of Authorized Agent for this project:
's Mailing Address:
9 Q2owicK
k24-e T Tr . NC Zk Z Z 4p
Number (2"
Agent's Mailing Address:
139
Phone Number (336) l0 3? — �?%'ISI
that I have authorized the agent listed above to act on my behalf, for the purpose of applying
obtaining all CAMA Permits necessary to install or construct the following (activity):
r property located at 3 8' "1 e N STD r, 04 all* AZE MA"eo-, I-tc- 2-kV&I
�rtification is valid thru (date)
a�, �P Z
Property Owner Signature Date pCM WEt,AENG ON NG

Date 6 //o h1k
RE: CAMA Application Notification
Dear 5jr
This letter is to inform you that I have applied for arPfiner CAMA Permit on
my property located at Lot 5e) , Block 3 K , Section with a
physical address of 38T j,AWje-A� S7iagF T ,
Ocean Isle Beach, North Carolina. CAMA regulations require me to notify
you of my intentions. I have enclosed a copy of my permit application and a
copy of the proposed project drawing.
If you have any questions on my proposed project, please contact Keith
Dycus, Local CAMA Permit Officer for the Town of Ocean Isle Beach at
910-579-3469.
Sincerely,
0161-- A ktaL kor,
44" o(,4'4 &cj

AND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERINOORING PILINGSBOATLLFT/BOATHOUSE)
I hereby certify that I own property adjacent to c7,94W 1, K[Gtq:! � f/L�so�!'s
(Name of Property Owner)
property located at 30 GyJ110A1 579WE lxe�
(Lot, Block, Road, etc.)
on 6-17in N.C.
(Waterbody) (Town and/or Country)
Applicant's phone #: 7D�'�5�1���� Mailing Address: 'F11 )
He has described to me, as shown below, the development he is proposing at that location, and, I
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 (IS') 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
-)-' CM 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
Xp--/ 4-.L- Av—7077/_
(Riparian Property Owner Information)
Signature

AND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(TOR A PIER/MOORING PILINGSBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to C7,94 t! Q[Gt 2bsoh�'S
(Name of Property Owner)
property located at ,( A/,Vlo t! S 6
(Lot, Block, Road, etc.)
on , in eU4^- N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 7e54-4W-Mailing Address: ���y /�o/`12-wc
Ala
lv % zgzg 6
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections -to his proposal. I under -stand that a pier/mooring-pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (I5') 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
kI do wish to waive that setback requirement.
------------- ----- ---------7-7-------- 7--------- -------7------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
Y40v I&N 4,me-k 4a
Mailing Address
c,4,6 tie. Zg'2z
(Riparian Property Owner Information)
Signature
TU�� -KaTo OoD S

Homes Si )p
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