67174D - Waller

AMA / []DREDGE & FILL KL VAI_1� A B
"ENERAL PERMIT Previous permit#
,New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources —7
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
t Name a f Ma (��0(� l-lff Project Location: County kleo,� C �Ii y
Street Address/ State Road/ Lot #(s)
A State
(�) E-Mail Subdivision —l--
ed Agent N ► i e �Z �(^ !spY1 1 (ii(1 �1 CitY ZIP
❑ CW f�EW 'PTA �S XPTS Phone # ( ) 03 5 River Basin
ElOEA !❑ HHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body nat
❑ PWS: 1 j
yes / no% PNA yes / o Closest Maj. Wtr. Body Al w
Project/ Activity
)00 (Scale:
ck)length
atform(s) _t—
Platform(s)
ier(s)
ngth
-nber
J/ Riprap length IrA '
: distance offshore
x distance offshore J
cannel /
)ic yards
ip
seJ Boatl
Length ^' so.
not sure yes
cum: n/a yes
yes
ktached: yes
ig permit may be required by:
-ocal Planning jurisdiction) I
1 aA6 ' f
1 U �Lt�' ����
`
❑ See note on back regarding River Basin n
( - - --, It
It
it - 1A
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NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Maa U���I�� Permit #:
Date: 0-1 /d�/���•
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
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet FINAL Feet
(Applied for. (Anticipated final
Disturbance disturbance.
total includes Excludes any
any anticipated restoration and/or
restoration or temp impact
temp impacts amount
0(4
Dredge ❑ Fill Both ❑ Other ❑
Dredge ❑ Fill �( Both ❑ Other ❑
J
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 0 Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

38/24/2016
12: 02 423--877-0153 FEDEX OFF I C'E7 05
"27
PAGE 82
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Owner's AkMV Ad&ms:
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f O"fy that I have wj6wi the ggat UW 8WM to so
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purpose of'pptgin�
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PrOPwtY OMW Signature Data
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ACKAa -,nrA>4
DrVMON OF COASTAL, M&,,, AGET CWr
ADJA.M'ff RIPARIAN PROPERTY iDWi" ER STATWSNT
1 hcnby =Y that I oven property adjw--nt to — Lt,,,, {hcL G` ,z ll, r
Prom' located at I .-2 14 �Scu i } ,+ (,L4sme of Property Owner)
an 't �� ((, nfit, Blod�y Road, etr-)
in 1- r{ 'L r1 �' cu(k N.C.
(W;terbodp} (Town and/or Ce®ta�r)
Agplican'sFbO f ;; `� J �i XliagAddress �- -I -i�'}
AelSbe has drsc�bea to au� as stxwo below d�4 , } ,, � , -; , �� c ► , , 1 � � 1 � <� � : _
and I have no objactiam to the proposgj, di�`°'1Dpmcnt bra a pmpostng az tt� ,
DMCRIPTION AND/OR DRAWING OF PROPOS" DLVB.I.APhCtM:
(Zndiv+iduttlPmPatimg devdOPM mt musi fill in description bdow or aftck a site &mvixW)
Ff 7on 6v% objections to what is e — _
xithA 10 daysof re<xi t �" proposed, ude most aotity the DavWon of CoasW Wfaaatemamt � fm j i6 E
p Of this ®once Correspondence shoald be ataatd to 127 CardbW Drive 141
IK-' *"reseatativea caa alto be coulacted at (910) 79&721,& �Ii gtoa, NC
a is ccatidered sam. ao no "m if ou ve been n C
— Mail
P t)' Owner Tnfio�=t k m)
S r �
1 t i li �' iI)t1
Prad or Type Name
Mpg AMU
Cttp1 Stale 1 Zip. .� `� �� �•
(RigsrismFVW4 Ovra�rTn ol7lLfinII)
Prat or Tjrpo Neota .,_ __...
Mailing AddressCity'--
s6
TdeDb om Nember i} i f _ 1., % - , _ :z 1-c _ _ , _ . r, . . - , - , .

CERTI UD MAIL — RETURN RE C'E]p r RE TESTED
DIVISION OF COASTAL IYUNAGEMENT
ADJACENT RIFARLAiN PROPERTY OWiNER STATEMEENI T
I hereby cer* that I own property adjacent to _ 6� Q 0 0" � l Ve -4-
`s
Property located at Game of Property Owner)
(Lo Blo , Road, etc.)(
on � cw0 � C m� �i�n—_. � X�.
e ��. N. C.
Applicant's (ne,erbody) (Town and/or Conaty)
phone #:—�� �— a �, '
HdShe has described to me as shown below the development he/she is proposing at that location,
and I have no obiections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT; y
(Individual proposing development must fill in description below or attach a site drawing)
If you have objections to what is being proposed, you must notify the Division of Coastai il�Isnagemcnt (D�-��
within 10 days of receipt of this notice CorrwNadenee should be mailed to 127 Cardinal Drive Ext Wiimia on, NIn riCng
DCM representatives can also be contacted at [phone].
No response is considered the same as no obiec 6n if You have been notified by Certified
(Property Owner Information)
Sic�gnature
Pant or Type Name
Mailing Address
City /.
(Riparian Prop Owner Information)
a �a AC
Signature
Pnnt or Type Name
Mailing Address
l .itv

CANAL
New Bulkhead wall to enclose access area
Existing
--------------------
Martha Waller
124 5ailflsh Or
lead wall Holden Ugzh NC 2b*2
a I A '121 AAAR
Scope Or Work:
Extend bulkhead Lvall to enclose access area
on north end of lot.
Maintain existing alignment