69410D - Edwards

CAMA / 1 DREDGE & FILL �a•�, �j A B
'ENERAL PERMIT Previous permit #
Date previous permit issued
Ne.+d ❑Modification []Complete Reissue El Partial Reissue
ized by the State of North Carolina, Department of Environment and Natural Resources ,. -1 {' (1 , -�
environmental concern pursuant to I SA NCAC
coastal Resources Commission in an area of
LJ Rules attached.
Name Jt. b1 to �� 6� Gt I � l
Project Location: County N Q l,l [ I 0 f i t- P
1
re ei, L� (.2c Ci cl
Street Address/ State Road/ Lot #(s) rj SL1,01 Ci i
(I J)-e ( { 1 State N L ZIP S-
! `L lilt
Subdivision aGi Ili V t
edAgent DO(1i7e( Sttirl-e°j
City lil�1 V111061bi✓j ZIP 2H)j
'� ES
i� `)t `PI a J Basin l G N
hone # (! ) River —�---
❑ CW El EW PTA )�PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body cc I (k s < < c� e� b i f ( (nat /c
❑ PWS:
fifi t
Closest Maj. Wtr. Body lv
yes / no PNA yes /,ono
'Project/Activity i►I� �l��i Ititw yi►��) �JU)��LfGIG�
v i:i l£t1��11 2 I�Gi�trvt/(Ip
tin -h►►-11tv
!ngth \
amber
td/'Aiprap length C1 C/
g distance offshore 2
ax distance offshore 2
ine Length t/I fC•
not sure yes nq
(Scale: VI,1
xium: ( h/a` yes no
>: yes I t i,l C a Ox a l 11
r Attached: yes no
ding permit may be required by: 1 S1(t ( 1 d/,NQ �t. ! ! (,vf.v CO ilFif� See note on back regarding River Basin

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
, 014AJ C/lw42tQS
Mailing Address:
/2 0 / 0" lol us13�2�
Cm py— 2'7 5/( o
I certify that I have authorized (agent) A s/HRc y to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) A26-Ai 73 u Lk N
at (my property located at) 5 Svu,-Jb S O i
This certification is valid thru (date) /01 11 LE
ner Signature
Date

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner SOH (4:dW*/MS -- u
Address of Property 5 ,Ot rnl ilk PC, 1,114M--AktV(% AX- �l �L—
(Lot or Street t. Street or Road City b Counlyi
Agents Name 8 D)4,oUtb`L R2�L7E MaihngAddress' 350(0 77T LL-Lti4 �—
Agent s phone * q1y` - 394 - R ; iur,-� NG 2 yd
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. s description or drawing, with dimensions must be provided with this letter.
zI ha%c no ob_jectitnu to this I ha%C objections it) this propowl.
N you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCAf) in writing within 10 days of receipt of this notice. Contact iMormation for DCM off cos is
available at or by calling 1-8884RCOAST.
No response is considered the some as no objection if you have been notified by Cwt*od Steil.
WAIVER SECTION
I understand that a pier, dock. mooring pilings boat ramp breakwater boathouse or lift must
be set back a minimum distance of 15from my area of riparian access unless waived by me (if
you wish to waive the setback, you must initial the appropriate blank below )
A)
1� I do wish to waive the 15' setback requirement
,� , I do not wish to waive the 15 setback requirement
(Property Owner Information)
.SiXrrW Jfe� f --
Print or T/pe Name
Marking Addhtss
r; L , _. 111 _
C /Star ip �
r0019,06
z;;zz:;T
on)
81,giuirirn.
Su*noer f lAc.h,
Pohl nr'ype Name
eQ-ol W O�q
O
Madincr AldieSS � . G
14&
Cdylstal p
-43c.- 8
Telephone Ndmbar r Emad Address
11In117
Toievhone Number! Email Ad"SS
,//—/—/,7

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
i
Name of Property Owner: KoLn
Address of Property: � S0 /m l s C— a4
(Lot or Street *, Street or Road, City & County)
Agent's Name* �V+NiEL S%%/'.L��/ Mailing Address: 3506 7111E Qi✓C- C7—
Agent's phone *: ?i0 - --,y(c — 999 3
I hereby certify that i own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are proposing. A description or drawiru7, with dimensions, must be provided with this letter.
I have no objections to this proposal. _ . _ I ha,,e objections to this proposal.
10 have ob Ai Wom to what is babg proposed you must notify the Division of CaasL1 Management
(DCAO in wHUV wfdrbr 10 deys of receipt of thus notice. Contact brfomof ri for DCU oflc" is
avaffitb/eathag Arvw.nccoostalmanaaement.netnveylcar'stagy=listinvorbycafbngf-8884RCOAST.
No response Is consAdered the same as no objection g you have bow no~by CerdlUid Nail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 15' 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 wish to waive the 15' setback requirement.
-Al 1 do not wish to waive the 15' setback requirernerit.
(Property O Information) i
CHI 65ew �
Pnni or Type Name
Mailing Address
City *) -7 I
Owner Information)
Print or Type Name
Mailing Address r
l ocrt ilk c- a'IS7n'�
City/StateiLp
(w? -1 ot�-1�u,�- se-

5 Sounds Pt
x
'IV
November 9, /3��
20�7 0012
Roads i�� Co —`�~--

r.
r
�Y

NC Division of Coastal Mgt. Habitat Impact Comp
Applicant: L " \ wXV
Date: `l/I
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
FIN
(Applied for.
(Anticipated final
(Applied for.
(Ant
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disti
Habitat Name
Choose One
includes any
Excludes any
total includes
Excl
anticipated
restoration
any anticipated
rest,
restoration or
and/or temp
restoration or
teml
temp impacts)
impact amount)
temp impacts
amc
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑