69324D - Hunter

rCAMA / DREDGE & FILL •� SIB
'ENERAL PERMIT Previous permit# A B
New L_iModification ]Complete Reissue CPartial Reissue Date previous permit issued
-ized by the State of North Carolina, Department of Environment and Natural Resources
.oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC U :7i'i. It j Uo
❑ Rules attached.
t Name 1­�p 6 4�L 4 Project Location: County SVW1%
2 5 -- Street Address/ State Road/ Lot #(s)
OC.� State /J C ZIP
i
(110) ;73''- 6oZ`t E-Mail Subdivision
ed Agent
❑ CW ❑ EW ❑ PTA )<ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
yes /(no ) PNA yes
City
ZIP
Phone # ( River Basin C- F I
Adj. Wtr. Body CA11VL ( (nat /I
Closest Maj. Wtr. Body )4 T�
Project/ Activity O&M T�,, � k 1 4-k A �D
i
(Scale: — ,
:k) length_
Rform(s) _
Platform(s)
igth t .
nber
)Riprap length_(
distance offshore 0
K distance offshore
is yards
p
;e/ABoatliftlld
Length 56
not sure yes qn
um: n/a yes
yes
ttached: yes
g permit may be required by: O' A�
.ocal Planning jurisdiction)
❑ See note on back regarding River Basin
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0710712017 08:01 Gane & Karshner DDS (Fg)9107396246 PAGE
PE002�1100�2
07/06/2017 13:58 9107549894 UPS STORE
/D- 73 — 6- ! 64 .. ....�., ",n,.acww� �ane�oYv nwIJ�R STATEMENT
I hereby certify that I awn Property adja
property located at-r�-
an
(W terbody)
The applica has described to rl�e, as
i have no objection to th
I have objections to this
DESCRIPTION ML
DI
(individual prapostr q devolopn
7 �.—
ulu�
`;/i �15 4&sc) 1 r
understand that a pier, dock, r
minimum 'distance of 15' from
tti
he setback, you must inial the
i do,wish to waive tk
I ,dc not wish to We
(Property (),w � nformation),'
sfgna4we
or
774
�rittig
a'raa
lt0 ,g
{Name of Pro erftwner)
ess, i.at� 13joak, toad, etc:j
Sri o4.0 , N.G.
{CitytTown andlor County)
gun' belbw, thb development: proposed at the 409- a locatiOn,
proposal.
DRAWING -OF PROPOSED Dt=VhLUV 1,'NJ
must -fill, in des;cripiion Wow or attach a M6 drawing}
S r � +e Ad9& 4<f*RA-t35
WAIVER.-SgUION
A inn, bf664AW,' hpathouse, lift, or groin must be set bacl
rif florian amen unlass waived by me. (If you Wish to We!
iate.blank below.)
e 15' skbaok requirement.
is the 15' setback requirement.
(Adja ht Pro owrner Informatlon)
Ignatur�
f ial�i� 45
Print or Type MaMO
/a?.3 _
Mai ing A
city tateMp
G�Y3oq— 3:2(-�p :7

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to BOB Ajb �, Is
(Name of Owner)
property located at ► RS STagr�Q�i�► �>Q
�/ _ (Address, L t, Block, Road, etc.
on �-i l xl �'I�tf�-�'*M�.- �D� in fVLtiA41 S , N.C.
(Waterbody) (City/Town and/or County)
The appli nt has described to me, as shown below, the development proposed at the above loca
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawin
/.V 601D-7% p&/S 7;Ze- Sroc. 4*AC-H0,e 6-e�,etf_
-M,4r /5 4z-So F-.4/!_4AP?
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set k
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to
the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property
Property Owner Inform n)
Print or Type Name
Print or Type Name
ZQ-7 STAie.E-i.S