69427D - Lewis

:AM{A / ❑ DREDGE & FILL
A B
EN RAL PERMIT
!a' Previous permit #
Date previous permit issued
Jew odification []Complete Reissue
❑Partial Reissue
ted by t e Stof North Carolina, Department of Environment and Natural Resources011­ I l 7 /' 1 J
ate
>astal Resources Commission in an area of environmental concern pursuant to 15A NCAC d ❑ Rules attached.
4 I i c, 6 t i
Name �� � h4'l � i "1 �"ti� ��. �1
Project Location: County iV
1
Street Address/ State Road/ Lot #(s)
State ZIP
201 E-Mail G{f ve T' 0 ,Subdivision
AAgent INk61;�� l�
City ZIP l�
❑ CW 1� Ew rm ❑ ES ❑ PTS
'i
.l hone # River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body
❑ PWS:
des / no PNA es / no
Closest Maj. Wtr. Body
Y°(Ll�hl)l�lVr �'�l�t�1l�� -�/i[(1
Project/ Activity I
r
c T—' i n r—�7
i�Y,TI- (Scale:
=k) length X 1
itform(s) Xl(C �<<1
Platform(s)
ngth
tuber
d/ Riprap li
g distance 1
ax distance
hannel
ibic yards
mp
use(Boatllift y 17
Wldoz'hg
ne Length
bot sGft-, yes no
>rium: ` n a yes no
yes no
Attached: yes if r j
ding permit may be required by: N Y L �' i 4 k ('-1 {n 1 i ❑ See note on back regarding River Basin

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant:
Date:
Describe below the 14ABIT4F 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
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts
amount)
W
Dredge ❑ Fill ❑ Both ❑ Other
�vO
W
Dredge ❑ Fill ❑ Both ❑ Other
V
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

N.C. DIVISION OF COASTAL MANAGEMENT
i
AGENT AUTHORIZATION FORM
Date
Vame of Property Owner Applying for Permit:
Zailing Address:
DUM WILMINGTON,
NOV 2 7 2017
:ertify that I have authorized (agent) ��/��--- Jto act i
half, for the purpose of applying for and obtaining all CAMA Permits necessary to
tall or construct (activity) iU�7�.� 47 `tc- t t'-1
;my property located at)
1-7 2 S -r" --e H- R 4
i certification is valid thru (date)

DMSION OF COASTAL MANAGEMENT
►DJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
as of Fropmy. / 725 �'c ��N Cez6&-K 2M Ail c P, i j: ,, ve--<
(Lot or Street ti, Street or Road, City 3 County)
)by certify that I own property adjacent to the above referenced property. The individual
ing for this permit has described to me as shown on the attached dnswing_the development
7tre. A descxintion or drawino. with dimensions_vided with this letter.
I :ve�no objections to this proposal. I have objections to this proposal.
have objections to what Is being proposed, you must notify the Division of Coastal Manspsrnant
) in writing within 10 days of receipt of this notice. Contact Information for DCM offices is
Ible at hti Ylwww.ncconstalmanacementno web✓cmtstaff4isdno or by calling 14MMWRCOAST.
dponse is considered the same as no obloctlon N you have bow notified by Certified Mall.
WAIVER SECTION
erstand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift muse-` — EC
3t back a minimum distance of 16 from my area of riparian access unless waived by me. MANGTON
vish to waive the setback, you must initial the appropriate blank below.) NOV 2 2 2017
I do wish to waive the 15' setback requirement.
I do not wish to waive the 16 setback requirement.
Information)
alure
ON
or iType Ya
Z1�011E� Rd.
(Riparian Property Owner Information)
Signature
If� VAC1%
Pifnt or Type Name
1721 F,1�4 Cree � xd

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner. Z-Z2,,C- LA7v1,15
Address of Property: 1"7 2 ' ruTGtl CrU K /Z,4j tv iu- "J TON 1 ,V6kv 1hiv ,ova
(Lot or Street 8, Street or Road, City 3 County)
Agent'sNamet
DAN+L-Sfr2LL�
Mailing Address: 350G
7'AC-L- P,,v C�v—
Agent's phone #:
"/C
Z_EY O !2
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 drawing. with dimensions. must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
g you have objections to what Is being proposed, you must notify the Division of Coastal Management
(DCM) In writing within 10 days of receipt of this notice. Contact information for DCM oft9ces Is
available of htto//www.nccoestalmanaoementnetiweb/cm/staff-listing orby calling 1-$88-4RCOAST.
No royonse is considwed the same as no oidection tf you have been notiy d by CorWied Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must �-) EC V E
be set back a minimum distance of 15' from my area of riparian access unless waived by ft1JKW1LM1NGT0
you wish to waive the setback, you must Initial the appropriate blank below.)
/J/t" I do wish to waive the 15' setback requirement.
NOV 2 7 2011
I do not wish to waive the 15' setback requirement.
nor Information)
Signature
Print or Type Name
I �
M' aU1lnp Address
Wl✓r�11J��1"� I
{R� n Propo Ow br Information)
S' lure
,T.s�y � 1A/�i/�2.av ✓
Print or Type Name ,ten
/ /a O/ /�vi Ghl e t
MalUng Address
01YISta�p
a e
TefthQm Number fEmail Address
Clty/Staftop
Talanhnnw Mumhar / Finall d nwec

y
e w
}
k
k
1

1
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: STE�UE LAZLI1 S
Address of Property: I7 2-S �C►2L-EK /Z,\ 1, i4-- -NG7orV ; AVrA-,, jrlevvj/
(Lot or Street #, Street or Road, City & County)
Agent's Name #: D/ /v, LZZ
Agent's phone #: 1/0 " 39(l - 8�83
Mailing Address:
350G 7-4LL- P, UC- Gi
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 drawing, with dimensions, must be provided with this letter.
//-X—1 I have no objections to this proposal. I have objections to this proposal.
ff you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http://www.nccoastaimana_qement.netlweblcm/staff-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
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.)
AJA— I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
nor Information)
Signature
C003
Print or Type Name
�eex
Mailing Address /i (
City/State, ip
(Ri n Prope Ow gr Information)
Sig0rature
JA/yJLTs l✓N�Zic✓
Print or Type Name
Mailing Address
IV ;-K q11
City/State2ip l/ ��

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
Name of Property Owner: GGll v/3
Address of Property: _L
GvIc4-k
(Lot or Street #, Street or Road, City & County
Agent's Name #: 6/4,- 1&,L -- 5-4 Mailing Address: -!;5-o& mac,
Agent's phone #: q/r0�'S8 3 �v�c•� rv-a�y, Ur 'I�y
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 p , posing. A description or drawing. with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
if you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http://www.nccoastalmanagement.netlweb/cm/staff-listing or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
ner Information)
Signature
gtpt-K)
Print or Type Name
1 �-Z
(Riparian Property Owner Information)
Signature
S�Ieve- .
Print or Type Name
1-72 I ��.��� C,, e e Ald

guta<NEAD
i