69250D - Mainous

AMA / Lj DREDGE & FILL
Irize
E N E RAL PERMIT �� Previous permit # A B
ew ]Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
d by the State of North Carolina, Department of Environment and Natural Resources �' ` j
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC ) P ! � O
❑ Rules attached.
nt Name d G S Zyj Project I ry VIM SLyi
.� Location: County
s %� Street Address/ State Road/ Lot #(s)
State ZIF' ` W ( 1� s `
0 �U) n2 E-Mail (AGlth OVS (AD (bAlv)1►'tf v. [t w% Subdivision —1 _` t
zed Agent jot( �`//W614-wY►'�Gt VI City �a R 1/` / -r( 4 ZIP N b i
❑ CW EW JE7 PTA ❑ ES ❑ PTS r hone (` 1 G) `1 3—q F 19 (River Basin b(�
❑ OEA ' ❑ HHF / ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body ��t a y 6a
PWS:
yes / ao) PNA yes / 4 Closest Maj. Wtr. Body i ,44/V
if Project/ Activity 1Q-471 ( t' ? X Qh
ock) length
'latform(s) _
g Platform(s)
length
umber
ad/ Riprap length
✓g distance offshc
lax distance offsh
:hannel
■■■■■■■■■I■■■■■■■■1
Bulldozing
No Q NMI
■■EWF W■1■■■■P'J■■ A ■■■1
�` ■■■■■■i■■■ice■■i■■■■i
(Scale: ( r,
❑ See note on back regarding River Basin
if

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ua.nvvaici mannc v�nau uwvu n..
6/21/2017
Allied Marine Contractors
6/21/2017
Backwater Marine Construction Inc.
6/21/2017,
Backwater Marine Construction Inc.
6/21/2017'
Roger Bilheimer or Courtney Muller
6/21/2017 '
H&H Builders LLC
Russell Davis
Joseph Mainous_
Jim Treadwell
same
Bill Sandersc
First Citizens Bank
5641
BB&T
2912
BB&T
2911
Wells
7151
First Citizens Bank
3918
Fargo Bank
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$200.00 GP 69145D
$200.00 GP 69250D
$200.00 GP 69251D _
$200.00 GP 69267D

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant d S �,hirv� Permit #: V50---(�s
Date:
o
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
(Applied for.
Disturbance
total includes
any anticipated
restoration or
tempimpacts)_amount
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
/
Dredge [IFill El [IOther
`
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 ❑

ca: WCrory
:;cver�or
KNORR
North Carolina Department of E^vironment and Natura► Resources
N.0 Diwsior of Coastal Management
John E.
9
AGENT AUTHORIZATION FORM
Date CQ --12'-�7
Name of Property Owner Applying for Permit Name of Authorized Agent for this proge
Owner's Mailing Address
Email✓�-��t�(Oc(�� Ur11��✓'. C O
Phone / RR �1 �
Agent's Mailing Address:
190
Ernad
i certdy that I have authorized the agent Irsted above to act on my behalf, for the purpose of applyin
for and obtaining all CAMAPermits necess"to install or construct the following (activity)
For my property located at l / Gf 46✓ y S r'. e- /

Y
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Nsme of Properly Owner — O -e t Q
Address of Property _ —1 A
lot ir 5-eel # twm of moan u;ry e Ccwnhl
Agents Name a LZ4 /as M&ling Aoo•ess 6 7
Awl's phone is 9/v Yy 3" `,f c5 ci,i
I hereby Certify that I own property adjacent to the above referenced property The ndrviduai
applyinq for this permit has described to me as shown on the attached drownthe development
they re proposing A ae3 tDtton Qr drawn with dimensions must be provided with this letter
`,q�p _ I ha�c nu ubtecltun. to this pro x,%o, I haveub)coions iv this proposal
yy '� M you hays obj*euons to what Is Doing prvpoetsd, you must noddy thtr D+»store or Coasts! U*mq*mi nt fDGtj in
wrtdng wfthln 10 days of mco+pt of th,s notice Corrospondonce should be mailed to 127 C&ranat DrWe Ert,
Klmingttl++, NC, 28405-3843 DCN roprgantstevas can also ba eontaerod of [phone] No rrsponss is
considered tho same as no otq*ctron d you how boon nodned by Cortlttsd Mall
WAIVER SECTION
I understand that a pier. dock. mooring pa rigs, breakwater, boathouse, lift, or groin 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 Wank below ;
"?p t do rush to wave the 15' setback recuirement
I do not wish to warve the 15 setback requirement
(propo7T,-�4,7
Ojo�.rftu )
ctp i+
I Signal tyre
,4 a,-,e L /4 <
Print a Type Name
...1 VL 7
Ms" Address
,is"m Proporty Owner Information)
- .SiXnururr
La d r , S
p,�nt rs• T drib
�101 ly-mou-�I vid
Mailing Address

f
CERTIFIED MAIL • RETURN RECEIPT REQUEST
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORA
Name of Property Owner
Address of Property.
0
(Lot or Street tt Street or noao_ (,icy a County)
Ag en is Name is�4c, Ma1ir,9 Address
Agent's phone it �/� - y�i 3' `ci c�jfj
r1
I hereby Certify that I own property adjacent to the above referenced property. The in&
applying for this permit has described to me as shown on the attached drawing the develof
they roposrng A description or drawmp with dimensions must be Orpvidd wit
h this le
�� I have no objections to this prufw>ai. I haNc ubjcctions to this proposal.
ff You haw objections to what is Doing proposed, you must nobly the Division oI Coastal Atamgemont (D
wrttfng wfthin 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drly
K%mington, NC, 28405-3845. &CM representatives can also be contacted at [phone]. No respo
considered the same as no objection it you have bean notWiod by Cort/hed Mail
wAI'VER SECTION
I understand that a pier, dock, moonng pilings, breakwater, boathouse, lift, or groin must be
hack a minimum distance of 15' from my area of riparian access unless waived by me (If yc
wrs to aive the setback, you must initial the appropriate blank below ;
Irv, i do msh to waive the 15' setback requirement �<a�
I do not wish to waive the t 5' setback requirement.
(Property Zn, ofrrt8ti ) A a er
Signature .Signature
Ao� /,4 <
r'mati,

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