69411D - Normann

(CAM4 / DREDGE & FILL
'E7esources
L PERMIT V,/ �/y\ Previous permit # A B
rv�Modification I C uwlete Reissue ❑Partial Reissue Date previous permit issued
^ized bo ar '- partment of Environment and Natural Resources
:oastalmmission in an area of environmental concern pursuant to 15A NCAC C%�� • W
N��mc�r►n I�tl�ty S u�tti N� �n if N�� flc fi oyej,
Rules anached.
t Name_ �� ������ �� f j I � � � Project Location: County �
12 2 U 44.44 (. Li 1 �I 1,4 Street Address/ State Road/ Lot #(s) �Cj 2)14L
L1 1jYd State NL ZIP ��jJ, [ aW
(1) VV 1�E-mail 110WAI n • ��Lt G ui l GA►� Subdivision
ed Agent MA a r Lt Wa fis Citytt l 111l 1 TcIUn ZIP28W L
❑ CW �EW �XPTA ❑ ES ❑ PTS Phone # ( ) — 1 River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ WA
Adj. Wtr. Body A I j11w i
❑ PWS:
Closest Maj. Wtr. Body
i'
F)es no PNA yes no ff
f Project/ Activity {� (� W 7 a, f Ch �V {
✓il ph%a C_Afu,Aci1 • (Scale:
ck)length to IX I q 7
atform(s) 01, -
Platform(sk �!
c
1 - ---t� !_ ...._._ l n l._.. ... I lali A—
ier(s)
■■N Mu■ NEW!
bic yards_
np
ise/ Boatlift
ulldozing
)y- III
■■■i■■uiu■iii■
yes no NEW V■■■■■■■
yes no
4ttached: yes a :�—t
A 11
ng permit maybe required by: N c AP nY{: (t)• ❑ See note on back regarding River Basin r
I nrnl Plannino hiricriirtinnl

®�CAMA / DREDGE A FILL
)�U 69411 A B C
ENERAL PERMIT
Previous permit #_
New Modification Complete Reissue
Partial Reissue Date previous permit issued_
As aurhor zed by the State of North Carolina, Department or Environment and Natural Resources 1U f
and the Coastal Resources Commtsston m an area of en—onmentai concern purs,;ant to I SA NCAC GI /' 1. ('7C 6 ,
Applicant Name 19jj ( ro Ij uty Sl1'vN Lr► ov)
1 `u W Project Location. County tidy` !•Mill L (jam -- ---
Address �Z1G kIIG�(�{�! (�tty{
SttrreetAddress State Road, Lot #(s) 'S �
City Jf1l1�j;11� State�L ZIPL13A-'
' CG�L�IX [44L—L
Phone # 1 ql(i) ll t! �>t' I E-11,1 6'141 0111 . WILI i114411 t,*- Subdrvrsion
-
Authorized Agent klitI LE l'An.�
'k i
C
C"Akll#t><IV i(1y/t,t�v,�_ SIP It ill
Affected Cw AEW XFTA Es PTS
Phone # (I1b ) L ' -qIIL River Basin Oily '�-11r'
AECIsj: OEA HHF PH USA N A
oyes
Ad Wtr. Body A I to.i.
I Y na Oman /unkn)
---_-_ .—
ORW es nu PNA yes ro
,�J1 )J ([[��
Closest Mal, Wtr Body )uid riLtt Sth'Lliq
i
�i
Type of Project' Activity
" i
`x
(scale: Li �.
11 IIJJ
er lei iengrn 4' ��15'
P.acdPiatfornvst hr'Xlri 'LLrt►C't�
f Piaclom,i
r
k{ 1%w
,,,.��♦+1%
banng
tinge. aterui
Groin ieirylth
V 1C1``�iiWj\Vdd ��
\
k,�
Bulkhead- Rtfvap Mn
t��1
1
\V R4`�
\ v
avg dis[.v¢e offsho —
t �
♦�� � �' -
�--- — I
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mar dstance offshv
l.ta/irV)
t
•
!
tr�
Boat ramp
al
( C�
Bwtnouse "OftPoLt
p
Brach 9.11cl <,ng
Other al. jIZU'
I
Y �;uaa� t
(I
I�^�
{d
r�
Shn.eine Length +�' 2tJ y
SAY n«sur res na
.t�,
`� �YISt)Ik� ljulr I1xeU:j
Mo-normm yes
`.'
Photos yes C"''
wAner Attxned yM
'V.lni(Ltt11 {'llty al, �t�t{I►�1 �;� �)111�
-d:t+^++'t
A twilding permit maybe required by Nt is Rall j`Y {1
U _ _ See note on back regarding River Basin rules.
-
f Note Local Planamg jurisdiction r',i L
,/
Notes/ Special Conditions 5�'17 LLL11ACLt� LL(Al, SILItt✓ hilit l(Ah.&Af V641Ptiti7L)s,i c;!71. b Ei tVt
,A is nl 4 1Oltlrlc 1, Vvi- iul h . 1 I i:1Mittvit1 i
/ erma Off s Pon d Ja
nitancesmac tateentonbkofpermrt"* Stgnat e J
L6Lt'� it j3�70 -3f 13/lctb
Aopi.caoa.. Gheck r bs�ing Date Ezpiratrtsn Dale

Letter of agent
I ( &�OrfAae► a have retained Mark Clements DBA, Clements
Marine Construction Inc, to make application for any and all permits needed to start
construction on the work requested for our property or properties.
By allowing Mr. Clements to make such applications I do understand that this will in no
way relieve me of any obligations to perform all work according to the building codes of
North Carolina, CAMA, DWQ or any other state and or county ordinances.
l %
Pru}t�a ,
SignA_jW_
date . •-/
f�
Contact information J
IN Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
AA/a/,✓W�� n�c z�r�Q3
A. na
6
B. Received by
O Agent
C. Date of Delivery
D. Is delivery address different from item 1? Yew
If YES, enter delivefR@@@ E6w. ❑ No
DCM WILMINGTON, NC
NOV 13 2017
3. Service Type ❑ Priority Mail Express®
❑ Adult Signature ❑ Registgred MailTM
n Art..it.gi . + .o

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 6eJ No rian is
(Name of Property Owner)
property located at 8534 Bald Eagle Lane
(Lot, Block, Road, etc.)
on AICW in New Hanover County N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 910 - 6 2 0- 9 5 0 5 Mailing Address: 112 Circle Drive
Hampstead NC 28443
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (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 not wish to waive
1 do wish to waive that setback requirement.
----------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
SEE ATTACHED DRAWING
---------------------------------------------------------------------------------------------------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
112 Circle Drive
Mailing Address
Signature
Hampstead NC 28443
City/State/Zip
Print or Type Name