67252D - Owens

�CAMA / ❑ DREDGE & FILL V l 3,)1 A -7
aENERAL PERMIT Previous permit #
44ew ❑Modification ❑Complete Reissue El Partial 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 C" �' C) G'
`` n ❑ Rules attached.
il�
t Name O Ot d (%1i i Project Location: County i „/�/y� Sty
�/ t-A d,�,] V6 ,-Ai ffll. % Street Address/ State Road/ Lot #(s)
State ZIP' g�� Z ' 1 li 1 t �, `�-( e 1' C4 L
Ob) 1612 I E-Mail Subdivision
ed Agent (� �aV is �dd� �G�S a� City D ZIP
❑CW ❑EW ❑PTA XfS �*M ' F hone # (<< ) %d R�iv/� Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA El W/A Adj. Wtr. Body A Vt 011 (nat k
❑ PWS:
yes / r ) PNA yes / ro) Closest Maj. Wtr. Body 0 ) (A.>
Project/ Activity n 'C 2i1� (,( C X t 7,1\&A4, k\^A Lrtr
,N IC" . `r\A
-k) length
itform(s)
ngth
Aber -
i/ Riprap length Q
distance offshore 0
x distance offshore 0
a Length _ SID I
G
�.�.r........,�
ig permit may be required by:-ri=tTrTe—� IL 1 `
42 f�!"' �% A ❑ See note on back regarding River Basin rL
_ocal Planning jurisdiction)
(Scale: l

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Ov-<A S Permit #:
Date: 02IbYl (-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.
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.
. Excudes any
restoration
and/or temp
impact amount
(Applied for.
Disturbance
total includes
TOTAL Feet[amount)
any anticipatedstoration
restoration or
tempimpacts)
INAL Feet
Anticipated final
isturbance.
xcludes any
and/or
mp impact
Dredge ❑ Fill Both ❑ Other ❑
( D0 0
0 ) a
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 [IBoth ElOther ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge [] Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill [I Both C] Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

vame) I Homer I I Number I amount I Number/ I Refund/Reallocated
ichardson Bill & Bonnie
onstruction Owens
Comments
GP
BB&T 6621 $400.00 67252D
SF rct. 3559D

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson
Governor Director
Dee Freemar
Secretary
AGENT AUTHORIZATION FORM
Date: January 13th,2017
Name of Property Owner Applying for Permit: Name of Authorized Agent for this project:
Bill & Bonnie Owens
Owner's Mailing Address:
3782 Windy Point Rd SW
Supply NC 28462
Will Richardson
Agent's Mailing Address:
3235 Seacrest Ave SW
Supply NC 28462
Phone Number {910) 297-0821 Phone Number f 910 ) 367-0335
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
Installation of Bulhead Wall
(my property located) at _ 1907 West SEa Aire Canal Supply NC 28462
This certification is valid thru (date) 3-17
Property Owner Signature Date

CERTIFIED iVL41L — RETUM-N RECEIPT REQUESTED
DIVISION OF COASTAL IYLkNUGEMENT
ADJACENT RIPARLAN PROPERTY OWNER STATEMENT
I hereby cer ifi that I own property adjacent to
Bill & Bonnie Owens
(y tame of Property Owner)
property located at 1907 West Sea Aire Canal
(Lot, Block, Road, etc.)
on Canal , in Supply
I
N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: [phone] Mailing Address: 3782 Windy Point Road
Supply, NC 28462
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Individual proposing development must fdl in description below or attach a site drawing)
New Bulkhead Wall
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCY1) in writ
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Bit Wilmington, N(
DCM representatives can also be contacted at [phone].
No response is considered the same as no obiection if you have been notified by Certified Mail
(PAAIj rmation) (Riparian Property Owner information)
gnature Signature
Will CRichardson
Print or Type Name
3235 Seacrest Ave. SW
Mailing Address
Supply, NC 28462
William Bland
Print or Type Name
Ro. Box 1445
Mailing Address
Shallotte N.C. 28459

CERTIFIED INTAM—RETLT—N RECEIPT REQUESTED
DIVISION OF CO_-kST_AL TN1A,NAGEAJENT
ADJACENT RI.PARLk-N- PROPERTY OWNER STATEMENT
I hereby certir that I own property adjacent to Bill & Bonnie Owens
property located at
on Canal
{;Tame of Property Owner)
1907 West Sea Aire Canal
(W aterbody)
(Lot, Block, Road, etc.)
in Supply
(Town and/or County)
Applicant's phone [phone] Mailing Address: 3782 Windy Point Road
Supply, NC 28462
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
1$
N.C.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Individual proposing development must fill in description below or attach a site drawing)
New Bulkhead Wall
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCtiI) in writing
within 10 days of receipt of this notice. Correspondence should be mailed to 1227 Cardinal Drive Est Wilmington, NC
DCM representatives ran also be contacted at [phone]-
No response is considered the same as no objection if You have been notified by Certified Mail
(Property Owner Information)
Will C Richardson (Auth. Agent)
Signature
Will CRichardson
Print or Type Name
3235 Seacrest Ave. SW
Mailing Address
Supply, NC 28462
4.parian Property Owner Information)
Sigaatur
Gregory Thomas Gray
Print or Type Name
(A PG o c y (G�
Mailing Address /
( `� D -7 S e l c i e C�d�ce