68570D - Pratt

DRAMA / 7 DREDGE & FILL M,
G5) A B
;ENERAL PERMIT Previous permit #
eew Modification ❑ Complete Reissue Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources —1
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC p r j'1 . IZOO
❑ Rules attached.
t Name os h VOl C r k I tom' i j Project Location: Countyf;i 1
L21 V 0A 6 iYl t C-f ( i7C Street Address/ State Road`/ Lot #(s)
kid VIC ► t State�� ZIP L j 4 ) 3q I , a old, _�ZM 6
(�) E-Mail A 1/*Wbdivision
ad Agent (kV-D 1ti1(1, (a/1 +1N by City/�O(a(AhJS)P Gt( k ZIP 29kG
`
El OEA ❑ NHF El IH A ❑ UBA El N/A Ane �F` ( L)5775-710 River Basin ,
Adj. Wtr. Body _�(j� n'at) /n
❑ PWS:
Vpt i �1 pNe vat i� Closest Maj. Wtr. Body
Project/ Activity
not sure yes no
um: n/a yes n
yes
kttached: yes
ig permit may be required by:
-ocal Planning lurisdiction)
I air D F ftta N -SI-P �K( 1
ai
❑ See note on back regarding River Basin ru

NC Division of Coastal Mgt. Habitat Impact Computer Shee
cant: S
tribe below th HABITAT disturbances for the application.
slues should match the name, and units of measurement found in your Habitat code sheet
Feet FINAL Feet
TOTAL Sq. Ft. FINAL Sq. Ft.
(Applied for. (Anticipated final (Applied for. (Anticipated final
Disturbance disturbance.
Disturbance total disturbance. total includes Excludes any
DISTURB TYPE
includes any Excludes any
)itat Name Choose One anticipated restoration any anticipated restoration and/or
and/or temp restoration or temp impact
restoration or
temp impacts) im act amount temp impacts amount)
C Dredge ❑ Fill ❑
Both ❑ Other
LA Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to M i 1 GLe 1 11. VIa o t.4 Q, i 's
✓� (Name of Property Owner)
property located at Jq V �l I (� ��(� t lb v d
(Lot, Block, Road, etc.) `
on--- c d o %6 lilaIL in -- �)C (� i�i ��lC- � 1J1.�� N.C.
(Waterbody) (Town and/or County)
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.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Applicant Information) (Riparian Property Owner Information)
M�
�Iing Address Signature _

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
Jus�►�.ca i�a-ti ��
I hereby certify that I own property adjacent to rYl i C.,iIQ f- f (� pha rG� F a
property located at 190 V10 b Id So nG
,� (Lot, Block, Road, etc.)
on(0l19 6 W1kod � Q.� in
(Waterbody)
(Name of Property Owner)
Uo/
a12O V) Is I- a C,4-,
(Town and/or County)
's
N.C.
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 (151) from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement
-----------------------------------------------------
-----------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
--------- —-------------- -----------------_--__----------
k—pplicam Information)-------------______--
L ,3 '82IUk-n
ruling Address
(Rip Pro rty er Information)
Si e

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: JQ
C—L
Mailing Address: "i 3 1/1[ fr
Phone Number: -22
Email Address: p J R }
i certify that I have authorized l 'i-Yaj?] i it) /A-
Agent / Contractor '
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: yqw
f '
at my property located at V 1Q I'� ;
in V ``lW County.
1 furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Offrcer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signatur
J . ,�
Print or Type Name
tT {�—
T -Itle
Date

CAROLINA BLUEWATER CONSTRUCTION
Custom Beach, Mainland, and Golf Course Homes
Complete Design / Engineering / Building
6934-9 Beach Dr. SW, Ocean 151e Beach, North Carolina 28469 [phone] J
181-6" 16-0" 22'-9"
L OLD SOUND CREEK
I
---------------------------
--------------- r 10" Piles I
Alum. Dock
I
I I—
I I
- I
O I I
Setback I
M
3.9 I
NORMAL HIGH WATER
LINE AS MARKED BY -
TOWN LPO
Existing Retaining Wall l
& Fence
I
I
I
I
reel #: 257GG014 I
rner. Joy Orlando '
401 Preston Village Way I
Cary, NC 27519
I
1
a
17-6Covered Deck
E
PT Decking
•-�
10'x10'
v
a
5x4' Walkway
3
PT Decking
�
�—{—EDGE OF MARSH
v
rn
Y
15'-0" Setback
4.
d
�{4.2
LOT 76
7,932 SF
Pod Deck --
Stamped Concrete
Decking
Pod 428 SF
12'x 24' X _ ---
8.8 r
Covered
Deck
/ Covered — —
Deck
IT
5.9
Parcel #: 257GG012
Owner Walker Brothers Enterprises,
3301 Fontaine Lane
Glen Allen, Va 23060

11/1/2017Jerry Mills Contruction Inc William Kelley First Ban_ k 1873 $200.00 1 GP 68535D
11/1/20'17 lBackwater Marine Construction Rodney G.Smith BUT 3039 $200.001GP68571D
11/1/20171 IWU Money Order from John West Rick Whitaker Wells Fargo Bank 17-649204322 $200.001GP 68572D
11/1/2017 Kath Lan ford & Thurman Binkley KathrynLangford BB&T 1008 $200.00jGP 68569D
- -—
11/1/2017 F and S Marine Contractors Richard Fisher PNC Bank 66781 $200.001GP MUD reissue of 69319D