69084D - Smith

-! CAMA / DREDGE & FILL
3ENERAL PERMIT �Previous perm t# A B
.New Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
�coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
• Rules attached.
t Name (i,t l t -1 i`� �• �111 I �1 Project Location: County �I
li ',A �V j d I i l 1 l 1{ 4 f Street Address/ State Road/ Lot #(s) ((,) ( l J I a I <I
State ;( ZIP'l LI l 5
I N It E-mail ` �� ( ' 'K-52 6 c(h t7C- (. O Subdivision
ed Agent City -- I I l (i( i i ZIP
❑ CW ❑ EW ❑ PTA XEs N PTs Phone # River Basin if` r
( ) ,
❑ OEA ❑ HHF ElIH El USA Wtr. Bod V C GUSA ❑ N/A AdI j 4 t ( rk '
❑PWS: Y It'�(nt/r
yes / no PNA yes / no Closest Maj. Wtr. Body
' Project/ Activity ' ; (f ; l i I I I n, j-) i i i ! U I ? ('� I i i /
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not sure yes no'
im: n/a yes no)
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ttached: yes ifio
(Scale: I" s
IV g permit may be required by: Q f i D 1 1 Uy Fv I`( t ((1 / / ((ill 1' u $e� note on back regarding River Basin
ocal Planning Jurisdiction)

CAMA / )(DREDGE & FILL
ENERAL PERMIT
lew ❑Modification ❑Complete Reissue El Partial Reissue
N° 69084 A B
Previous permit #
Date previous permit issued_
rized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 04 �1 , 11 (7o
Rules attached.
nt Name f11 Tf M Oq D. Sri (f� Project Location: CountyNe w f1"oye i-
�Q Zb`t lNj �t�Sv1� VC AVt • Street Address/ State Road/Lot#(s)_ILZoq j/V
i/j�WblVlq��l/► State Al& ZIP2POL{O3 AVt_
# (9U) SZb-14 jj E-Mail CIS 021092P Yeth 00. UPP"Subdivision
ized Agent NlA' Cityw i lKA� VLOf�VVI ZIP 2(2?H
d ❑ CW ❑ EW ❑ PTA XES W PTS Phone # () River Basin
❑ OEA ElHHF [IIH ❑ UBA ❑ N/A Adj. Wtr. Body aYQo(I -fd (,ti'&K nat
ElPWS: —�'
yes /(n3 PNA yes / no Closest Maj. Wtr. Body V✓W
A Project/ Activity COYI Strtka ✓12 W rU K+h1X k1t I at,VlA LVA rid COG Pfa
ock) leneth
(Scale: r 0
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ength
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NC Division of coastal Mgt, Habitat impact cc.-Apputer SheOt
Applicant: T[W 5ta��
Date:
Permit #: (000V
Describebelow the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in Your Habitat code sheet. et
TOTAL Sq. Ft.
pIW
(Applied for.
(An*
DISTURB TYPE
Disturbance total
did
Habitat Name
Choose One
includes any .
anticipated
ra
restoration or
atr
temp impacts)
irnps
2— O
Dredge ❑
Fill
Both ❑
Other ❑
r/
Dredge ❑
Fill G1
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 ❑
Dredge ❑
Dredge ❑
Dredge ❑
Dredge 0
Fill ❑
Fill ❑
Fill ❑
Fill ❑
Fill ❑
Both ❑
Both ❑
Both ❑
Both ❑
Both ❑
Other ❑
Other ❑
Other ❑
Other ❑
Other 0
,L Sq. Ft.
TOTAL Feet
for.
FINAL Fe
(Anticipated final
ipated final
urbance.
(App tied
Distutance
disturbance,
odes any
total includes
any
Excludes any
restoration dfor
r braffon _
vcartamp
-anticipated
restoration or
temp P RIt
ci amount)
temp impacts
amount)

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 4j,oN
i
Mailing Address: 42�k4 1nf i'�I In.�Z ut e — JfC
Phone Number: 9 / U -- 5 ?—co `"L �f I l
Email Address: -s Cy/� ,
I certify that I have authorized ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
in County.
I furthermore certify that l am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Print or Type Name
Oc�Wr?2
Title

ars, Courtney
I: tim smith <[e-mail]>
Wednesday, April 12, 2017 10:20 AM
Spears, Courtney
act: Re: rip rap permit
'ourtney. Hope you're having a good day so far! Here are the measurements as close as possible, of the
sd to put the riprap rock in.
,th: 80 feet
h: 6.5 feet on average with bulk on upper side of marshes edge (bulk of rock will be layed into my yard
At: no more than 1.5 feet, estimated average of 1 foot.
)e this is what you need. Please let me know as soon as you can about the permit and I'll get the landsca
.-d. Thanks so much for your help.
Smith
L Wrightsville Av.
nington, NC 28403
)10.520.1411 (anytime) or 910.799.8840 (work)
from Yahoo Mail for iPad
vednesday, April 5, 2017. 3:42 PM. Spears, Courtney <courtney.spears ancdenr.gov> wrote:
im,
1 some time today so I went to take a look at your property. I was getting to drafting the permit, but I
some dimensions from you. I need to know the length, width, and height to be sure the appropriate
is constructed. According to the rules that slope can be no flatter than three feet horizontal per foot
cal, and no steeper than 1.5 horizontal per one foot vertical. Once I get the measurements I should
)le to issue the permit.

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property: (O o -o '1 " k
(Lot or Street #,
Agent's Name #:
Agent's phone #:
or Road, City & County)
Mailing Address:
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.
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. Con espondence should be mailed to 127 Cardinal Drive Ext,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been noted by Certified Mail.
WAIVER SECTION
1 understand that a pier, dock, mooring pilings, 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 blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Information)
Signature
Print or Type Name
�, z° V "z +/,Ile
ilin� Address
A re-
(Adja ent Pro O nor Information)
Si Lure
-
,,,, u~�
Print or Type Name
((26i1 w/f l(9t1-15vILt-- &Z^
Mailing Address
�t

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF. COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMIAIVER FORM
'_ JI-1
Name of Property Owner:
Address of Property:
Agent's Name #:
Agent's phone #-.
✓I
(Lot or Strut #, Street or Road, City & County)
Mailing Address:
zo
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
P-I have no objections to this ro osal. I have
p p objections to this proposal.
If you have objections to whatis being proposed, you mustnotify the Division of Coastal Management (DCM) in
writing within 10 days of -receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Cer0ed Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
bad 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pro Owngr Information) (Adjacent Property Owner Information)
Si
Signature
Ph'nt or Type Nam
11 .le
Mailing Address
Print or Type Name
6LW 'Jn u114tSv iLL- {4�+n
Marling Address

- ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to -T�- h S�1t►-I 's
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.)
on40 c n.. V in , N.C.
(Waterbody) (Ci /Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above loca
i
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must rill in description below or attach a site drawin
.
Nj
---WAIVER SEC
&Y119'
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set b
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to
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.
(Pro wner Information) (Adjacent Property Owner Information)
Si ure �' ' Signature
f /4�. A=. dire,: rl_
P%* t or T e apme Print or Type Name
&Z,J /�/l,4i 1�,�'l id A'i'✓ &2-- tea«, ►stsv duL. %��i.