64619D - Bray

yAMA'/ ❑ DREDGE & FILL � � ' ► r`� 6C
xENERAL PERMIT Previous permit # -7-,
New ❑Modification `.Complete Reissue 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
! "I ❑ Rule ttached.
Name ('(acA Project Location: County
Z Ve <-',de
Street Address State Road/ Lot #(s)
State i —ZIP__=~y'�� � Z— �� 1%
x # ) ___...._... Subdivisio
�d Agent City u 5 >< eI- ZIP �Y
Cw Ew PTA ES PTS Phone '# ( ) River Basin
OEA HHF IH UBA N/A
Adj. Wtr. Body
PWS: FC:
fes 1-nZPNA yes / no
Project/ Activity
k) length
gth
fiber
/ Riprap le)Vh
distance offshore
c distance offshore
innel
is yards
P
e Boatlift P X/-,
Length
not sure yes no
not sure yes no)
am: n/a yes n�
yes n�
ttached: yes no)
Crit.Hab. yes r no
I07
Closest Maj. Wtr. Body
(Scale:
r
g permit may be required by: ftllkJ.& D ' 0 See note on back regarding River Basin rc

7
,AMA; ❑DREDGE &FILL
iENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources glo
�astal Resources Commission in an area of environmental concern pursuant to 15A NCAC '.J
�i ❑ Rub flatbed.
Name <Y t%'"
__ Project Location: County -E
b ve t Street Addr State Road/ Lot #(s)
State ZIP ' ( cam"- ��'"�%
-14 _ `� # () -- Subdivision'
1
�d Agent � . � C Y �'u.�t'�'�-- `a City � i v � L�,-� 5 ZIP � �7
CW 4 EW PTA ❑ ES PTS Phone # (_) fiver Basin
❑OEA ❑HHF IH El USA _ N/A
Adj. Wtr. Body
PWS: ❑FC:
-es, PNA y�n� Crit.Hab. yes ono
Closest Maj. Wtr. Body
Project/ Activity
k) length
fiber \
/ IZprap li
distance i
: distance
is yards
P
�l3oadift �� X/�.
not sure yes 6159
not sure yes n
um: n/a yes n
yes n
,ttached: yes o
ig permit may be required by:
(Scale:
❑ See note on back regarding River Basin ru

(f
f IK \ f-ki N AJ% W to
Sall Sound-
it
sound Subdivision
ng Facility
84-04
Riparian Corridor
Lines �+
�7, : 2
Pro�ose� 3 4
12' ?< (LI -2.0'
Propose .Community
Docking aciiliy
Pelican Soudd subdivision
ermit Application
County,
is
!-14768
GSSC; LLC I
Property
i
P
aA►ROL IdI�B
80 foot setback requirement from the AI Channel
IMI
20 foot Drainage
Easement
Existing �rivate Docking
Facility Stat® Permit No.141-05
Note: Water d
Normal Low V�
on U2/09. Co
Normal High V
Verified by Ms
with NCDCM i
Distance of W.
600 feet acroi
Line Type legend
------ Normal Low V
• Waterward ec
Coastal wetia
...... Normal High u
........ Upper Limits of
i - — USACE Sectio
Existing and roposed Conditior
Top Vie Plan Sheet 1 of 2
Dra n by R. Mairs
AuOust 15, 2009
Srkale: 1 "=60'

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: -A, A, 6
Address of Properly: NZ (0Ve5; v tdt
(Lot or Street #, Street or Road, City & County)
Agent's Name
en,,
Mailing Address:
192 d`7�x,00
Cf
Agents phone #: _00
3(0 7
Ak 2eYq
3
1 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.
I have 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. 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 Lou have been notified by Certified Mail
WAIVER SECTION
I 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.
(Property Owner Information)
Signature
Print or Type Name
X" (Adjacent Property Owner Information)
�Owl_
Signature
Print or Type Name
Mailing Address
t 1l COVE sI DE [-ARSE
Mailing Address

ALIT�Kw
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
i
Date J S
Name of Property Owner Applying for Permit:
pr�b(ze� 'Rjl�
Mailing Address:
1 � z 0:3v e— t,.,,, e
I certify that I have authorized (agent) ff I �0� le'YV14 '-) to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) ft
at (my property located at)
This certification is valid thru (date)
1Z-31-15
C)

5/7/20151 Allied manne contractors, LLG Henry von murray m o w..•.. GP 646+�
T� Andrew Brav — -- ---- —� 19D

4b division of Coastal Mgt. Habitat Impact Computer Sheet
applicant: ,�Permit##:
)ate: 5-�—
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
Dund in your Habitat code sheet.
labitat 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
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Ck
Dredge ❑ Fill ❑ Both ❑ Other \T
Dredge ❑ Fill ❑ Both ❑ /ther ❑
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 0 Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑