66187D - Hennessey

'CAMA / ❑ DREDGE & FILL T t` �1 �� `t,' Y 661.87
rNERAL PERMIT Previous permit # A B
ew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
prized 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'[ W
1 1 "❑ed Rules attar .
it Name (Ai LL' C �V yProject Location: CountyW
`—WAY Street Address/ State Road/ Lot #(s)
StateZIP AN
�E-Mail n Subdivision `
zed Agent �y l� V VV k& �� i City j�yV�T ZIP /\
i ❑ CW T XPTA ElES ❑ PTS Phone # ( ) ` River Basin L14.1
❑ OEA i] HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body V� V �. nat
' ❑ PWS:
yes , P N A yes no Closest Maj. Wtr. Body
no��

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11/12/2015 Allied Marine Contractors LLC Scott Tucker B of A � 7909 $200.00 GP 66192D
11/12/2015 Richardson Construction Brian Hennessee BB &T 6162 $200.00 GP 66187D
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NC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant: -�,�,Q S� Permit #.
I
Date: U ( t�
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen
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.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated fin<
disturbance.
Excludes any
restoration and/
temp impact
amount)
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 ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both 0 Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

R
North Carolina Department of Environment and Natural Resources
Division of Coastal Managerwnt
Bevely Eaves Perdue ,lames H. Gwgson Dee Freemat
Governor iairesbr
SpCfei3r
AGENT AUTHORIZATION FORM
Dow. L'i 10 1
Na►re of Property Owner Applying for Permit; Name of Authorized Agent for this project.
5�'
Owner's Mailing Address: _
- Z 9., Y 4
Phone; Number
Agent's Mailing Address:
Phone Number
i certify that I have e:nhoriied the agent fisted above to act on mar beheif, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
�. �1� Q Ly L)loC'f. w. ,. -4 '►Z-, _ Al •L. t
(my property located) at
This certification is valid thru (date) L)
Property caner Signature Dap

N
New Ell
6x8 finger for ramp
North
CREEK
Existing 16x12 float
Same location
New 16ftx6ft float attached to
existing 16ftx12 float
New
24x8 stationary dock
24' ---
New Bulkhead Wall

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA p.I LMOOMNGPHZVC,&BOATLIFrIBOATHOUSE)
hereby certify that I own psaputy adjacent to �-'�' i Q Yet VK
(Name of Property 6;i er)
�
property located at ►
�•- I ,rc' L &-T (A r n
(Lat, Block, Road, etc.)
in S, t,� +4 e D C t N.C.
(Wateirbody) (TOWA 31410r Conaty)
AppllaiaNs ph one il: q `�" 7� A dcirraa: t c ( �yt
!moo uf� Po r Ai L -If vd�
He, bas destbed to me, as shown below, the development he is proposing at that budox6 and, I
hive no objections to his proposal. I undentand tlmt apicrlmooring pitiags I boatlift / boe*ouse
must be sat back a minimum distance of fifteen Pict (15' from my area of ri mdm areas XWM
waived by me. (Uyou with to waive the setba* you most inftW the appropriate h�k
below,)
I dst aut wishtr) waive
I le wish to waive ibat sctbwkrequirtmew.
DESCRnMON AN-DIORDRAWING OF PROPOSED DEVEMPM NT:
(To be fil ed in by Lndlvidual proposing dsvelopmefttj
Umformadou £or Property Owner Applylug
for Permit)
�o L
1&ffing Address
City/stalamp
i it 1 Li: V. 4 Cl I
(Riparm PMPerty OwseTJAfa. Lion)
re, Ij
.. Sire
Print TVPeName

r
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A'IEoORthGPIII7GSBOATW'T,BGATBUli�E�
r Le=by ce; bfy that 1 own property adjacent to - - IVI I `g 1' ( INI C t
C - me of Property Owner)
property located at C, t t.: T-k
1
-� 110t, Block, Road, etc.) --
arf N.C.
(FYaterbody) (Twn and/or14 Ccrunh) '
Applicant's phone 4: 1'1&ffing Address: ` f i-' y c.. ` V-?
He has dcsc,-1etl 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 pitangs I boaft / boathouse
mint be set back a minimum distance of fifteen feet (15D .from my area of riparian access unless
vvaived by Int. (If you wish to waive the setback, you must initial the appropriate blank
below.)
140 not wish to waive
I do wish to waive that setback requirement.
I)L5CRJPT10N ANDIORDRAWING'G OF PROPOSED DFVEI..OpNIENT:y____--
(To be-frited in by individual proposing development)
-e tt
Qr`c�t►
(Information for Property (w"MerApplying (Riparian Property OwnerInformation)w_
for Perrnitj
MailingAddress5` i _� � t i c .
CitytStareJZip L/ -�� i G i+ fit~ z. t:` Fyia•�i ° fX z` Y
Print or Type, Ner ne