64795D - Hughes

J CAMA / ❑ DREDGE & FILL Q � `L 4
3ENERAL PERMIT Previous permit #
�New ❑Modification uComplete Reissue El Partial Reissue Date previous permit issued ?4
rized by the State of North Carolina, Department of Environment and Natural Resources n
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC (9-4 f Zo d
—I ❑ Rule attached.
t Name 01" t Project Location: County
0��zzl
Street Address/ State Road/ Lot #(s)
14 /bm A�f}� State .., ZIP �" X O� t C 6 I' 1� GON
Ity
V—Y—) Fax # ( ) Subdivision
ed Agent " i r, r W N City —I PA P57E I�� ZIP Zff 'T
cw �F, Ew PTA ❑ ES ❑ PTS Phone # River Basin CFl
OEA ❑ HHF a I ❑ UBA ❑ N/A Adj. Wtr. Body 1 LL Gi-t-N,
Pws: ElFc: O�'SPr ► lr
yes / no PNA (ISV no Crit.Hab. yes / no Closest Maj. Wtr. Body
Project/ Activity 1(e z.rJN4l,4, Le 't i ' 121 'ew Alar' /'1 ( Tam/ / /
:k)length
%g h
nbew
I/ Ril � length_
distance offshore
K distance offshore
annel
is yards
1p
;q oMat- JZX1Z /
illdozing
k Y
Length Gf
not sure yes 1
not sure yes no
im: n/a yes no
yes no
ttached: yes no)
(Scale:
g permit may be required by: /� /
\\ A _ n _ _ T-'In
.
❑ $ee,note 7 b�kiegaryil River Bar rL

8/19/2015 8/24/15
Rick West for West Docks
William Mauney
mrst 6anK 1 U 1 $b00.0[7 I tir b4i3aU 0s4u
_ GP 64740D Q$20
First Citizens Bank 5436` $100.00 renewal fee, MP 31,
Wells Fargo 393 $400.00 major fee, 1 mile o
NC State Employees Credit Unior 1428 $200.00 GP 6478611
First Citizens Bank 15880 $475.00 major mod MP 28-
BB &T 11651 $100.00 renewal fee, PM 1'
BB &T 5294 $100.00 minor fee, 209 Ca:
NC Baptist Assembly
?
John Aldridge for NC Baptist Assembly
8/21/2015 8/24/15
8/21 /2015 8/24/15
8/21/2015 8/24/15
Johnnie S Hawkins Jr
Specialty River Woods c/o Steven Woodcock
John King
Butch Saunders
8/24/2015
8/24/2015
8/24/2015
North Carolina Coastal Federation
same _
Christopher Lutterloah Sr
_
same
Donald and Joanna Reich
_
same
8124/20151
Bald Head Island Limited LLC
Bruce Marek, representative
First Citizens Bank
1523 $100,00 renewal fee, MP 1!
8/24/2015
Bald Head Island Limited LLC
Bruce Marek, representative
First Citizens Bank
1522 $100 00 renewal fee, MP 11
8/24/2015
Pippin Marine Construction LLC
Chris Hughes
Wells Fargo
3483 $200 00 GP 64795D
--
l

rig Division of Coastal Mqt. Habitat impact Computer Sheet
Applicant: I' Permit #:
Date: k zt/ �—
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.
Excludes any
restoration
andfor 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/o
temp impact
amount)
W
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 ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other 0

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date y I
Name of Property Owner Applying for Permit:
Cl l
19
Mailing Address:
7N 9 1 -D gym iax-Ae L -e.
W AYp N e-- 27S9'�
I certify that I have authorized (agent) ' ate- Pei n to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at)
0 1?� e P Con S1'. M (-- .
This certification is valid thru (date) I S S
�/)L)1)S
Property Owner Signature
Date

) hereby certify that ) own property adjacent to,
property located at _ L Q F?en
on rY► t 0-r12 A (Address
(Waterbody)
The applicant has described to me, as
locat
I have no objection to this
I have objections to this p
C hulls HL) l,Q 5 's
(Name of Property Owner)
an SN'.
Lot, Q(ock, Roa etc.
}} A v*n P S N.C.
(City/Town and/or County)
below, the development proposed at the above
ial.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must NO in description below or attach a site drawing)
I understand that a pier, dock, mooring piling,boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' irom 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 16 setback requirement.
(Property Owner Information)
4�L
SignatHre�,S
Print,oCCt::Y�11 pe 1game _ 1
(Adjacent Pr pe Ow er Information)
Signatur
/e T, � e s
Print or Type Name I) I Q

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to � n +S f"t VL, 4 S
(Name of P orof perty Owner)
property located at 2 A �dr SN. -
on m t'P_-P (Address, Lot,
in
(Waterbody)
etc.
and/or County)
I
N.C.
The applicant has described to me, as shown below, the development proposed at the above
locatior.�
✓ 1 have no objection to this propo al.
I have objections to this
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must A# in description below or attach a site drawing)
I understand that a pier, dock, mooring piling , boat ramp, 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)
Signat}{rhct�y t�VL�se S
Print or Wpe acne
74 �1 1
(Adjacent Property
Print r Ty ame

122