66217D - Lutterloah

,CAMA / ❑ DREDGE & FILL Q �� `
iENERAL PERMIT Previous permit # A� B +
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 e (7
t i 1'/ 610
/ ❑ Rules ttached.
Name C/�lO �- iJ '�� �1' ' Project Location: County
Street Address/ State Road/ Lot #(s)/
r -�c. State
Ale
ZlP r.:Yyy�
16 �2' l E-Mail _ Subdivision
:dAgent jJh JZ�1G�i+- City�t�2' ZIP
❑ CW A /)&ES ❑ PTS Phone # (� River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A /^
Adj. Wtr. Body h'r C- na n
PWS:
(es PNA y ' no Closest Maj. Wtr. Body
Project/ Activity
:k) lerigth
tform(s)
�latform(s)
er(s)
igth
nber
I/ Riprap len 0
distance offshore
c distance offshore
e Length
attached:
�r
(Scale: (Z2
ig permit may be required by:
_ocal Planning jurisdiction)
❑ See note on back regarding River Basin rL

rum (name)
s LLC
Scott Tucker
B of A
BB &T
I Brian Hennessee_
ction Inc
Federal Point Yacht Club
_
First Bank
uction Inc
Ray Sito
First Citizens Bank
same
- - --
- ----
B of A
----- -
same
same
PN aBC nk
J Navy Federal Credit Union
B of A
ing, Corp
470 Anderson, LLC
_
IB of A_
'James Taggart
s LLC
Hays Lambert
B of A
—
ifiz 5-mk
_
1 Sta, ank
- ern
First Citizens Bank
First Citizens Bank
same
BB &T
ht
same
BB &T
Jon Grimes
Chris Lutterloah
_
Wells Fargo Bank
7909 $200.00.GP 66192D _ TM rct. 0441D
_ 6162 $200.00 GP 66187D _ i-TM_ rct. 0_440D
_ 9922 MOM major fee, 910 Basin Road, CB NHCo RM rct. 0381 D
3957 $250.00 major fee, 462 Causeway Dr, WB NHCo RM rct. 0379D
324120 $100 00 renewal fee, MP 61-12 RM rct 0380D
1007 $600.00 GP 66197D _ 1JD rct._1054D
_ 4012 $600,00 GP 66115D JD rct. 1053D
7000 $100.00 minor fee, 179 Topsail Road, NTB Ons.Co JD rct. 1056D
5123 $100.00 minor fee, 230 N. Anderson Blvd. TB PN JD rct. 1057D
7996 $200.00 GP 66215D JD rct. 1058D
^•233 $100.00 minor fee, 135 Soundview, Hampst. PN JD rct. 1063D
S100.00 minor fee, 111 ^ _, nuda Wynd NTB Ons JD rct. 10621)
1553 $100.00 minor fee, 411 C ',:;!and Dr. NTB Ons JD rct. 1061 D
14264' $100.00 minor fee, 614 Hampton Colony Cir NTB Or JD rct. 1059D
1103 $536.00 NOV 15-18D, $250, $250, $36 TM rct. 0435D
742767 $400.00 GP 66219D _ HS rct. 0996D
18168 $200.00 GP 66216D _,HS rct. 0994D
59183420956 $200.00 GP 66217D
1
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NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: (7 fl L ✓�-v j " l2
15ate:
Describe below the HABITAT disturbances for the application.
All values should match the name, and units of measurement found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FI
(Applied for.
(Anticipated final
(Applied for.
(A
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
di:
Habitat Name
Choose One
includes any
Excludes any
total includes
E)
anticipated
restoration
any anticipated
re
restoration or
and/or temp
restoration or
to
ternimpacts)
impact amount
ternimpacts)
ar
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 ❑

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
l
Mailing Address:
dl4 �4 W, 2 P
00
I certify that I have authorized (agent) i Win G/,/ Y' !!!S 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) No
This certification is valid thru (date)
a

I hereby certify that I own property adjacent to C[�s� .E�i���
/ of Property Owner)
property located at �� /�%�.�1< /—'
�(Address, 1. % Bloc oad ate.)
(Waterbody) (City/Yown and/or Counter)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must till in description below or attach a site drawing)
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 16 setback requirement.
(Pro y t7w er Information) (Adjacent P bperty Ownp nformatlon)
x'ALP
i nat a Sign e
rint or Type Name Print or rype Nalhe
ifn dd c 3 Mau; a
ct �sr tee/ cffy! ism e
Telephone Number

I
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMIAIVER FORM
Name of Property Owner: `- r17 fG
Address of Property: 4-7 o
(Lot or Street #, Street or
%
Agent's Name #: //l� ��i jP-L"5 Mailing Address: `
A
Agent's phone #:
, City & County)
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 oposing. 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 you 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.)
T
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Si nature
Print or Type Nam
(Adjacent Pro erty Owner Information)
Sig lure
,o��
Print or Type Name
101 S C I r Or
� a
Mailing Address Mailing Address
e 1 A- u a 2

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