64731D - Morgan

y ,�S
n
CAmA / 7 DREDGE & FILL - 04
iENERAL PERMIT Previous permit #
Vew Modification L�Complete Reissue [-]Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources I
>astal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Rules attached.
Name i �t n1 I . 1 �1 L i�G ("I J✓. Project Location: Couni Vi t �.
Street Address/ State Road/ Lot #(s)
Yl State 1' ZIP f j L �1G ✓ I b I
G22 ,CFax # ( ) Subdivision
d Agent City _ I Jt ►'1 ZIP
❑ CW X EW ?PTA ❑ ES ❑ PTS Phone # ( ) �3G1 VYIE River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A El PWS: 1-1 FC: Adj. Wtr. Body Leh GUc (nat m
es no PNA yes I no ; Crit.Hab. yes no Closest Maj. Wtr. Body
Project/ Activity
o length
.> 520�. i Cx IC
r(s)
;th
ber
Riprap length
Distance offshor
distance offshor
nnel
c yards
Boatlift
Idozing `Y
Length L.-
not sure yes no j
not sure yes no
im: n/a., yes no
yes no
tached: yes rno
permit may be required by:
(Scale: ' �/ Z
❑ See note on back regarding River Basin rul

i�CAMA KEDGE • FILL
1� O U Y t
GEN R L PERMIT
Previous permit #
New ' rood ,cation i ]Complete Reissue ( ]Partial Reissue
Date previous permit issued
authorited by the ate North Caroilna, Department of Environment and
Natural Resources
d the Coastal Resot,mv Commission in an area of environmental concern pursuant
to I SA NCAC
Rules artached,
�n �
County,.__
iplicant Name
c
Project Location:
Idress P Or �X
Street Address/ State Road/ Lot #(s)
�YI ni _ snag zlp��rlQ"f
one # � 4•V Fax iF L_
ithorizodAgMt,
f
ZIP Zq"
aty togs
-
fected t 1CW X!W fTA D[s I I PTS
:C 1.7O111A ❑M!M DIM ❑UaA t IN/A
`y..
Phone # (_ -)—OM+— _-- River Basin W �.►'
s).
Adj. Wtr. Body--- -- Ak
rVVs: OK:
Rw: yet (_m Is"A yes n C it.Hab. yes
Closest Maj. Wtr. Body----- -�-" -
of Project/ Activity
Pier (dock)
Platiom>(t)
Ftnper pie►iil
Groin 6rigth
number
Bulkhead/ RKirap lenpdi
avp distance offshc
mare distance offsh
Bun, chatnti
cubk Yards
Boat ramp
Boathouse/ Boatkft
Bean ,tldo:i� �� ���
Other X
ShoreUne Length
SAV: riot $ure yet no
Sandbags: not sure yet
Moratorium. Ns no
Photos: no
Waiver Attached: yes
A build+ng permit may be required/// )
Notes/ Specla4 &lWitionf L
i
(Scale' I /� Z (7
COWAW
See tote on beds regarding River Basin rules.

Michael Gerke
6/22/2015 Clements Marine Construction _ ISmith First Citizens Bank
Smith
6/22/2015 Radiant Investment Inc. Harry L Kraly Crescent State Bank
6/22/2015 Dennis or Beverly Morgan same High Point Bank and Trust
GP 64639D C
3826
$1,200.00
GP 64679D
GP 64680D
4380
$100.00
renewal fee, M
5001
$200.00
GP for 124 Chi
EDP D HE
v
E _,
O L >
Ni
a) L
0 ? 0 C
0 0

C Div?sifln of Coastal Mgt. Habitat impact Computer Sheet
plicant: �VLtS �. Permit #: (�3
te:
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ind in your Habitat code sheet.
bitat 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)
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 ❑
lox l(p = I(00

at McCrory
3overnor
ANW.YWA
J�,A
NC ENR
North Carolina Department of Environment and Natural Resources
N.C. Division of Coastal Management
AGENT AUTHORIZATION FORM
Date: is
me of Property Owner Applying for Permit:
ner's Mailing Address:
0i3aI
John E. Skvarla, III
Secretary
Name of Authorized Agent for this project:
Agent's Mailing Address:
Email:
Phone
rtify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
and obtaining all CAMA Permits necessary to install or construct the following (activity):
my property located at
certification is valid 1 year from (date)
l

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
S;
(Lot or Street #, Street or Road, City & County)
Agent's Name #: rr C A S,- Mailing Address: _I . D /Zo X s/
Agent's phone #: 33� - g$Y� 6,2yi „.�, y yf . 27 3 7a
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 re proposing. A descriotion or drawing. with dimensions must he provided with this Icttor.
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 Fart,
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
( r erty Owner Information)
Signature
a
e417 S d An Sr.
Print or Type Name
"?o&x �-
Mailing Address
//. C, 27 :?7n
(Adjacent Prop�rrty 9wner Information)
Signature
Print or Type Name
Mailing Address
CiQ�i it/"- 19 -IV >_r-

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed t
Y
A. Si ture
❑ Agent
0 Addressed
B. Received by Prin d me) C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3.
Ervice type
Certified Mail® ❑ Priority Mail Express -
Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ Collect on Delivery
4. Restricted Delivery? (Extra Fee) ❑Yes
2. Article Number (7 014 2120 0004 0892 6 819
Transfer from service label)
PS Form 3811, July 2013 Domestic Return Receipt

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property: l� Imo„ j, H. Uo Ue---1 &ac -1 i nC
(Lot or Street #, Street or Road, City & County)
Agent's Name #: _ 1 Jinn,' filorcari -C.- Mailing Address: _10013oX s i
Agent's phone #: 3� 6 Q Q q, A26 0 *7 '� 1-70
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 drawinq with dimensions must be provided with this letter.
I have no objections to this proposal. __ _ 1 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 Mai!
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15from 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.
Pr Lperty Owner Information) (AdjacentPropertyOwner Information)
Signature Signature
Print or Type Name
I�C13�X si
Mailing Address
Print or Type Name
/,ZD,S VANDr7I-a Yfrih'r -S
Mailing Address

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