64716D - Walker

,CAMaA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
1New L Modification El Complete Reissue ❑Pa'rtial Reissue Date previous permit issued
>rized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ R es attached
nt Name �
� ,
�
L C x---
Pt
State hi C- ZIP
t ) C�, x�
Fax # ( )
zed Agent
r
i ❑ CW
EW
1KRTA
❑ ES ❑ PTS
❑ OEA
❑ HHF
❑ 11H
❑ UBA ❑ N/A
u PWS: ❑ FC:
yes. / Ho PNA yes x no
I Project/ Activity
)ck) len�gt�h t_(
n(s)
angth
ember
Crit.Hab. yes / noJ
rd/ Riprap length
g distance offshore
aid distance offshore
har* el
ibic yards
mp
ise/ BoatI t
lulldozing
t
f �
,\ I
ie Length
not sure yes
i
;s: not sure yes
lum: n/a yes
yesPOO
no
Attached: yes
ng permit may be required by:
Project Location: County
Street Address/ �State Road/ Lot #(s)
'4 �2
Subdivisign
City �`; G\Lt ZIP �c
Phone # ( ) ---- River Basin G
Adj. Wtr. Body Y%A i U L C- f -ELA—' nat
Closest Maj. Wtr. Body _r(-(5A ((_
(Scale: I
❑ See note on back regarding River Basin i

7/13/20151 Ray or Heidi Cox Pender County Utilities NC State Employees' Credit Unioi 4602 $400.00 GP for PnCo ut
7/15/2015 Andrew or Bailey Gordaon ---� same _ NewBridge Bank 1209 $400.00 GP 64714D
7/15120151 1 John or Martv Walker I same I First Citizens Bank 1 5090 $200.00 1 GP 64716D

SAC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: '^ K wm'f ,� Permit #' YtJ6
,l
Date:
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
and/or temp
impactamount)
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 ❑ Othe
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 ❑

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Jo%n s
n n (Name of Property Owner)
property located at 4 35 1�� g�+ C. Iq
on C ��� k (Address, Lot, Block, Ro d, etc
in tca N.C.
(Waterbody) (City own and/or County)
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 fill in description below or attach a site drawing)
J�-Y" -�'K-P-J 00C—<
P , •.
P,t�se/9
.J
LJ 3-0, C-
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) (Adjacent Property Owner Information)
/1/ , I _
rtmt or I ype Name
Mailing, ddress 1 , „ , —., „ ,, i,2
mawng AWress _ _

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Jokm 00-wte- 's
(Name of Property Owner)
property located at 4357 f' 5�, s R
(Address, Lot � Block Roa , etc.)
on mt'
� a C- 1 , in i , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
have objections to this proposal,
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
c��5 Ib X!v Pec.V-
Q,:' -�tKeJ noc.1-
�cJr�W� C.�
V(
WAIVERS CTION
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.
(Pr perty er Information) (Adjacent Pro y Owner Information)
S iat re Si azure
tvh" 73e e- n " L yr c- -
rint or Type Name Print or Type Name
Y3� /�Slj.s Q� (133 h��h'-� (�d
Mailing,lddres§ - MajlingAddfess ,