63164D - Byrd

iCAMA / DREDGE & FILL
'ENERAL PERMIT '�� Previous permit#
New ❑Modification CiComplete Reissue El Partial Reissue Date previous permit issued
•ized by the State of North Carolina, Department of Environment and Natural Resources 7+ { • ��0�
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �{
.� Rules attached.
:Name �+ U Project Location: County V Wl (A4—
w WryV\ V Street Address/ State Road/ Lot #(s)
)01 k StateNZ Z ZIP_ �4uz- j(,1.b tt
( �) 6 3 Fax # ( ) i SubdivisionT� h(
�d Agent �, City 5"t� ZIP �VVLL
❑ CW AEW PTA ElES ElPTS PM' ne # ( l0) &7 —O River Basin l...U(O1
OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A A li
❑ PWS: ❑ FC:
ees /(no) PNA yes no Crit.Hab. yes no
Project/ Activity
11111WHIMINIM MEW on
igth ���� =M=
■■■■■�■Mi
iber ■■■■ i
Riprap length_ as
■■■■l�■■I�i
is yards
P
C!/Bo%li)ft 12 >c
Ildozing
Length 40
Adj. Wtr. Body wV\i (nat
Closest Maj. Wtr. Body
IN. W difal
iWlilrl�i�■■�■■■■O
1.
IF.
(Scale: I y '
❑ See note on back regarding River Basin
- 1 ,

::—
WILLIE CLARENCE RICHARDSON
DBA RICHARDSON CONSTRUCTION 5592
PH. 910-842-5596 3235 SEACREST AVE SW 66-112/531
SUPPLY, NC 28462-2589 ._� /4/
Date
Pay to the I ��
Order of ��
Dollars —a,—
BRANCH BANKING AND TRUST COMPANY
\ 1-800-13ANK BBT BBT.co.
c031(P I D
:053L011211:00052152t.Agp?iiangqq;3

IC Division of Coastal Mgt. Habitat Impact Computer Sheet
pplicant:
ate:
Li/ZS/j
ascribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremei
and in your Habitat code sheet.
3bitat 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 fir
disturbance.
Excludes any
restoration anc
temp impact
amount
L M
Dredge ❑ Fill ❑ Both ❑ Other
l WC�
I QV v
ODredge
❑ Fill ❑ Both ❑ Other
l
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 ❑
100 = oo et

Xw
rinr«r}mpn+ ref Pm4rnnmAnt ,;,nH Matural Resnl lrr8,,
i tiJl Lt. iJW Viii is --e Lti ♦{t�Vili.
€ ivision of Coastall sManacer ent
Gavtsg FartiiiG James H. Greason
vernor i iI 4;4tyr
Lite `reel
rl-
vc .
Ar,FNT 4.1_iT nRl7ATiON FORM
iaie- 4 "'1 '"I
q_
,P of arnnarty Owner ?solving for Permit: Name of Authcrizeu- Agent Tor this project.
ier's Manting Address:
n A L.3 ,o_s� Tc,4twml c�. r
i=tiyent's %%lahir#gi rtOUTeSS:
Sr_ cr e s+ 4-f k_S(J
sna �s, ir, s� �7 � V �r� �atZ� Phone 'Number
n ck �, dax mtbt- c*) ooa" c. ykc�
.+if.. {sent s hnv- nilthnn7¢cl the agent listed above to act on my behalf. for the purpose os a plyin
and obtainina all CAMA Permits necessary to instal' or construct the tostowing !activity;:
is certification is valid thru (date'
L 111-7-4q—

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to
(Name(ot Property Owner)
property located at a 3 co,� Tc . ,X I
(Lot, Bloc c, Road, etc.)
on Al W Val , in -c.t t )Sc � tc__�' , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #:il���'% 3S Mailing Address:, 3 U3 �arTc,. LY
He has described 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 pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (1 T) 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 not wish to waive
�'1q YA I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
Mailinc, Address
SAP[u IBC_ 2�11tgba.
(Riparian Property Owner Information)
Signature Y14 41e-- avl_ ►2 R r S

ADJACENT RIPARIAN PROPERTY OWNER STATEMNT
(FOR A PIERzNOORING PILINGSIBOATUFTBOATHOUSE)
I hereby certify that I own property adjacent to R i I ')( • r -rk _. fs
rty (Name o PropeOwner)
property located at _ - ": C ti
(Lot, Blo&, Road, etc.)
on-, L , in E 'Lk r c' c o t cl- , N.C.
(Waterbody) (Town and/or County)
5
Applicant°s phone #: ft � 7--t.�`� Mailing Address:2 2 . .G Jeer, +. , t (-
Nbc , `a
He has described 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 pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (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 not wish to waive
I do wish to waive that setback requirement.
-------------------------
DESCIZIPTION A--N-D/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
--------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
Mailing Address'
Signature
ai^e�

rasac C-(
Eft wide pier
3sq E�f
16ftx24ft
14ft for boat lift
12ft

R
't
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