63223D - Federal

(;AMA / ---'DREDGE & FILL xk��0 3
iXNERAL PERMIT Previous permit# S
'slew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources h
)astal Resources Commission in an area of environmental concern pursuant to I SA NCAC , / • ie%f. "'
�t ules attached.
Name l /` 1 r G! & Project Location: County Utiy y!C>�/},✓
art Street Address/ State Road/ Lot #(s) 9iO %�risf;
d ;:
A
State/ r.— ZIP 747
1p
l/ Fax #
d A,gent
❑ CW {SEW
a PTA O ES ❑ PTS
❑ OEA ❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑ FC:
as / no PNA
yes /(no) Crit.Hab. yes k n
'roject/ Activity
•tl� f�0
:) length
r(s)
,th
ber
tp length
lisistanance offshore
distance offshore J
nnel
yards ' --
V Boatlift
dozing
Length >
not sure yes r no'
not sure yes /Pid
m: n/a yes ncs'
(Yy no
[ached: yes !"
permit may be required by: ��JYh 10/1 641-641►.s
Subdivision
City CQyU 164 Ree-e , ZIP //2g� el
Phone # ( ) '"�viwt� River Basin L!
Adj. Wtr. Body ' 4 of&v- C f nat
Closest Maj. Wtr. Body 41Wk,_
A
)r
(Scale: f �-►�/
r
❑ See note on back regarding River Basin ru

alicant:
P,kr�`C� 7
Permit #: � 3-2--a 3
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
)itat Name
DISTURB TYPE
Choose One
TOT
(Al
Distu
inc
ar
res
tern
Q y✓
Dredge ❑
Fill g--E3.th ❑
Other ❑
Dredge ❑
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 ❑
4L Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
iplied for.
(Anticipated final
(Applied for.
(Anticipated final
-bance total
disturbance.
Disturbance
disturbance.
udes any
Excludes any
total includes
any anticipated
Excludes any
restoration and/or
ticipated
oration or
restoration
and/or temp
restoration or
temp impact
impacts)
impact amount)
temp impacts)
amount)
z1rz

N.C. D ISION O1= COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date L
Name of Property Owner Applying for Permit:
F-c- d e,ea / fo I V, -� � G c- k-�- C I
Mailing Address:
9lu
Co en�
I certify that I have authorized (agent) pCI C L41� f �OUb to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) S �
at (my property located at)
This certification is valid thru (date) d
n
Property Owner Signature () Date

I hereby certify that I own property adjacent to
property located at ) / V
--c U)W
(Watedxmjy)
iJ,�C
(Name of Property Owner)
and/or
. X ice.
The ap0eant has described to me, as shown below, the development proposed at the above
locati
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
RECEIVED
DCM WILMINGTON, NC
APR 0 ? 2014
l � i" —Isapi
I understand that a pier, dock, mooring pilings, breakwater, boathouse, rift, 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 '11� t #A Wksh 19 WO00% #�R 1-T
f do na wtsh to waive f i5�setw�ra n t.
(Prope wner Information)
o U �_ 1.
Pn t or Ty ame 0 �
iT
(Adjacent P
sty Owner Information)
' c 0-- , -,,I 1 , E, i c -L--
Print or Type Name

ADJACI`UT 1±2if ARtAN PROPt-R1Y 0104tR S-TAT+-i i'
I herebycertify that I own property adjacent to nn , , C / C/ '
fY P P Y 1 �NdP����,.�� � �t� s
n 11 a o ( (Name of Property Owner)
property located at
on �C W �lJ
, in,
�QQD
i
(Waterbody)
(CityrTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
1%fw.abiocomtoProposal
i have objeclions to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
RECEIVED
DCM WILMINGTON, NC
APR 0 7 Alk
WAWER sECT K)N
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 +arid to wa the IV
l do not wish to waive the 15' setback requirement.
(Prope Owner Information) (Adjacent Property Owner Information)
Prin�jpr Typ ame Print or Type Name

STATE OF NORTH CAROLINA
Department of Environmental and Natural Resources
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
FILE ACCESS RECORD
DIVISION OF COASTAL MANAGEMENT
DATE / TIME 6/30/15 10:00-11:30
NAME Jeremy Dickinson
REPRESENTING self
PHONE [phone]
Guidelines for Access: The staff of Wilmington Regional Office is dedicated to making public records in
our custody readily available to the public for review and copying. We also have the responsibility to the
public to safeguard these records and to carry out our day-to-day program obligations. Please read
carefully the following guidelines signing the form:
1. CAMA Maior Permits are issued out of the Morehead Citv District Office. The COMPLETE
file is in the Morehead Office and may contain additional information and/or comments which
may not be in the WIRO file.
2. Due to the large public demand for file access, we request that you call at least a day in
advance to schedule an appointment to review the files. Appointments will be scheduled
between 9:00am and 3:00om. Viewing time ends at 4:45pm. Anyone arriving without an
appointment may view the files to the extent that time and staff supervision is available.
3. You must specify files you want to review by facility name. The number of files that you
may review at one time will be limited to five.
4. You may make copies of a file when the copier is not in use by the staff and if time permits.
Cost per copy is $.05 cents. Payment may be made by check, money order, or cash at the
reception desk. Copies totaline $5.00 or more can be invoiced for your convenience.
5. FILES MUST BE KEPT I7V ORDER YOU FOUND THEM. Files may not be taken
from the office. To remove, alter, deface, mutilate, or destroy material in one of these files is
a misdemeanor for which you can be fined up to $500.00. No briefcases, large totes, etc. are
permitted in the file review area.
6. In accordance with General Statue 25-3-512, a $25.00 processing fee will be charged and
collected for checks on which payment has been refused.
FACILITY NAME COUNTY
GP /a RL 6 NHco