65033D - Honeycutt

CAMA El DREDGE & FILL 14
IIENERAL PERMIT Previous permit #
New ElModification IJ Complete Reissue Ll Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources
Dastal Resources Commission in an area of environmental concern pursuant to I SA NCAC t-2 7 /V - 17— e5�O
0 Rules attached.
�-
Name 1'e, /,1 &41-- ci T7 Project Location: County /I Al—< /0
f4 Street Address/ State Road/ Lot #(s)
State VC ZIP loge
Fax # Subdivision
:d Agent city ZIP
El CW --j PTA E ES Ll PTS Phone# River Basin -C-141C!'—
El OEA 1-1 HHF --1 lH 0 UBA EJ N/A Adj. Wtr. Bodye7eo'?/5
D PWS: El FC:
'es rffo�) PNA yes - no Crit.Hab. yes no Closest Maj. Wtr. Body
N---
Project/ Activity
(Scale:
SEEM
MEMNON
MEMNON
EMEMMOMMUM
i��i■■eiiiii����r�r�■�.�■■■■■■■■■�
!r(s)
ENKLE
,th
ber
Riprap length
MEAWO
mom
H■■■I
Oistance offshore
M
MEMO==
■f
�i�■■■■■�■■�■
distance offshore-
nnel
NONE■OEM
yards
I
EMEMEMEM
0
EnNEENNIMEMEMME
MENNIN■MENE
WEEMOMMEEMEMEMMENNEEM
!dozing_
M
W■■■■
I■■■■■■■■■■■■■■■r��nr;■■■■■■■■_■■
L11111■
IWISFANIM
MEEMEMEMENEEMEMEN
IMEMEMEMMEMMEM
EMMEEMEM
Vk-AIMMEEMEMEMEMEMEEM■MEMEMEMEMEEMEM
ME
M11
11,11WIMMIMMINIMMINEENNE
Q
Leng6�1
E.11,1,21
No
not sure yes
not sure yes
1111MMEMEMEMEMMEMEN
M: n/a yes n(x)■
mom
INEEM
mom
MEEINMMENIM
MML!qNNM
M■�EV1
m
OMEN
permit may be
required by: Ll See note on back regarding River Basin rul

Date
Check
Check
Received
Check From (Name)
Name of Permit Holder
Vendor
Number
amount
Permit Number/C
12/3/1024
North American Money Order/Brandon Grimes Jennifer Honeycutt BancFirst, Stratford, OK
203478662
$200.00 GP 65033D

C Division of Coastal Mgt,
>plicant: j ►i
ite:
Habitat impact Computer Sheet
4 11GL Permit*
ascribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
abitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp
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/o
temp impact
amount)
Q
Dredge ❑ Fill El Both ❑ Other
impacts
Z6-
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 171 Fill ❑ Both 0 Other ❑

C i i f F COASTAL MANAGE-MER7
A-DJACER-T REPAE RAN PROPERTY OWNER NOTEFEC���'E0t4ll��`AE�'f R F4RC�
1� IJ4A"o, r . , �
Ivarr,e of Propeilty Owner,
Address of PrQpariy;
.>dr
(!_cat or Street f, Street or Road, City & County)
Agent's game:
Agent's phone;*
fJaillng Wress:
f hereby certify that f awn propsqZ adlacerft 4o the dp�i
erty. The individual
applying for this permit has described to me as shown on the etta� � rawng.tha development
they are proposing, A desk ccl trine with dimensions �►usf he nro��i�a�` ��ith this I�tter.
F. havb no objections is this prQpasO, _--1 have obieotiOils to this pfoposal-
If you have able to K�haE f baing P f € oc1, :iou must nc * tho Ofvfstor of C Ce(M&nagamont (RCA°) in
If you ve a e ��� of racp,,pt of this notfca. Corrospondalco should be trr0ilad tm in cara�lnel Drive Ed,,
tfi.�lfmfrtgton, NC, 28405.3848. DCA4 Mprason�adves can also be contacted at (910) i88=721�, (�® rosportse Is
,.,,,,cr,rnrmd tho sacra as no Wacdor ffyol hE-va boon notf&d by CerV fed [6811.
WAIVE-k SECTICN
f understand that a pier, dock, mooring pipings, breakwater. boathouse, fife, or grain must be aeY
back, a minimum distance of 16' from my area of riparian access unless waived by ri16, (if you
fish to wive the setback, �ou u€ t tf the appropriate blank bslow,)
do vAsh to �kraiva the 15, setback regr!irement.
_ ! do not wjish to w.1alve the 16' setback C-aquirsment'
(E�rc�p®fir Ct�nsr Et�gartt<iattc�c�l
Igna r
rinticr 7
7ypee game
Wa-Ang Address
( .d acot�t Properq OWIZIU tnroRnal one
si;rtuture
1ni or —Type Name
4Mr-111—n ddr€ss

i['ti;D wykiLy RETURN P E0EEP1` R 9-u-'m8 "0
DIVIsioN- OF- COASTAL MANAGSMER
ADJACENT REkAR IAN pRppERTY OWSER NOTIFICATION AIV R FORM
Name of prop€t &Ly Owner;
Address of Property;
(Lot or Street J!, Street or Road, City &
Agents Name 0: u� �Q^�d / �•-
Agent's phone;'*',
�% l� S�
Mailing Address:
l hereby certify that l own propsrty adjacent to the above referenoeddpro yThe ft evindividual
development
applying for this permit has described to me as shown on the attached Ba
t���,„ wit din`lensions must be nro�'ide� v�ith th's l�_�3t�C•
they are proposing. A des crir�tio or t d
1J let haveno objections to this proposal. ,,.r---1 have objections to Ns proposal.
if }eau hove ot:Joctions to why E i� balm pttt(�ot ac0, i'ou must nc iify the D!vlsfo ofoI rtaar>zont (QCIk") In
writing wittrin ?0 dgys of recut of ti�is notiC4. Co► upondoico shouid be moiled to 127 Ct�reUnki Dribrtsve els
44Rirning�MtE. Mt:, 2Sd65-384s6. ®CT Mnww�ttves can also be contacted sf (Sit®) ig 72T5, Mtn map -
___ Oka e�nrn Fir` no c)bI(#dd0l if t'C, hEva boon notified bg CettKted lGe&il.
W-Atj'ER SECTICN
1 understand that 9 pier, boathouse, lift or groin must be sat
dock, mooring pilings, breakwater,
back a minimurn distance of 15' from my area of riperisn access unless weived by ale. (if you
wish to taraive the setback, You c€�� � tU the sppropriats blank belo��f.)
.0/,2 t do vAsh to tvalve the 15, setback requirement.
da not wish to WIRENs the 9 V setback fequiramant.
;p i er I(If*rmzt€onJ
g0l e ; I
k 114 C
print or Type Name
N1 9-LA) &I
Wa ling Addmss S , h
0&\e Yl C �, Wyf—
v-djat ent ProparL1r ownCir to OM81taonf
Signature
rir►f or �'fTe erne
f
Me ling Address

FA
7xl a
�f
r