63161D - Hardee

CAMA / DREDGE & FILL Q�( A ` iA
'3ENERAL PERMIT Previous permit#
1New 'Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources —+ `, .'-1Oo
-oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC t
(� ules attached.
t Named `U�al�s /��''tJ�1�, VJ ��rL Project Location: County ^okt. w\ a",
VV Q LI 1yL Street Address/ State Road/ Loft,#(s)
A 0u- W n State NC ZIP Z � �' T 4, C�-vt
'g) ��L70
Fax # Subdivi§i
teA"e4r v
ity (� (AA,zip
❑ CW EW ❑ PTA ES ElPTS P ne [ V River Basin L�-M
❑ OEA ❑ HHF '❑ IH ❑ UBA ❑ N/A
El PWS: ❑FC: Adj. Wtr. Body GL.Q \. ` nat
ve /� PNA vec /.lint Crit_Hah_ vac /�1 Closest Maj. Wtr. Body �/� YV
' Project/ Activity
J
klh
lengte offsh rece offish re
W Boatlift X
ig permit may be required by:
-- I 1 1
❑ See note on back regarding River Basin rt

WILLIE CLARENCE RICHARDSON
DBA RICHARDSON CONSTRUCTION 5592
PH.910-842-55963235 SEACREST AVE SW 66-112/531
SUPPLY, NC 28462-2589 S[G •�C/[.
Date
Pay to the
Order of �
�t �C Dollars
e.va.
BRANCH BANKING AND TRUST COMPANY
(o3i'(4I D KB (3i(031)
F 631 ip2b (o3Llo4b G�J .��-� ` NP
1:053 10 1 1 2 wo000IS p i S PLAq a 4KKan r, r,Q a

C Division of Coastal Mgt. Habitat Impact Computer Sheet
plicant: aW(t,6 �1&40J �— V-kU Permit #:
ate: 1'gl
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen
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 fin,
disturbance.
Excludes any
restoration and,
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
`� 1
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 ❑
12,>c I-2, = I t a

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A1..r}h r nrn4;nn nnnartrnnn? of Pnwirnnmant P nri W;;hiral PSru {f^P�
AVISIGiri Of Coastal Manacement
r�rlj Pay, c pp—r—d ? k James H. treason
vemor lire:. cr
uee tree
ACC PNT Al i i i-inRI ATION FORM
pate- S-- -
ne of Prnperty Owner Anollvina for Permit: 1Name of Authorized agent Tor tnis pra;ecE.
tler's Mai-Afing Address:
�—�} n,,.,, Alf c, � 7
. gent' iV%a%%3r Age+'SSS=
IDA
;, -hTv fhnf t hava ni ithnn7e , the anent listed above to act on my behalf, for the purpose of app#yizg
- •--1 -- ---- -
and obtaining all LAMA Permits ne cessartt to, instal' o, construct the tottowing i acIIvII�i)_
its certification is valid thru ;rtatej

10,
16"0
CANAL
8ftX16ft Float
-UP New Boat Lift
8ftX16ft Dock
50'
Matt Hardee140 Tuna Dr
304 Westwood Dr
Elizabethtown NC 28337
1-910-874-4020
16'10

i-2014 14:33 From:APEX PTO 9195671538 To:9108425597 P.1/1
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOX A PIEAX00RING PILING"OATLIPTIB�O�ATBOVSA?
I hereby certify that I own prop' adjacent to 1���- _ LLA P k is
(tiame of Property Owner)
property located at
OLot, Block, Road, etc.)
on in.a v._ N.C.
(Wat{eerbody) (Town and/or County)
f
Appiiraut' a phone #: 9 jk1 b/ -- u Mailing Address: �,3�'� w
U to Lw&Aaat r Q 3'i
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections tD his proposal. I understKA that a pier/mooring pilings / boatllft / boathouse
must be set bade a minimum distam of ftiieen fern (151 from my arm of riparian wmss unisss
waived by me. (If you wish to waive &e se#bmk you mart initial So appropriate blsuk
below.)
I do M wish to waive
`' W--,Li_g wish to waive taut setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be fdkd in by in*viduai proposing development)
(Information for Property Owner Applying (Riparian Property C*ner Informatio
for Permit)
Mailing Address — 1 Signature
City ip Print or Type Name
,