63180D - Hughes

CAMA / :❑�I pREDGE & FILL rya
iENERAL PERMIT
Previous permit
flew —]Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and
Natural Resources �( �c
G� ` ` 140 01700,
oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC f ❑ � chid.
--�
:Name
Project Location: County R�
(� 1 f1t• t' GV t
Street Address/ State Road/ Lot #(s)
�1
State ZIP'=
i ` 3 t �fsS t.Pti1�-111!
_l
" 1`,9 Fax # (_)
ed Agent tlt
Subdivision_
City �A' ZIP 7`n `H
❑ CW 'KEW NPTA K2fES ❑ PTS
j❑"
River Basin C
Phone # f
UBA N/A
❑ ❑
❑ OEA ❑ HHF IH
, . '. l
w
Adj. Wtr. Body tW�nat
❑ PWS: ❑ FC:
yes no PNA yes / FCrit.Hab. yes / no
�) �
Closest Maj. Wtr. Body
' Project/
:ngth
'�tuber
,�Riprap length_
g distance T-
ax distance offshore '
Oannel 26 /O©� X
ibic yards
ldoz
0
ne Length
not sure
gs: not sure
wium: n/a
ling permit may be required by:
Bain

Bank of America
ALLIED MARINE CONTRACTORS, LLC 08-03 ACH R/T 053000196
910-367-2159
92 HAROLD CT.
6484
,:
66-19/530 NC
58754
HAMPSTEAD, NC 28443 41- B
PAY TO THE �/� f
ORDER OF.AJe- i $
a
n �/ O4e- � ` -o DOLLARS u
w
LL
MEMO LL
I/aq G,
AUTHORIZED SIGNATURE
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Division of Coastal Mgt. Habitat Impact Computer Sheet
►licant: PrjaVl 4e S Permit #:
e: I) f 2ZI
;cribe 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
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 fina
disturbance.
Excludes any
restoration and/(
temp impact
amount
r pp
V W
Dredge ❑ Fill ❑ Both ❑ Other
ZS6
2 S 9
Dredge2.4
Fill Both ❑ Other ❑
Dredge Fill ❑ Both ❑ Other ❑
Z 60p
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 ❑

IMA
7*
RCDU4R
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director Wii = G. Ross Jr., Secretary
Date / - 61 I Lf
Applicant Name
t9l" h4
Mailing Address /11 �.3 A�r
v
I certify that I have authorized (agent) 174�e,,�,., to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) Zmae-L 6u1*J k•,g7 , a4- e fir,
at (location)
This certification is valid thru (date) I Z - 3 t -/ Y
Signature

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to ktA-\ I
(Name of1roperty Owner)
property located at
(Lot, Block, Road, c.)
on , in /,A ti 4fe—e , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: fl t o 3(e 7 Mailing Address: 9 Z bk O
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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
--------------------------------------------------------
(Information for Property Owner Applying
for Permit)
(Riparian Property Owner Information)
7 3
'Miaig Address
Signature

DIVISION OF COASI'AL 11tIANAQEb E
DJ ACE T ItiPA►RiAN PROPER'T O NQ' CA'ITOIst'Vii R FORM
f Individual Applying For Permit
of Property:
(Lot or Street #, s+eet or R(rad)
^� c
(city and Courrty)
Pam; C,/-) ,
Y certify that I own properly adjacent to the above -referee proper_ e it dlvidual
g kir this -e> has descril)ed to me as shoes on the attached drawing the ie7elopmeut they
3osing. A description or drawing with dimensions, should be provided whh' this letter.
have olajeci ion to what is being proposed, please write tie Division of CoasW
em-ent W ! CardiaW Drive pension, WHmingtoi4 NC. 2MW or caH 9%-395-3 0
10 days of receipt of this now No response is considered the same as no objection if
ae been mollified by Cerliffed Maila
stand that a Fier, dam mooring pMngs� break -waster, boat 1110use or boat hT,. w be
a jui ni msain- distance of IT f -om mviarea of riparian mess - zmiess waived by Me (IF
,h ,ro wee a, o setL-Ick you must in= aa appropriate Uwfl- below.)
I do wish to waive the 15` se[haek ML
I ,- not wish to viaive the 15' setha& I Utiament
Da{e
for- AVIA

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$14
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