64017D - Milam

iCAMA /'- DREDGE & FILL
GENERAL PERMIT Previous permit# S/r99:
]New EModification iTcomplete Reissue El Partial Reissue Date previous permit issued
)rized by the State of North Carolina, Department of Environment and Natural Resources , /
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
1@ ufes attached.
it Name 11 .s Project Location: County /(��ti✓ �lr-��!
IV/ State Ale, ZIP���04
73/ ~B371F'ax # ()
zed Agent �T/Ls / r� c,
I L(CW ©'EW �TfiYX ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
yes / / PNA �fe nos / no
f Project/
-I
"n.th 4 'Y %/ S
A
Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s) /
Subdivision
City
Phone # /U— YaRiver Basin `�
Adj. Wtr. Body �f% (_/ll�C at.,
Closest Maj. Wtr. Body
9
(Scale:
��■■1�■■■■!nr��:F:,■■UZ
■►:4[�
:i■��ll;iL�i�(1�lli
1�!'���1111�■■■i".ii�i■■■■v■■■■�■■■I■■ltG��C■
��i1L�
imber
l�?�■!S!!�61!f■I■■■■■■■■■■SI■■!■■■■/1!
■■■
�
■■1■■1lI
d■
I�
_
�1�l■\\■■■■■■
i
ax distance offshore
■■f�■■■■iai
■■■■■■r.■i�l■■■■■■■■��
ME
MENEM
EI
F ■■■■■W:1
PA/J■/�!�►1
�#■■■■■■/J�2
hannel
GME■■Eti
OWWI■■■■■■■■■■
bic yards—
mmmaimmoli,
■■■1■■■■■1�11►/■■■N■■■i!■■■
■■■■■■■■I
■■■■�I■■■■1■■■■■■■■■�■■■!�■■■■■■I
•
}�_
LiLiLl
■
O
.
VWWw
Now
EFINEW_1116,
II,,I
���LLT
Ing permit may be required by: /i'11 CGi• bw. DeDl. _ El See note on back regarding River Basin

OAMA / 'DREDGE &ILL
iJE N E RAL PERMIT Previous permit #
New l-_-Modification --Complete Reissue ..:Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources ? t , , / 'C
oastal Resources Commission in an area of environmental concern pursuant to i SA NCAC /`7 L Rules attached.
Y Name J �' �Q.,y _- Project Location: County— AA!te
5� g !'tC✓►iLlil - ___ Street Address/ State Road/ Lot #(s)__ _
l J✓Jf/__ _ State_ ZIP; —. — --f
fax #
Subdivision
{! --- ---
City— zip
ed Agent . — --„
f M. r PTs Phone # l�t�+t� River Basin
h� CV1/ '��'i�N ❑PTA (—_) _ �1�_ /� y /1
O OEA C HHF '� IH C U8A a NIA Adj. Wtr. Body ti`` - Tx G mil - _ nat
O PWS: — FC: -- �'�—M G�
yes /� PNA es. ! no Crit�li-'ab. yes ! no
Closest Maj. Wtr. Body -
F Pro' t/ Activity %N�-��/�Osr i''i ✓.?� i� ' ��-' ram._
tale:
Kk) length_ ,�S X G _, _..__— i . .._r
n(s) 1 'X /f1
aier(s)—y---— �_ -
angth
,2f� ►ter
T _ amber-
�f
ad/ Riprap length_._
7 '
rg distance offshore___ l
�i " _
,ax distance offshore �f � / y� -
- J�
:hannel
I
ubic yardimp
s _
_.
�...
wse/ Boatlift g
Bulldozing—--
0.1
i
line Length
not sure ;
ags: not sure yes ( -
orium: n/a yes )
y
s: ea r � i ,
,r Attached: yes
ding permit may be required by: A! C/�- El see note on back regarding River Basir

DENR CAMA Daily Check Log for WIRO
Date
Received
Check From Name
Name of Permit Holder
Vendor
Check
Number
Check amount
Permit Number/Con
8/1/2014
8/1/2014
8/1/20141
Hon Construction & Concrete LIC
Holden Dock & Bulkheads _
coastal Marine Piers & Bulkheads LLC
Wafford
Brian Kirkman
Leonard Ta for
Milian
BUT 1073
First Communi Bank 5835
lWells Faro 197171
GP 63984D @$200
GP 63993D
GP 63985D _
1 GP 64017D
$200.00
$200.00
$200.00

IC Division of Coastal Mgt. habitat impact Computer Sheet
,pplicant: iCaG,�, lC Permit #:
gate: 1/
'�9/
iescribe below the HABITAT disturbances for the application. All values should match the name, and units of measureme
)und in your Habitat code sheet.
labitat 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 amm�ount
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated fi
disturbance.
Excludes any
restoration an
temp impact
amount
L-- 47
Dredge ❑ Fill ❑ Both ❑ Other
Q
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 0

, • t
/ • 1
n 11
c, t'
r
r'.7 7"
1
I
I
I
I
I
I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to r'1; �G� ► �- I,�� ��d. a/ s
., (Name of Property Owner)
property located at —S
Loo
(Address, Lot, Block Road, etc.)
on _ %�i �� ��s �' c e �c in /y E «, i�a �: « C' N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Sec 0 ` lnc "
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back
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 wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Sig tur
CU <ti�r
Pr or Type N hme
y caner Information)
SignaturJ / "
r
Print or Typ blame
card JA I _ 0 ✓/ _0

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
R11CLOVOi
r
A.
B. Rq6e'iyAd by (Printed _ , C. Dat of Delivery
10
D. Is delivery address different from Rem 1? Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Nu
(Tiansror froommservice label) 7013 1090 0001 3548 1050
s
PS Form 3811, February 2004 Domestic Return Receipt
CDaits
MHCDO
Ronnie Smith
LPO
DW Review
(U/
Scan to DMoye
M
102595-02-M-1540;