63217D - Morris

6CAMA / ! DREDGE & FILL V H'
3 E N E RAL PERMIT Previous permit #
}New Modification -Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resourc� Commission in an area of environmental concern pursuant to 15A NCAC
es a�Ved.
t Name Project Location: County ��
,.?,2 !2, �, C+��-s,ri,.� 4A%" . Street Address/ State Road/ Lot #(s)
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:ed Agent
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❑ UBA ❑ N/A
❑ PWS:
❑FC:
yes I/hV
PNA yes /,/n"q'
Crit.Hab. yes / no
Project/ Activity
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ig permit may be required by: �� El See note on back regarding River Basin r

COASTAL EARTH WORKS INC.
PH. [phone]
1955 MIDDLE SOUND LOOP ROAD
WILMINGTON, NC 28411
4125
j s� 66-456-531
DATE 4 �' / L
PAYTO THE
� )
ORDER OF .p V V` 1 I$ 20c),
t
%T d DOLLARS
FIRST BANK
WILMINGTON, NORTH CAROLINA 28403 �.
FOR Ter d11. y - -- "r
■nnnn■ 1 > r-.,■ .■n r- :i i n■ r-r n.• i r 0nn I n 2n Diu

4pplicant:/�(/ l'�6�'/t/�S
Permit #: � �2
)ate:.
iescribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
)und in your Habitat code sheet.
TOTAL Sq. Ft.
(Applied for.
abitat Name DISTURB TYPE Disturbance total
Choose One 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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount
�Q
yJ Dredge L3}' Fill ❑ Both ❑ Other ❑
9
ve�
ill VBoth ❑ Other ❑
/ ✓w
l j b�
ll ❑ Both ❑ Other ❑
#Dredge
ll ❑ 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 ❑

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _UJ i i l Q �m F, Y► o r Y 1 5 's
(Name of Property Owner)
property located at ola (I N L �rn i nV�h u
(Address, Lot, Block, Road, etc.)
on , in l.c�r,G N.C.
(Waterbody) City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
7/ 1 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)
d u c. <' d. r- e cd.3 i h 5
WAIVER SECTION
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 wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
Signature ignature , Doug] as Dal t ,Jr. OWNER
SYCAMORE SURGE, LLC
Print or Type Name Print or Type Name
2209 N. Lumina Avenue
Mailinn 4rOrncc AA-A:-
AJJ��

:NIUMIM11.411 11119101 :MAOMMA I191 LW41 I WINVIAL btu
Name Of Individual Applying For Permit: am Jf
ors.. 0-
Address Of Property:
, J4, 2 g4-0 0
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above -referenced property. The individual
applying for this permit has described to Me as shown on the attached drawing the developmem
they are proposing. A description or drawing, with dimensions, should be provided with this
letter. DreAL
_ I have no objections to this proposal.
..
.. 1 •. • •�.1131molnel Z4 =Tir.' ►• ••� •� • • .n
7piliyn
SECTION
I understand that a pier, moorinbreakwater, bo�h�use, lift or sandbags must be
set back a minimum distance o ' from marea of ��iaff access unless waived by me. (If you
wish to waive the setback, you must i ' al5propriate blank below.)
I do wish to waive the 15'
I do not wish to waive the 15' setback requirement.

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NCD04R
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
iael F. Easley, Govemor James H. Gregson, Director
Authorized Agent Consent Agreement
William G. Ross Jr., &
is hereby authorized to act on my beh
/ (PrinW Name of Ageno
Jer to obtain any CAMA permit(s) required for the property listed below. The authorization is limited tc
.ific activities described in the attached sketch.
'.ATION OF PROJECT:
►PERTY OWNER MAILING ADDRESS:
o NA- P YAI/ Frresf 4r
N_C.96©G
PHONE NO. q
HORIZED AGENT MAILING ADDRESS: RECEIVED
DCM WILMINGTON, NC
_ APR 1 12014
(( 33 - `1� c� PHONE NO.

■ 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:
C /4rM S
f0�
z 84o3
A. Signature
X ❑Agent
12 ❑ Ad re
B. Recgi�rgd bx(Printed Name) C. Datb o eli
D. Is delivery address dift\ef(�ii item ❑ Ye:
If YES, enter de�IJv\\ss below: ❑ No
o �0.ti
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4 Restrirt.H r).N a .,0 ics.., -
�_.... _ . -...� L i Yes
Z. Article Number
(Transfer from service label) 7 010 16 7 0 0000 1604 4803
PS Form 3811. February 2004 Domestic Return Receipt
02595-02-M-15�n
■ 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: L1 G
sy coMc t-C sUJ'j'e
j o 5 �e%Fer� S� SfC /4ao
P" 'ok-e 1 � 2-
10''
A.te�6
❑ Agent
X ❑Addressee
B.q( ante Name) C. Date of Delivery
r
D. Is deli s e is Item 1? ❑ Yes
If YES. eA deliverq�ibes�dlow: ❑ No
OCM WILMINGTON, NC
APR G 12014
3. S rvice Type
411 Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7010 1670 0000 1604 4834
(Transfer from service label) ---.-