63162D - Purdy

�CAMA / . DREDGE & FILL 1A.
GENERAL PERMIT
lNew Modification ❑Complete Reissue ❑Partial Reissue
A.
Previous permit #
Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources,
-oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
" 11 Rules attached.
it Name j �S tll Project Location: Countycj�gJl /li/
tV1 Q"i Street Address/ State Road/ Lot #(s)
I RState Wt, ZIP 2 *ftow � 4 2 &
ax (#��(_) Subdivi io -Y r,�
:ed Agent NI WAS �S1 ity ZIP :�"
� 1
❑ CW �;l€W PTA ❑ ES ❑ PTS P e �# v) �1 River Basin wy�
❑ OEA ❑ HHF LJ IH ❑ UBA ❑ N/A
Adj. Wtr. Body (nat
❑ PWS: ❑FC:
ye / no PNA yes / o Crit.Hab. yes �no^ Closest Maj. Wtr. Body
Project/ Activity
ck)
ly
ngth
tuber
J/ Riprap length
distance offshc
x distance offsh
cannel
)ic yards 11
ip
se/ Boatlift
illqozing
I—Ax
a Length %V
not sure yes Eno
not sure yes
cum: n/a yes no
8ys
n^olttached: )Qn /c
ig permit may be requirec
(Scale: I ��

WILLIE CLARENCE RICHARDSON
DBA RICHARDSON CONSTRUCTION
PH. 910-842-5596
3235 SEACREST AVE SW
SUPPLY, NC 28462-2589
5592
66-112/531
Date
Pay to the
Orde�r- of
$ � )
Dollars
BRANCH BANKING AND TRUST COMPANY
\ 1-800-BANK BBT BBT.o
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C, Division of Coastal Mgt. Habitat Impact Computer Sheet
l
plicant: /��R
�iQ` Permit
te:
g I�
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremer
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
V v""
Dredge ❑ Fill ❑ Both ❑ Other
3
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 ❑

%-2014 08:51 From:APEX PTO 9195671538 To:9108425597 P.1-11
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C;ANAI
8ftX16ft Float
New Boat Lift
UP
N II 7ftX16ft Dock
16'10
- -- - - 50' -
142 Tuna Dr. Morris Purdy
8213 Netherlands Dr
Raleigh NC 27606
919-669-2660
16'10-- -

ADJACENT RIPARIA' PROPERTY OWNER STATEMENT
(FOR A PIERIM00R1,VG PILINGS1B0.4TLIFTBOATHOL4SF-)
I hereby certify, that I oN%m property adjacent to AIL C^ ' Lnrl
(Name of Property Owner)
property located at —Nts�TIL,.nCIJ__ , ,
(Lot, Block, Road, etc.)
in A
Si f
7 �
(Walerbody) (Town andlor County)
r,
Applicant's phone 4:91 —t; 41tMailing Address:Fza /clr i$��an1�s br
He has described to as sho-,vn 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 (1 41� 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 A_-iDiOR DRAWING OF PROPOSED DEVIi.LOPTY ENT:
(To be filled in by individual proposing development)
(Information for.Property Owner Applying
for Permit)
Mailing Address
(Riparian Property Own Information)
'� w Signature

�./, vcr �`Q-•-t c� Inc- ! � Y�
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFTBOAMOUSE)
I hereby certify that I own property adjacent to hLu 's
(Name of Propertyt Owner)
property located at 14C Tc441CA -
(Lot, Block, Road, etc.)
in Ctd%`k , in 14 N.C.
(Waterbody) (Town and/or County)
Lpplicant's phone #:919- 44 2 "ailing Address:7-213 AJrAelWi5 6-
ie has described to me, as shown below, the development he is proposing at that location, and, I
tave no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
nust 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
Klow.)
I do not wish to waive
D" wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
C, f i i u )C eQe i f-
(Information for Property Owner Applying
for Permit)
Mailing Address
(Riparian Prope% Owner Information)
/✓1,`1d- 00 C—. H t vE
Signature