62686D - Taylor

CAMA / ❑ DREDGE & FILL
iENERAL PERMIT') Previous permit #
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources W . , �� O
oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
7 Rules attached.
� Name i� �.�lProject Location: County t'yuK5yji
Street Address/ State Road/ Lot #(s)
--Rwd State_ ZIP J70 ,� L.1�N1)1Y
( ) Fax # () Subdivision i Y
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CW EW PTA ES PTS Phone # ( %O) — U�2 River Basin U(Wti
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(es / no PNA yes / no Crit.Hab. yes / no� Closest Maj. Wtr. Body / �JIJ� ✓
Project/ Activity "I] C A -n
_ _ (Scale:
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er(s)
igth
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distance offshore
x distance offshore
annel
sic yards
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NC Division of Coastal Mgt. Habitat Impact Computer Sheet
i
Applicant: U I/1 D & 6 I �u-
Date: 1� ...
Z/1 /) *
�
Permit #: �ZGM
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremi
found in your Habitat code sheet.
Habitat 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 f
disturbance.
Excludes any
restoration ar
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
Z
Z
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 [:1 Other ❑
Dredge ❑ Fill ❑ Both 11 Other ❑

William G. McRainey u" --l-
Ph. [phone] 7796
1462 Village Point Rd. S. W. ee-1215/531
Shallotte, NC 28470 a'1zj
830
200
t')Ing
( Dollars
WACCA8 s•` FF.Iu
W MAW <"
w �.�.
S) toga t, NC 28459
www.4gafcarnawbpnk
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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date January 4, 2014
Name of Property Owner Applying for Permit:
Robert B. Taylor
Mailing Address:
31 Concord Street
Ocean Isle Beach, NC 28469
I certify that I have authorized (agent) William McRainey to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) Build Dock ,
at (my property located at) 31 Concord Street, Ocean Isle Beach, NC 28469
This certification is valid thru (date) April 4, 2014
Property Omer Signature

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Robert B. Taylor
Address of Property:
31 Concord Street, Ocean Isle Beach Brunswick County
(Lot or Street #, Street or Road, City & County)
Agent's Name #: William McRainey
Agent's phone #: [phone]
Mailing Address: 1462 Village Pt Rd SW
Shallotte, NC 28470
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 development
they are proposing. A description or drawing with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmanagement.neticontact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been noted by Certified Mail.
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 er Inf rmation)
S �ggnature
Robert B. Taylor
Print or Type Name
31 Concord Street
(Adja%cent Property Own nformation) _ik
Signat e
Myrtle B. Hare
Print or Type Name
C/O Alan Hare 8102 Johnson Mill Rd
Mailing Address
Mailing Address

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