63148D - Vlahoplos

�,CAMA / Fj-' DREDGE & FILL ly ` 4
�ENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue ElPartial Reissue Date previous permit issued
>rized by the State of North Carolina, Department of Environment and Natural Resources t �U
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC i
,I ❑ Rules attached.
it Name ^� U S Project Location: CountyV VfY S' W k-(,
Z>U Vs(Gl y, Street Address/ State Road/
�Lot
� `#(s)
i Stately V ZIP GU li� �l►1 1J�� K 1/t!1 t7� VtiJ ��
l) Fax`# ( ) Subdiv' ion fl
zed Agent iGi�ea ✓ 1V� A Yi C'1r� `t U t f1c�L tiet.Y4�,� �F l(� ZIPI❑ CW �EW PTAjj�S ❑ PTS e #) River Basin
OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A / I `-
❑ PWS: ❑FC: V"
yes % no PNA yes no Crit.Hab. yes /!no
f Project/ ActivityVL 1L i I
Adj. Wtr. Body L V kk U I i (nat(
Closest Maj. Wtr. Body �� W
Vi(\
�) `) (Scale:
)ck) length NTAc
mgth
amber
Ld/ Riprap length_
g distance offshore
ax distance offshore
hannel
ulldozing 14
11
AW
ng permit may be required byj
❑ See note on back regarding River Basin r

NC Division of Coastal Mgt, Habitat impact Computer Sheet
Applicant: N�s V �pPermit#:
Date: Z/ .
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurem(
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 an
temp impact
amount)
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 ❑
7-
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

WILLIE CLARENCE RICHARDSON
DBA RMARDSON CONSTRUCTION
PH. 910-842;5596
3235 SEALL T AVE SW
SUPPLY„N, '28A62-2589
II n
Pay
BRAN,Ch BANKING AND TRUST COMPANY
::I -* 800-BANK BBT BBT.00m
to I �.
For_ Q, � n /9 G lQ5)1 4bb -
5553
66-1121531
Date
s 6ze)
Dollars
� Ffatllf o
Pacts.

# t, f' rn$nn rk�ra3rirr{A'+� of o+irnnTnanf wzr3 Rl +tr�l F �[(�tZrt'PS
1iil U l iJtLN{ lii a1.+rW u irVl it u a-
Uliil9m of Coastal Managernii esi
Beverly E=_Ves lames H. Grgsm
Governor
A.Q-9 1T Al lI-HQ !7Ai i0fIQ FORM
r,!em% Qf 01ropQ ty Owner A atykia for Permit Name at' Authorizzea Agent Tor inns prole
0-1
Owner's Maging Addrrik: rye t �s aiii,�7 Actoress:
Phone �4umber`s—
J
g r8r0f, shot I hsava zt+iih7ri as d the agent listed above to act on my oenalf, for the purpose of apply
for and obteir4no all CAMA Permits necessary to install or canstrum ine rottomng tamivay
�! p.
This 0elIffWbn to valid ru (date)-
�a �
7 /
Pr opedy Ownet 8fpnat>ure fate

T17V151rQ ► OF C C�_ST.4.� �� 'v max. °vT
ADu ICEIN T RIP ARAN PROPERTY 0' VN ER ST A TE3,M T
Name of Property Owner:
Address of Property: C ri 2eL;el lU 7 ? -
ot or Street n; Streeter Road, City « Count-,,-)
Applicant's phone #: `—Z `D `� N4ailing Address.
I hereby certify that I o-'-► property adjacent to the above referenced property. The individual applying for tI
has described to me as shown on the attached drawina the development they are proposing. A description of
with dimensions, must be provided with this letter.
I have no objections to this proposal. I ha ; e objections to t> is proposa
If you have objections to whit is being proposed, -You must notify the Dii ision of Coastal Managemerei
is vfritiug within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal I
Wilmington, NC 28405-3845. DO"A representatives can also be cautacted at [phone], No respo
considered the sa-r a as no obaectiors if von have been notifled. by Certified flail.
VVA1 `ER SE( -TT -it0 Ni
1 understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum d
15' from my area of riparian access unless waived by me. (if you -wish to waive the setback, you must initi;
appropriate blank below.) �1ohd�,
1 do wish to waive the 15' set back requirement. � 7
I do not wish to waive the 15' setback regwFeuient.
(Property Orvaer Information)
Signature ,
?rint or Type Name
Mailing Address
TlUarlan '-PP n r Owner Information)
0
5i nature .
'
dgo
h A 10, 5�,,.
Print or Type Morns
3014 Ftit1Jj n.
Mailing Address

_DMS10i`e OF COASTAL M�.'�AG]F! MEET
ADJAMNT R Pry LkN PR01>ER'I Y OWNER STATEMENT
Name ff{PTOpCItj' Owner-� I t
Adtl= of Property:
(Lot or
Applicant's phone #:W/ D-fF3 F'
!, Street ar itnad, City k County)
Mailing Address:
hereby ter* that I own property adjaceat to the above referenced
has described to me as shown on the attached drawing the de�vela property
The individual applying for
t with a pmentthey are proposing_ &gMn�tiasa ar
I have no objections to this proposal.
I have objections to this proposal
yr a abjeetkms to ►hat is beiRg Proposed, yqo �a'est etataiy the Division of Coastal management
maul
#og with to dQys of rapt of t1�9s notice_ Cor res ge
�d pondence should be mailed to 127 Cardinal 1:D
n 14 NC 284CM-3843. DCH regreseat4tives cam also be contacted at (910) 79&7215. No respoa
�t reel t9ae same as no ablecdon If 6*Ve been notified hit s•A,faa:_ nAr—
I Undergud that a W %lk stcno-m
15' front my ama off- ' dam' moctnng Pilings, breakwaW, boathouse, or lift must be set back a M
nparisu access u'de" waived by me. � You wish to waive the setback uust ��
a blank below.) you mabst tnafsa
I do wish to waive the 15- set back'quirement
I do 'mot wish to waive the 15' set bwk requirement.
` S4 t- -s ••• • • ems+. a-ea�;v[ iAAaiygDAJ
4
� � h
tlf Tye�W—
Printal?me
"121hn9 address
0
(tiparise Pmp6rty Owner Informat ow
Si
Print or Type Name
1%%ailing Address
e

Vacant Lot On