64059D - Wagstaff

F-)CAMA / V DREDGE & FILL 9'liA 11 O`er mf f '
GENERAL PERMIT Previous permit#
New Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
iorized 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 % (J
2Rules attached.
tnt Name-G'� {�/� rt Project Location: County IZ. u►�►SVJ
s � i RJ I L- L '�,rUNC f -t' ft ; Vt V)g Street Address/ State Road/ Lot #(s)
State N(.ZIP 2,-7(ot?3 ' .�jQ W , ►%'L- Pttj o
# n-1-71) 1- �0 - LM1 +fflV
JE ( ) TVV0%i&(Y15 rt*
Subdivision
ized Agentk-P- t((fi! 1' NeV
1 Nrr- C �K�J. W -J'UnV
City iklL. ►fit_ /t-I��
ZIP 7,8
d ❑ CW ❑ EW ❑ PTA
�-ItS ❑ PTS
i
Phone # ( )
River Basin t�uy
❑OEA ❑HHF _IH
•
=UBA El N/A
Adj. Wtr. Body mUNTbt?
MuZ�-�iE
'
V Ydy y
yes /: no PNA yes
no Crit.Hab. yes / no
Closest Maj. Wtr. Bo
A Project/ Activity
�2 \ V (�5Y V�� t}'�7�
� 41 f t � ►1 rV (r�
(Scale:
ock) length
M(S)-
length
umber
ad/ Riprap length
vg distance offshc
iax distance offsh
:hannel
ubic yards
imp
Use/ Boatlift
Bulldozing
ne Length
not sure
gs: not sure
,rium: n/a
Attached:
11
ling permit may be required by: U 'ARL See note on back regarding River Basin

DENR CAMA Daily Check Log for WIRO
Date Check Check
Received Check From (Name) Name of Permit Holder Vendor Number amount Permit Number/Co
Marine Construction Inc.
11/26/2014 American Marine Construction INC
es Perry Marqaret Waqstaff First Citizens Bank 85738 $400.00 GP 64059D

4C Pivisjon of Coastal Mgt, Habitat Impact Computer Sheet
\pplicant:
)ate: I ( / i
Permit #: 84C5q
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measureme
ound 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 amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated fii
disturbance.
Excludes any
restoration ani
temp impact
amount)
l 1 1
Dredge ElFill K� Both ❑ Other ❑
I �� l�
`
OO
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 ❑
rc
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both. ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

Michael F. Easley, Govemor
order to obtain any
NIUM14K
,North Carolina Department of Environment and Natural Resources
Division of Coastal Management
James H. Gregson, Director
Authorized Agent Consent Agreement
William G. Ross Jt
is hereby authorized to act on my l:
(Printed Nate of Agent)
MA permit(s) required for the property listed below. The authorization is limite,
)ecific activities described in the attached sketch.
OCATION OF PROJECT:
��yv�, Y-� . Z BSE� S`
ROPERTY OWNER MAILING ADDRESS:
Q I,� 28,0 - 1�9 1 `1
PHONE NO.
.UTHORIZED AGENT MAILING ADDRESS:
6R. 1N NI
.1• ► . ...pal 9
PHONE NO.
ignature of Property Owner:

1741 tv'9-5s
Noma of Individual Applying For pamlit: `(` jL(-(�a et
Aat em of Prope:M :3 ci
(Let or Street A. Street or R:osd) _
i0r-v and Comer)
hereby certify that I own property adjacent to the above-referencea propc.-Y. The irtdiridual
applying for this permit has described tome as shown on the ached drawing the dgVek)WnMtheV
are ptaposing. A description or drawing, with dimemlons. should be Provided with tip 1e{{ft
K — _ ' have no objections to this proposa;
If you have objections to what is bdag proposed, please wrlrt the Dl,iswiun of Co
Management, 127 Cardtnal Drivo Extsaaion. Wilmington, NC 28405 or call 410 796-72-15
within 10 days of recalpt of this notice. No response is considered the some as no objed6nii
you have been notified by Certified Mail,
WAIVER SECTION'
I understand that a pier, dock, =oringpWugs, breakwater, boat house or boa: lift tAwkbese
bcka minimum distance of 15' from my area of riparian access - unless iraiv' b. nk, tlfyo,
%vish to waivt the setback, you must initial the appropriate blank, below
do wish to waive the i 3' setback renuire^,e
i do not A-ish to waive the i t' setback,-.alzirtT-rr
®m1

P.
AMERICAN MARINE CONSTRUCTION
3600 Old Bridge Road
rt, North Carolina 28461
rk(ArX
DocK
INVOICE NO. #
(910)41,
(910)49,

%ftJ tGIl Js
NUM Of IAtitvidual Applying For P!! ailt: (riC!-i`
adtfrees of Ptop[P h i n
,L of or Street it, Sweet or Rotdl
f 0tv Bud CotM..) --
! hereby cerdry that I own propeM adjwatt to the above-refemaced propc y. The indivldw
appi�ing fOt this permit has desaiW to me as Shown on the ataached drawing the devdoptn ache,
are prOMI Sing. A descritnion or drawing. wit dimensions, should be CrOVided with this L,}e,
K r I have no objections to this proposa.
If You have objections to what is b*Wg proposed, please write the Di. islun of CaG5*1
Management, U7 Clardtaal Drive UtensWa, Wilmin;ton, NC 28405 or c:111 `}1�?96-7215
wirbia 10 days of recelpt of this notice. No response is considered the some as no obie 6nif
you have been notified by Certified Mail,
WAVER SECTIOIN
I understand that a pier, dock, amoriugpiliags, breakwater, bout house or boat lift dnnskbeset
beka minimum distance of 15' froth my area of riparian aecess - unless tiraived b. me. (ifrsu
% isb to waive The setback, you must initial the appropriate blank below
do wish to waive tha 15' setback renuire.­ ---.
i do not wish to %veive the t;' setback
.rNF-mr-inw. .