61507D - Anderson

�- GAMA / _ DREDGE & FILL Ob M 61,
GENERAL PERMIT Previous permit#
r- New 17111odification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
orized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC +
_ 5�Rules attached.
nt Name k, Ar1elt�S�r Project Location: County 1I-) I i i
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State
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d CW EW PTA ES ❑ PTS
011 Ill I UBA ❑ N/A
PWS: Ill
Street Address/ State Road/ Lot #(s)
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Subdivision 1 l+rt- 1 t)
City --till ZIP -.-�
L42—
phone # ( ) River Basin ;JJWI
Adj. Wtr. Body dCW(LC( TL- II►.)
f 1 �
yes / no PNA yes / no Crit.Hab. yes / no Closest Ma). Wtr. Body ��` W t,V
A Project/ Activity
(Scale:
ock) length
m(s) X 1 V
piers)
length
umber
ad/ Riprap length j
vg distance offshore
iax distance offshore
-hannel
ull yards
imp
ruse/ Boatlift
Bulldozing
KAM r
7t
-' E
ne Length _
not sure
yes
( no
gs: not sure
yes
(no
)rium: n/a
yes
'no
yes
no
Attached: yes no
ling permit may be required by: `�1rU1154�1 C!4- CLt'%y1I 1 _. ElSee note on back regarding River Basin

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NOW
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Name of Individual Applying For Permit: J--
Address"Of Property:—_—
c
county)
I h�'+�bY certify that I ovn-
raferQnced property- The indivl ua�er'tY 1 adjacent to the above -
described to me as shown on the attached d�avin r this development
has
they are proposing. A description or draws 9 the daveloptaent
should be provided with th;s letter. nl, with dimensions,
—Z-- I have no objections to this proposal.
I understand that a pier, dock, mooring pilings, breakwater, boat
house, lift Quat be eat berJc a min
Eroa� i area of riparian access unl*ss waived b Man distance of 15'
to waive the setback, y y me- (If you wish
eelov_) Z� initial the appropriate blank
I do wish to waive the 15'setback requirement.
I AQJ= Wish to waive the 15'setback requirement.
'1 ture
bete � * •
rent Kane
elephone Humber p t-h 4krea Coda H R

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D zI AM Y T
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Name of Individual Applying For Permit: KC, V., ; h4r-e n
Address"of Property:
v1i1 � e- Lv t
(Lot 'or Street Street or Road, Czty & County)
I hereby certify that I own
refer,mnced property• Thm individu property
tY adjacent to the above -
described to me is shown on the attached dravinying r this permit has
they are proposing. A description or dratwi 9 the development
should be provided with this letter. ng' with dimensions,
___ ____ I have no objections to this proposal.
C understand that a pier, dock, Mooring pilings, MUSS, lift braa)cvater, boat
Must be set back a minimus distance of 15•
!ram my azea of riparian access unlees waived by me. =o valve the , l,Qn (If Q
}slow.) setback fast initial the appropriate blank
I do with to waive the 15fsetback requirement.
I AQ-J= Kish to waive the 15•setback requirement.
Date A60
ru,t xame
elephone Humber v *ti a r.._ �IF= HN R

, N V
W O
°W o�LETE THIS SECTION
N N O
2 N is 1, 2, and 3. Also complete
' cted Delivery is desired.
■ t�nnt 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:
s4o Ire C-
� El Agent
1 ❑ Addressee
4f.rl Name) I C. Date of Delivery
D. Is delivery address different from item 1? ❑Yes
If YES, enter delivery address below: ❑ No
3. Service
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
l o 5— 4 Restricted Delivery? (Extra Fee) ❑Yes
7j ij
2. Article Number 7011 0110 0000 8670 5463
(Transfer from service label)--------fM595-02-M-1540
PS Form 3811, February 2004
Domestic Return Receipt

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U.S: ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action ID. SAW-2013-00290 County: Brunswick USGS Quad: NC-LOCKWOODS FOLLY
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner: Kami Anderson Agent: Greg Holden
1620 Summerview Court 1502 Stone Chimney Rd
Bolivia, North Carolina 28422 Supply, NC 28462
Telephone No.: n/a Telephone: [phone]
Size and location of project (water body, road name/number, town, etc.): Site is located along the
Lockwood Folly River at 1620 Summerview Court, Bolivia, Brunswick Countv, North Carolina.
Latitude: 33.9700654°; Longitude:-78.2463416°.
Description of activity: Construct a docking facility with a floating dock and boat lift as shown on the
permit plans received by this office on 12-20-11. The docking structure shall not extend more than 21
feet from the existing bulkhead on the Property.
Applicable Law: Section 404 (Clean Water Act, 33 USC 1344)
X Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number: GP 197800056
Nationwide Permit Number:
Your work is authorized by the above referenced permit provided it is accomplished in strict
accordance with the attached conditions and your submitted plans. If your activity is subject to Section
404 of the Clean Water Act (as indicated above), before beginning work you must receive a Section 401
Water Quality Certification from the N.C. Division of Water Quality (telephone [phone]). For
activities occurring within the twenty coastal counties subject to regulation under the Coastal Area
Management Act (CAMA), prior to beginning work you must contact the N.C. Division of Coastal
Management in Wilmington, NC, at [phone].
Please read and comply with the attached conditions. Any violation of these conditions may subject
the permittee to a stop work order, a restoration order and/or appropriate legal action.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain
any other required Federal, State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of
Engineers regulatory program, please contact Mr. David Timpy at [phone].

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Applicant: j�/j'A,t, Permit#:
Date:
3/4 i3
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
'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
impactamount)temp
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

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HOLDEN DOCK B BULKHEADS 4871
GREG6�'tVi'�I/�A-B DOROTHY HOLDEN se- 871
:; Q:a0�84,2 732 HRS;NCpL.4WO4W HERS 5202842 r"j .�bAn