61603D - Beede

`CAMA / ❑ DREDGE & FILL I
3ENERAL PERMIT
JNew ❑Modification ❑Complete Reissue ❑Partial Reissue
Previous permit #
Date previous permit issued
razed 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
Rules attached.
it Name 1�1 1I (/(�.C, Project Location: County 'PYU 1151v ! i s_
l Q 1 1 (1 y (t u �, ((� Street Address/ State Road/ Lot #(s)
t V 1-0- State N ZIP
` IG 17TZ_ IC` — Fax ,#( ) Subdivision
:ed Agent /� �A �1T1(%1 e bV I � c� / a ^City �►. t�S Z I Pc'O--
❑ CW -7 EW Cj'PTA ❑ ES G PTS Phone # ( 0 15 Zk River Basin L u m
❑ OEA ❑ HHF 71 IH ❑ UBA ❑ N/A
Adj. Wtr. Body n
ElPWS: ❑ FC:
yes /lo PNA yes /, no Crit.Hab. yes / no)
losest Maj. Wtr. Body
f Project/ Activity
(Scale: `i -
)ck) length L X V
n(s)
rier(s)
:ngth
amber
�d/ Riprap length
g distance offshore
ax distance offshore
hannel
bic yards
mp
ise/ Boatlift
lulldozing ,
W\t
ll
to Length _
not sure
yes
no --
,s: not sure
yes
no
rium: n/a
yes
no
( yes
no
Attached:
yes
no
ing permit may be required by: YxmW i Lk bl�— ❑ See note on back regarding River Basin r

R
4 � AV Oc,
- ♦14
Y
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Ha
O
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue dames H. Grepw Dee Freeman
Governor UWeCtDr Secretary
AGENT AUTHORIZATION FORM
Date:
Name of Property Owner Applying for Permit: Name of Authorized A lent for this project:
Jolrakyld
Owner's Mailing Address:
6 f 9 Phone Number (9I6)
Agent's Mailing Address:
Z��d9
Phone Number (01Y) S q Z 3 d 2-2'
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all LAMA Permits necessary to Install or construct the following (activity)'
(my property located) at
This certification is valid thru (date)
Pro erty Owner Signature Date

03(
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\d5600 V
Cok C�
;R
ea

applicant:
)ate:
Permit #: U I I , O-30
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ound in your Habitat code sheet.
'abitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
tem 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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
I `
O'
Dredge ❑ Fill ❑ Both ❑ Other
1 C)
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 ❑

MARITIME BUILDERS, INC. 12-06
1957 STONE BALLAST WAY SW
OCEAN ISLE BEACH, NC 28469-6537
/U
2514
66-19/530 NC
DATE 2210
8 7.
kof America''I
053000196

■ Complete items 1, 2, P i' 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print 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:
,¢5 svc, XW
�5 �5 q .6 �l�
A. Signature
X ❑ Agent
❑ Addressee
B. Receive y (Printed Name) ate of Deljv
It
D. Is de ivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label) 7 011 0110 0000 8670 6729
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print 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:
A. Sign ture
X 17 ule' ,r, ❑
B. e by,(Pri ed e) C. Dat of pelivery
37
D. Is delivery address di erent from item 1? es
If YES, enter delivery address below: ❑ No
3. Service Type —
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label) 7 011 0110 0000 8670 6 712
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 ;