62656D - Beecher

CANM / L DREDGE & FILL Vol 6. ?'!
11ENERAL PERMIT Previous permit#
1New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
•ized by the State of North Carolina, Department of Environment and Natural Resources •� -!
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
J y Er t ❑ Rkles attached.
Name n t-T �--► ^�� Project Location: County b YA S O vJ
�2-) W • C�` - � f l� Street Address/ State Rod / Lot #(s)
AM1e<;S'TF.I4\b State N C ZIP ?-�s44-5 S
)'-V4 Fax # ( Subdivision
ad Agent i-4iY-*-/ I ro City'>U I 1 ZIP 2C;�
CW ❑ EW : � PTA �i❑It S ❑ PTS
❑ OEA ❑ HHF IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
yes no PNA yes / no Crit.Hab. yes no'
Project/ Activity
:k)length
er(s)
igth
nber
I/ Riprap length
distance offshore
x distance offshore
cannel
'ic yards
,p to X OK Zo
se/ Boatlift
illdozing
Length 0�
not sure yes nog`
s: not sure yes E
ium: n/a yes
yes Rno
\ttached: yes
Phone # ( River Basin
Adj. Wtr. Body A t � f sC nat
Closest Maj. Wtr. Body �'�'` o •
I^e,vvi o e s ,,�-e-'I &&A a 2r V)Da4 (vv-k
(Scale:
rig permit may be required by: ✓� ' See note on back regarding River Basin n

pplicamt: , r M ,/�e�+ Permit
ate: ,2. 3 ^ 13
!scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ind in your Habitat code sheet.
5itat 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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
1
Dredge ❑ Fill ❑ Both ❑ Other
dge El Fill Both El ElO
FDre
dgee ❑ 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 ❑

►RI CONSTRUCTION, INC.
252 ENNETT LANE
SNEADS FERRY, NC 28460
BankofAmerica.
ACH R/r 053000196
66-19-530
b
16
SIGNATURE
111002593un 1:0530001961: 2370L5337748ii'
2593
a
c
0
N
DOLLARS -f
8

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N.C. pIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date J
Name of Property Owner Applying for Permit:
Mailing Address:
to 11 NV hnC-1V r, J t IW�A
I certify that I have authorized (agent) 1�11712-1 o act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at)
This certification is valid thru (date) 62I Ll
,k

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Jlr-n
Address of Property:
(Lot or Street ##,�Strreet or Road, City & County) r 1
Applicant phone #: q) o �� �� u 1��1— Mailing Address: (AyTh nug1
A9� `L-Ane-d LO - �-S Krois V
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.nccoastalmangementnet/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WA.;'✓ER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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 Owner Information)
m__ ge—
gnature
T kt-"" 'tz S !-� . 4k s4&'-e
Print or Type Name
(Riparian Property Owner Information)
i
S-
zgiVure'�
Print or Type Name
Mailina Address
Mailing Address /

■ 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:
jyc rM`A1istuS
a k\ Iy(IS o 0.
CGXVj M aj-� t l
A. Sign
❑
X Agent
`� Addressee
B. ecerved y
c r
Name) C. Date of Delivery
D. s delivery ad ifferent from Rem 1_ es
If YES, enter delivery address bell:
' n
)"14f
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Retum Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number —
(Transfer from service label) ,——— " L.u u u u 1, 3991 3823
PS Form 3811, February 2004
■ 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:
Alt SWO Is
5 3y C� �w� -tTh
fAgj, qiZ�AS' I
Domestic Retum Receipt
102595-02-M-1540
A. Si ature
X ❑ Agent
!� ❑ Addressee
B. Re 'ved by red Name) C. Date of Delivery
D. Is delivery address Idifferent from Rem 11 ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Retum Receipt for Merchandise
0 Insured Mail 0 C.O.D.