62638D - Beam

C/,,\MA /I DREDGE & FILL �T? 6 / ty °
GENERAL PERMIT Y Previous permit#
/New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
>rized 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 Q 7 fln
l ElRules attached.
it Name /r // l Project Location: County 4/e1-1
�5 %GS / /—r < I Street Address/ State Road/ Lot #(s)
A ,,�� _ State ,IC ZIP 4�44� // �% % t�G/ Ir
�SG'fax # ( ) -- `.--
,r» Subdivision
zed Agent t'?��YC. % y��y �'j City 1114 `?lf'42� ZIP
I Cw EW y PTA ❑ ES G PTS Phone # River Basin
OEA HHF IH UBA i- N/A
Adj. Wtr. Body A441 �ys�i�y � (nat
PWS: FC: ��ww
yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body w1� 44tt2�J/�✓�
of Project/ Activity /��/ljjflj�'19�i, ll' •'� ��r^j��/jam
lock) length
-m(s)
pier(s)
length
camber
:ad/ Riprap length
ivg distance offshore
nax distance offshore
channel
:ubic yards
amp
)usaioatliW� 1-9 %1 n
Bulldozing
(Scale:
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■�■■■ rn-INME
WHOM
■■■NI■ Av■11■■■■■�■
ONE ■■n ■■■■■■ ■1N■■■■■■ppi �
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i

)plicant: �4 %
3te'%
Permit #
�'zi�' 39
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet
DISTURB TYPE
3itat Name 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
andlor temp
impact amount)
TOTAL Feet
for.
(Applied(
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
p
disturbance.
Excludes any
restoration and/or
temp impact'
amount)
^ /
G' v ✓
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 ❑

r
CONSTRUCTI+'.
10 ON INC ®Raft away
3212
6B30365
Date
n/ $
l Det.ii..�
3532061458n■ 032i2

Letter of agent
I /I,//L L. &q;M d. ���,�-vt� have retained Mark Clements DBA, Clements
Marine Construction Inc, to make application for any and all permits needed to start
construction on the work requested for our property or properties.
By allowing Mr. Clements to make such applications I do understand that this will in no
way relieve me of any obligations to perform all work according to the building codes of
North Carolina, CAMA, DWQ or any other state and or county ordinances.
Pr t ,t
Signature '
f /�'.5-�0-jW2 � d� �A�csSA� date
Contact information

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: PI) r, i� J( 13eaoo
Address of Property: (00L+ 0)) ct I —a 6--d
(Lot or Street #, Street or Road, City & County)
Agent's Name #: I" o,,K ale r\Ae f)+5 Mailing Address: ) 1 Z C ►y-L de- pr►�
Agent's phone #: qj/� Zo g505— j `1GM 105 �eC, L Z L 3
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 y 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.nccoastalmana_gement.net/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.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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)
Signature
Print or Type Name
(Adjace roperty Owner Information)
C — I
Signature
Print or Type Name
33S to

irs, Robb L
m: Mark Clements [[e-mail]]
t: Wednesday, September 11, 2013 12:54 PM
Mairs, Robb L
eject: Fwd: lift replacement
t from my iPhone
;in forwarded message:
From: <bange(a;ec.rr.com>
Date: September 11, 2013, 10:47:45 AM EDT
To: mark clements <cl ementsmari neco (1bel I south.net>
Subject: Re: lift replacement
Good morning Mark,
I have no objection to you replacing Bill Beam's boat lift.
Bill Ange
---- mark clements <clementsmarineco(abellsouth.net> wrote:
good morning bill, attached is the request to replace mr.beams boat lift, if you have no way of
printing this form and returning it, please indicate that you have no objections by e-mail and I
will submit this to rob and see if he will be ok with that, thanks for your help in this project.
Mark.
RECEIVED
DCM WILMINGTON, NC
S E P 11 2013