62528D - Booth

�CAMA / ❑ DREDGE & FILL
3ENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized 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
R les attached.
t Name ✓' �r,•-n -�1� i � Project Location: County //.2,_
l C� ��''/ram . Street Address/ State Road/ Lot #(s)
_ 7�V MI h - State ZIP 2 V
4 C Fax # (—)
zed Agent
I CW EW PTA
OEA HHF ❑ IH
u PWS: ❑FC:
yes / no PNA yes
Project/ Activity
ock) length
length
umber
ad/ Riprap length_
vg distance offshore
iax distance offshore
channel
ubic yards
imp
iuseKatlift
Bulldozing
_-_}-
/
m
.,.. /L
ne Length
not sure yes Cl
gs: not sure yes
wium: n/a yes
,,y�/es�anAttached: /ves7L�
ES PTS
U BA N/A
Crit.Hab. yes
Subdivision
City k1/ lt*l;,. kh
Phone # ( ) River Basin
Adj. Wtr. Body i S �/��/� nat
Closest Maj. Wtr. Body
(Scale: A
ling permit may be required by: Y11 e*1 ©, 7/7S b/r2!%J05 ] See note on back regarding River Basin

plicant: , ��//i�t Permit #: 2 5 28
te:
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
itat 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)
ge ❑ Fill ❑ Both ❑ Other
!?er
ge ❑ Fill ❑ Both ❑ Other
ge ❑ 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 0 Both ❑ Other ❑

Rob,
I got my neighbors to initial the changes to the plan (the floating dock) as you
requested and I am including a revised drawing and both Adjacent Riparian
Property Owner Statements with this note. Please let me know when I can pick
up the permit.
Thanks very much,
bsh t'
RECEIVED
DCM WILMINGTON, NC
,JUL 0 3 2013

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RkCEIVE�il)
DCM ILMINGTON, Ni

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to !+Uk(-L i A -A- W.1 s
P(Name of Property Owner)
property located at 2 l� S LF 121 /%
n Ut-zl<
(Address, Lot, Block, Road, etc.)on I Z S , in • Mi) Oeri— , N.C.
(Waterbody) (City/Town and or County)
The applicant has described to me, as shown below, the development proposed at the above
location./
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMEKite
(Individual proposing development must fill in description below or attach adrawing
I 5-b( h tf-
Tp �4-c L I VT S
RECEIVED
DCM WILMINGTON, NC
JUL 0 3 2013
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.
r 1646tmation)
Si ature
I-- L- �. co
P90or Tye Name f
(Adjacent Property Owner Information)
Signature
Print �pe Name I
�_

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Ai
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DT
RECEIVED
DCM WILMINGTON, N
JUL 0 3 2013

f" K°
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Y 9
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M.
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i r
oer

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 1k(. , _t_ i om. i c _ �j UB 114 's
n (tope of Property Owner)
property located at 3 2 �v {' F �� � X(0&-
(Address, Lot, Block, Road, etc.)
on P ��C �t -`c �-a�- _,in L 1 L Nl l /U 6 i D r) N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatipn.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT------,,,
(Individual proposing development must fill in description below or attac a site drawn►
V 1 CA
i 4 x 1 4- PCA-:rF--91L##A-
10 AT-
D C- K
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, 'mp m ,P9-$et
back a minimum distance of 15' from my area of riparian access unless w i o
wish to waive the setback you must initial the appropriate Ink CM L I I Ui'�, �1C
y blank below.
I do wish to waive the 15' setback requirement. JUL O 3 2013
1�. I do not wish to waive the 15' setback requirement.
(Pfgperty Qwrf r inf ation) .(Adjacent Proj3krty Owner I
Print or Type ame Printer a Name/
27 �� 11..

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9,y - cCotM� Olt
i
i 9
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RECEIVED
DCM WILMINGTON,
11 11 n ,% 9R11

Tit�

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own propert adjacent to U) I l_ L t A b.' t L V J000" - f 's
C�(Name of P operty Owner)
prope located at 3 Z ('c—
(Address, Lot, ,dock, Road, etc.)
on in,d,
�I�I LA4 IA.)(," �) N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
_/.� „L_ - I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
1� L
...J7 C ((-
RECEIVED
DCM WILMINGTON, NC
AUG 2 7 2013
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.)
1 do wish to waive the 15' setback requirement.
(P
I do not wish to waive the 15' setback requirement.
ation)
Signgtune
AUI�-'V(r4M
Pri t or Type ame
acent Prope ner Information))
i at r
CY
P nt or Tee Nam ,
7I �