61595D - Correll

❑CAMA / -J DREDGE & FILL
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GENERAL PERMIT
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Previous permit#
Alew ❑Modification ❑Complete Reissue ❑Partial Reissue
Date previous permit issued
prized 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
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nt Name r 0 6L�- "I %?.l�L�..L
Project Location:
Rules attached.
County k_k i -'• .: , � : C w-
s V L% + - y� 11- I.)(Z
Street Address/ State Road/ Lot #(s)
(J !�"7� C .AY`✓' State NJ( -ZIP aY405
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# ) ,. &x # ( )
Subdivision
ized Agent (ttL i k"-O Mrtfl? AX. — X.)(04"t l 41Z('
, City C'+�L !SL^10
ZIP 2
d ❑ CW ❑ EW _ PTA 7 ES a PTS
Phone # ( )
River Basin LOr
❑OEA ❑HHF ❑IH ❑UBA El N/A
Adj. Wtr. Body
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;�-; � �w �i ,hiat
❑ Pws: ❑ pC.
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yes / no PNA yes / no Crit.Hab. yes / no
Closest Maj. Wtr. Body
A Project/ Activity
ock) length f / }' L
m(s) i
" x 1 C)w I
pier(s) 17 'It 1 Z.f )c 31
ength
umber
ad/ Riprap length
vg distance offshore C
iax distance offshore—�
:hannel
ubic yards
imp
wse/ oath
Bulldozing
.4411101wj;
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wagWORT
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(Scale: { // .-
ling permit may be required by: 2A-V 1 5L f'y ❑ See note on back regarding River Basin

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 6 JI-3
Name of Property Owner Applying for Permit:
P%,Or� C6fre)l
Mailing Address:
(P3/)9 E
I certify that I have authorized (agent) All I'd to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) C� �,�� OWZ4111 Ae) /, { / i 6tAk I ,
at (my property located at)
-Ps/
This certification is valid thru (date)
Property Owner Signature Date

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street or Robd, City & County)
Agent's Name #: �f'�iPl� ��+t�r� Mailing Address:
Agent's phone #: �'�/�'�b�,��� 153U ,HGr9 l'!A� A-
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.
14'' 1 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.nccoastaimanagement.neticontact dcmA 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 Informatio
Signature
k6l�,rk
Print or Type Name
ro�nzj r V
nt
Print or Type Name
Owner Information)
L-) L C 1 �% c�� Or
AA..:I:..... A.J.J-.-.....
A/..:1:-- AA.4.,..1...

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street or Road, City & County) a
/�1o(, /`�— Mailing lc/
Agent's Name #: �,��f< /' g Address:
Agent's phone
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 ar proposing. A description or drawing, with dimensions must be provided with this letter.
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.nccoastalmanagement.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
W Wwish ive 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 Informatio) (Adj P perty Owner Information)
6
Signature / Signat
Print or Type Name Print or Type Nam

a,pplicant:
ro"Mc0
Permit #:
S
Date:/_'
l q�
L�)z4113
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ound in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
abitat Name DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
L_Wl�:#ge
❑ Fill ❑ Both ❑ Other v ��� ` ,zz I
Q ❑ Fill ❑ Both ❑ Other 13 7 1 1319
Fill ❑ Both ❑ Other ❑ (2 C�J ) ZL
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 ❑

5701
Bank of America
ACH R/T 053000196
66-19/530 NC
IE CONTRACTORS, ILLC 08-03
58754
910-367-2159
2 HAROLD CT.
)STEAD, NC 28443
$
DOLLARS
Ge 61's
95