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Bank ofAmgr ca. 2282
►TRUCTION, INC. ACHwrosa000l/
LANE 66-19-530
RY, NC 28460 / �s
dj_�j
DOLLARS
8

c
cant:
Permit #: o � 3
5(z"1(C�
-ibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
1 in your Habitat code sheet.
TOTAL Sq. Ft. FINAL Sq. Ft.F
(Applied for. (Anticipated finaled
DISTURB TYPE Disturbance total disturbance.bance
it Name Choose One includes any Excludes anycludes
anticipated restoration
restoration or and/or temp
temp impacts) impact amount)
L Feet
for.
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑ Fill ❑ Both ElOther 35
Dredge ElFill ❑ Both Elther ❑
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 ❑

574
":;AMA DREDGE & FILL
GENERAL PERMIT
Previous permit #
�;ewModification Complete Reissue Partial Reissue
Date previous permit issued
authorized by the State of North Carolina, Department of Environment and
Natural Resources
id the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
-
Rules attached.
)plicant Name
Project Location: County
Jdress I A-D
Street Address/ State Road/ Lot #(s)
tyState NK—ZIP ­L-7-4�-11--
)cine # E� Fax #
Subdivision——
ithorized Agent
Ci ty zip
fected CW A—EW ,IOTA ES PTS
Plione # River Basin
:C(s): OEA HHF 1H UBA N/A
Adj. Wtr. Body _
PWS------------ :­FC:
RW: yes IcSjo PNA yes k� or Crit.Hab. yes
Closest Maj. Wtr. Body
�pe of Project/ Activity
Pier (dock) length__
Ilatform(s)_
:ingerpier(s) 2­5
groin length
number
3ulkhead/ Riprap length
avg distance offshore i #
max distance offshore i
lasin, channel
cubic yards
Scat ramp
batho
U�f
'each BulWozinig
3
X '14 �rj
her I a �Y'
horeline Length - — -------
OW: not sure yes
3ndbags: not sure yes
loratorium: Na yes ilia,
holes: yes
laiver Attached:
building permit may be required by:
Special Conditions
� 2—
k1C
'k�-414
See noon back regarding River B4ip rules.

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date '2 2-0 13
Name of Property Owner Applying for Permit:
)�fln± 'De in
Mailing Address:
1.415D wnd6e- PJ
I certify that I have authorized (agent) AY_ lTl` i1012t I na-S G' lin jkl(./to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) byai- (tI f if G bck aLk-Kahin , ,
at (my property located at) Y'Q� U w lh .•
This certification is valid thru (date) R () 1.9
h
roperty Owner Signature
�//a p/J
Date

14
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im
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05!0412013 07:07 910'2893F 94 DUPLIN WINER'r'
PAGE 021
GARDLINA PACI;ERS INC
05,'�' 7/2013 7.5: a3 :11,99$967�14
CERTIFI D MAID RETUFIIV Ri=Cf_i i EiEQugsTr:D
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN pROPIERTY OWNER NOTIFICATIONANAIVER FORM
Name of Properly Owner:
FAIR-7 02
Addm-ssof property: - � -- s►,�`sa-.—: .�W�_T. - --
(Lot or Street #, Streri or Road., amity � County) _
Applicant phone*, .
��(ZLI-- Mailing Address:
I hereby certify that I own property adJrarent to the abova referenced property. The Individual
applying for JhIs permit has described to me as shown on the attacghiM ddr- wi ed * et lol mem
er,
posing. A descript pn or drawing., w h iC�.�u$sha;re no objecticros to Qtis prc�}aasal. J have objeakyns to this prti+posai.
rryou have objection : to what it- being prapo;,,ed, ydu ►rru !�,r notify the orvrsiort of Coastal Afs►nagemeni
(DCM) in writing within 10 days of rea;pipt csf this notice, t:ontact infbrmation for DCM off7ces is
availabin at www.nccoasfalmnngemi�nf.neticontar, ,-dem.htm of hy, caffinq 1-8884RCOAST Nu
rap once is coirsldered the same as no ac Jac 1F ou + &an notMed b Certfl?ed M-1.
WAIVER SECTION
i understarod that a pior, dock, Mooring pilings, breakwater, boathoww or lift must ba sot back a
minimum distance of 16 from my area of riparian access unless waived by me. (If you wiari to
waive the setback, you rpu,g phial the Appropfiate blank below.)
I do wish to waive. the 15, setback require"frt.
i do not wish to w aivo the 15' setback requirement.
F CtFro-writv Owner. tnfnrmotin
Signature '
f Print or T1pe Name
i Mailkw Addmss
r�y�s�t�izip
I
21a

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: _ _
Address of Property: 1 r i v
(Lot or Street #, Street or Road, dity & County) ��^
Applicant phone #: ► �`� �__ Mailing Address. � ► �i °_
11-�n � ► �iG ��
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 dimensit,_ s,-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 bei ijpropnsed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipi of this notice. Contact infl-.'nation for DCM offices is
available at www.nccoastaimangeme:.it.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if ycrf have been notified by Certified Mail.
WAIVER SE�„ION
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.)
�P-*—�C I do wish to waive the 15' setback requirement.
I do not wish to waiv,:k the 15' setback requirement.
Ki av«�
y Owner Information)
Signature
Print
or�Type Name
Z
Mailing Address
V 2L
( P►'Df�'9"� ner Information)
Siknajdre
Print orYype Name
Mailing Address 7.1