60705D - Daughtry

CAMA / '-' DREDGE &FILL NO• 60
GENERAL PERMIT /K,
Previous permit #
I�New 71Modification -]Complete Reissue Partial Reissue Date previous permit issued
orized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC �i • 1 I ly
Rules attached.
nt Name 1 k4yt, Project Location: County �, ✓U V1 S �� ! t;�1
s �} Street Address/ State Road/ Lot #(s)` +%
State ZIP_ t�i 7�►',l.C,�
# (11 )L0 ` � 3(x ` ' Fax # ( () Subdivision � �f•1 1 ,
izedAgrrnt ❑(�VV -- fl VIS I di ��iGIf�,� A(1, L, ity4-;Lit►, &(4( .� ZIP
d ❑ CW AEW X PTA ❑ ES ❑ PTS Phone # (111 ) ` 4 � 4tn River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A 1
Adj. Wtr. Body(nat
'
yes / no PNA yes ,� no\\ Crit.Hab. yes no,, Closest Maj. Wtr. Body
A Project/ Activity
ock) length
m(s) --
pier(")
length
umber_
ad/ Riprap length
vg distance offshore
iax distance offshore _
:hannel
ubic yards_
imp
ruse/ Boatlift
Bulldozing
a[ nr/J o.'r. Nil %th
y
ne Length ")
not sure yes
no
gs: not sure yes
no
mum: /n/a } yes
no
no
yes
Attached:
_
i
yes
no
ling permit may be required by: iW
J
a
11[yNA
(Scale:
� V�Ll CL ❑ See note on back regarding River Basin
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AW *Creceipt ofthis Ne 6ft t3armp*vAom*sboum w owtbb 3Y1(rsr#hud lhi" X
I & 1 I . OF on dw be cor- - deA at (910) 7064M No visposm it
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of tkm ugm udm waived bq mC. (lfyoa wh 6 bF �• � k, year mut%
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Nlassage Envy Southpoint
9194333299 p.1
L112010 10:42 FAX
CERTIFIED i11< � UjUgN RECEIrF RK"ESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RI.PARIAuN PROPERTY.OWNER STATEMENT
Name of Property Owner.
Address of Property:
(Lot or Strcat 9, Street or Road,
& County)
® 003
Applicant's phone 4: Mailing Address 1910 r% h rd t, �70—
I hereby certify that I own property adjacent to the above referenced property. 7hc individual applying for this pear
has described to me as down on the attached drawing the development they are proposing. A doscsiZiM of dr&vAi
vyi;t diuw iotm - Circe be provided wi ibis ette-k,
1�t< 1 have no objections to this proposal. l have objections to this proposal.
if you have objections to what is be* proposed, you mat notify the Division of Coastal b (nuagerneat (DCM
in writing wifta 10 days of receipt of this notice. Correspondence should be maded to 127 Cardinal Dk ive n
W1lmiugtoa, NC 28405,3M. DCM irepresentatives can also be contacted at (910) 79&7215. No response is
considered the same ga no opierrbn if 12u bne been notified ky t<ertirwd Wlkd .
WAfVER SECTION
I underswad that a pier, dock, mooring pilings, breakwater, boathouse, or lift roust be set back a minimum distinct i
15' from sly area of riparian access unless waived by me. (If you wish to waive the setback, you must inttlal the
appropriate blank below.)
I do wish to waive the IS' set back requirement.
Ido notwish to waive the 15' set back requirenaoaL
0w;►er
Do y 12-%-``�
Pratt or Type Name
Mailing Address
City I Statc J Zip
Telephonei(umber
Lion)
sm,mlatute '-6b �s
Print or Type-GiNam
ling Address
2
City I S t Zap Q
Telephooc Number 91.

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AGEN AUTHORIZATIQK F_O
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if
Name of Property Owner Applying for Permit: Nome of Aui mtwd Agent for this project
Nr
Owner's AkNn``g�/Address:
' /6 6" ya &&262,eA a e- J V� C
Phone.Number p
Agent's Agafli V Address'
I certify that i have auttwrized the agent fisted above to act an my behalf, for the purpose of $P*ft
far wo obtaining al CAFAA Permits neoessary to ir► UN or construct the totlowing (activity):
(my pmpwtY IoCBW at
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4pplicant: bav
ba"
Permit #: 4
Date: O
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
3und in your Habitat code sheet.
abitat 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 ❑
O
Dredge ❑
Fi
Both ❑
Other ❑
0
Dredge ❑
Fill ❑
Both ❑
Other
O
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 ❑

'WATEoRKMAgRIINpEgS. CONo� 84RUoCTION INC
SUPPLY, NC 28462
> the of `41C
BRANCH BANKING AND TRUST COMPANY
1-.-BANK BBT BBT
1161
/ 66-112/531
Date
Dollars