62589D - Ferguson

CAN'tA / DREDGE & FILL
iEN ERAL PERMIT
New -Modification Complete Reissue '—Partial Reissue
�i
Previous permit #
Date previous permit issued
,`� J:
?I tJ
zed by the State of North Carolina, Department of Environment and Natural Resources
:)astal Resources Commission in an area of environmental concern pursuant to 15A NCAC
ii � ff ,, }} r ules attached.
Nam � Sc i� < 1 Q � � t Gl Y'�T Project Location: County ��1 � 4�1(`f
3U1 AY( Street Address/ State Road/ Lot #(s)
State ZIP 2 d 6ti 1. ►' -A
" ��•• --``Fax # () Subdivision
d Agent j r✓Yt t 4' J IV i t"� Y� f S City "AkW_P ZIP lM
CW ZC EW 21.PTA Li ES ❑PTS Ph�o () '�3 River Basin V r^
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
El PWS: ❑FC:
Adj. Wtr. Body nat n
,es / no PNA yes no Crit.Hab. yes / no Closest Maj. Wtr. Body
, `W
Project/ Activity _I
.,`X6
k) length
s)
ar(s)
gth
fiber
/ Riprap length
distance offshore
( distance offshore
innel
is yards
P
;e/ Boadift 7`
illdozing
Length
not sure yes no'
not sure yes no
um: Ca�) yes no ` }
Yes l�.no/
'
attached: yes no--
ig permit may be required by:
Lk1
1L�Y11 11,1 �
(Scale: 1 -.00-
-` ❑ See note on back regarding River Basin rL
U. , i / 1�-1 � � 1 A , n " I . i J A 6 rr,1 �iuf,�j nl.

VS
Applicant: qq n n 1 Y C lil l s
alV V i 1/ r Per it #:
Date:
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
`ound in your Habitat code sheet.
labitat Name I DISTURB TYPE
Choose One
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 ❑
TOTAL Sq. Ft.
FINAL Sq. Ft.
(Applied for.
(Anticipated final
Disturbance total
disturbance.
includes any
Excludes any
anticipated
restoration
restoration or
and/or temp
It impacts) I
impact amount)
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
Disturbance
disturbance.
total includes
Excludes any
any anticipated
restoration and/oi
restoration or
temp impact
temp impacts)
amount)
Dredge ❑ Fill ❑ Both ❑ Other ❑

w
2�q b
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lr. ila C'` S•nl�ren rl.1r:'-r=7T:r�^ �r -:r-:'�Y}Y'iL2ft;' ':'? :!^�iif"r=i �.t]Ct';e•'t'^•4
Di'visicn of Coastal 3ana4e Sri
—ri7—':,1 :-?trpttRr, yltc mV!!-- 1.', uiGncn;
'Go Jernor viecti i�ii
u!=i SIT A ITHO P17n T IO P° :RM
. f �r±eL4Px"Jt/ Owner Ei �' rr���.� ;inn for !� i. .. ciiTiB D i ili3E!'Fi?�:t A�8t1L �C;r il�i5 pro,,
! 1. Js n t!•s'R.. ­4r. s-sii
-
%"1uC!!!�
Phone Number
.,t.r . }i-<nt i h,:rc ai r+hnH-7=d the anent ai. ted ahove to tact or...mv behalf. for the purpose Ji app!
rcr 2i1 Sr'F'�M^
necessa `! .ems«or conostruct me m.,mo%v rig kaCII llt rI.
This cpho*icaticr► is V21id ti r u ;date; _ "' �._3

Page
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERWOORING Pff"GSBOATLIFTBOATHO USE)
I hereby certify that I own property adjacent to U'uly M . Gars• is
(NamelofProperty Owner)
property located at 3
on C'W
(Waterbody)
i agac Yes
,(Lot, Block, Road, etc.)
C
in 61= I YW cSW 1d— N.C.
(JrawnlAd/or County)
Applicant's phone#: `W`E'gg�—�3`� Mailing Address: Ave, 5V4
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pierfmooring pilings / boadift / boathouse
must be set back a minimum distance of fifteen feet (I50 from my area of riparian access unless
waived by me. (H you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be frlled in by individual proposing development)
;5" cd6aclrt C�Yaw►nc�
(Information for Property Owner Applying
for Permit)
Mailing Address l�l e n CASignature
City/� e/ its p Print or Type Narne

V • JA V Q"c 'YCJ'Y7
t'. lfl�l
CIrR UIEn M,&% — RETURN RECEIPT RE0 � S
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby cer* that I own property adjacent to
property located at 39a 3
acne of Property Own
(Lot, Block, Road, etc. t I t
on -C- W , in 6u Sw .0 N.C.
(Waterbody) own and/or County)
Applicant's phone #: L}D'f — 9 $ 3 lv 3 44 Mailing Address: 3 51013 SQc�c rest hv*
He/Sho has described to me as shown below the development he/she is �ripohng at that location,
and I have no objections to the proposal.
..... ...--------- ------ ..r.... ««..............0 wrrrew...A....... ......... ...rru ur 0.................
DESCRIFnON AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Individual proposing development must fill in description below or attaCh a site drawing)
*-UL Q-iac�ka J Ya w 11115
If you have objections to what is being proposed, you must notify the Division orcoostai Management (Dcm) in writing
within 10 days of receipt of this notice. Corrospondence should be mailer! to 127 Cnrdinal .Drive Ext. Wilmington, NC
DCM representatives can also be contacted at [phone].
NoIVo rwneons a is considered the same as no oblecrlon if you have been notilted by Cerd fled M1il
roperty Owner Information)
Signature
T v M Gayst
Print or lype Name
3 2 a3 L o�cXes iyJ
Mailing Address
City / We/zip
(Riparian Property Own e4 on
Signet
HL4kab _ (�Yo1 A hale
Print optype Name
d 55 F kew %r k Rye
Mailing Address
nos
City / State / Zio

ug.15.2013 01:30 PM Richardson Const & Marine 9108425597
PAGE. 2,
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIBR/MOORING PILfYGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 3uAy M . L gyot _ 's
(N-a a *(Property Owncr) —
property located at --Jal 3 aeacrcA Ave- SVJ 6XApV)v �
(Lot, Block, Road, etc.) 11
on �- W in 'Stkr) tj 1SW1C�'i ,PI,C.
(Waterbody) (T n and/or County)
Applicant's phone Mailing Address: &12.3 f
�t Ave- 5W
aga
He has described to rrie, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand chat a pier/mooring pilings / boatlift / boathouse
must be sat back a minimum distance of fifteen feet (I5� from my area of riparian access untm
waived by me. (If you wish to waive the setback, you must initial the appropriate hlank
below.)
' .> I do not wish to waive
�f�,/I do wish to waive that setback requirement.
DYSC1111v1.1011 AWOR DRAWING OF PROPOSED DEVELOPMENT:
(To be,flled in by individual proposing development)
CLrn w %V1
(Information for Property Owner Applying
for Permit)
3aa5 s ricves�s Ave sv l _
Mailing Address
ANC,
as��City
:EL I 0lED
DCM WILMINGTON, NC
AUG 1 5 21013
(Riparian Property Owner Information)
Signature
Print or Type Nacre
Q1u - a6 - u335
TA P,,h"m--1Ctmt�r
s4a- 3+,51 . -
Telenhone NLimher

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