61626D - Ewing

❑CAMA / ❑ DREDGE & FILL 1
GENERAL PERMIT Previous permit #
FINew .❑Modification --Complete Reissue ❑Partial Reissue Date previous permit issued
orized by the State of North Carolina, Department of Environment and Natural Resources ( 1
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
�?n Rules attached.
nt Name Project Location: County
s QC, KO'\►5 �✓1Street Address/ State Road/ Lot #(s) •_
a:' 6(State N C ZIP Z _1. _r i,-lit i4/()% f r i g r�� ✓�L�
O d 0 ) Fax # () Subdivision
zed Agent t4l City E . zip Z5Li L
❑ CW ZEW 7i PTA _ ES ❑ PTS Phone # ( ) River Basin
❑ OEA ❑ HHF ❑ IH UBA ❑ N/A Adj. Wtr. Body tti a ( (nat
PWS: ❑ FC:
yes / no PNA yes / no Crit.Hab. yesno
Closest Maj. Wtr. Body LA) L\)
)f Project/ Activity 141C' ji i'.t.i { v1� ` `1 �O l-
(.t i l fit_ (Scalp '=
ock) length
ength
umber
ad/ Riprap length
✓g distance offshore
iax distance offshore
:hannel
ibic yards
imp r -�
use/ Boatlift Z � x 1 L
Bulldozing
ne Length _•T:
not sure yes no .
gs: not sure yes no `
,rium: n/a 'es
no
no
Attached: ( yes A— � I I I I I i I 1 1 1 i I I I I I I I I I 1 1 1 1 1 11
ling permit may be required by: 1 ❑ See note on back regarding River Basin i
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.15.2013 02:45 PM Gordon 7043331359
PAGE. 1/ 1
00 02:14p JIMMYS MARINE 9105790844 p.1
HAND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIER/MOORINO PILINGS%BOATLIPTIBOATHOUSE)
I hereby certify that I own property adjacent to 's
p //9(Name of Prope Owner)
property located at f o01>r/I�ay( p2� 1
Lo
(Lot, Block, Road, 6tc.)
on _ � ./I//�L in 4�/x
(Waterbody) (Town and/or County) /
Applicant's phone tf:0 69S"-��'/� Mailing Address:. foal &109vfs..crr
fie bas 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 pier/mooring pilings / boadill / boathouse
must be set back a minimum distance of fifteen feet (i 5') 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 not wish to waive
I do wish to waive that setback requircment�
__ _ ,_- -- -- --------� ----- ------------------ —------------
—
SCRIPTION—AND70RMUWl14 PRgP05EA DEVELOPM"8".
(To befrlled in by individ cal proposing development)
(Information for Property Owner Applying
for Permit) i
Mailing Address
AJW
citylstaterzip
Telepl ee t tuber
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number

Aug300004:23p JR-AMYSMARINL 9105700844
ME
HAND DELIVER
ADJACENT RIFARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIKOOKiNG PILINGSIBOAHJFT ZOATHOUSE)
I hereby certify that I own property adjacent to `� Ol✓��� r✓�� % %� `s
(Natne-of Property - er)
property located at 4lfL!/�✓N��^`/t 7f -
(Lat, Block, Road, et'c
p
on C, /✓�3 L , in Ale N.C.
(W2terbody) (Town wdlor County) jJ
Appiicast's phone #:G%D 450"- � �1 � Mailing Address:,119"/ 411
Ile has described to me, as shown below, the development he is proposing at that location, and I
have no objcotions to his proposal. I understand that a picrlmooring pilings / boatlift / boathouse
mu-st be set back a minimtun di3taoee offifteen feet (I5') from my area of riparian access unless .
waived by me. (if you wish to waive the setback, you mast initial the appropriate blank
below.)
1 do not wish to waive.
I do wish to waive that setback requimment� ----'u---_--"
(To be f filled Ur by individual proposing development)
-- -- --- — - --- - - - ----- --- -------�.._._------ .�.—_ �_...----------- -- --
(Information for Property -Owner Applying (Riparian Property Owner reformation)
for Permit)
.��---
Mait ing Address T—�! S iguaut: c
c itylstwzip Print or Type Natne
-
Tc humbe / / --
-f5 % �1
Signature Uete
Telephone Numbar
-5--8- 13
Date
s

22- Loy
l�V
r a

-D LAU l� 11 iq uvq vt
I
(kj� I �-q(

1077
15-3/540
873
Date

Permit
We:
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
,und in your Habitat code sheet.
rbitat Name DISTURB TYPE
Choose One
TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet
(Applied for. (Anticipated final (Applied for. (Anticipated final
Disturbance total disturbance. Disturbance disturbance.
includes any Excludes any total includes Excludes any
anticipated restoration any anticipated restoration and/or
restoration or and/or temp restoration or temp impact
temp impacts) impact amount) temp impacts) amount)
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill B0th ❑ 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 ❑