61630D - Greeson

CAMA / DREDGE & FILL
ENERAL P E R M I T Previous permit #
New - Modification - Complete Reissue '—Partial Reissue Date previous permit issued
rized 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
ORules attached.
it Name 6rrecs-t1l.7 Project Location: County 11VIO
Street Address/ State Road/ Lot #(s)
-- State& Zip All /4XI;1
Fax #(_) Subdivision %-- -
zed Agent City Zip
El CW EW PTA ES PTS Phone # River Basin 4­4
OEA El HHF = lH ❑ U BA Ej N/A rw
Adj. Wtr. Body (nat
PWS: FC:
yes no PNA yes no Crit.Hab. yes no Closest Maj. Wtr. Body
A Project/ Activity
ock) len��h
m(s)
pier(s)_■,1, ■ ■ ■�■■■
iength
umber
ad/ Riprap Length
vg distance offshore
iax distance offshore
-hannel
ubic yards
NEW EEE�Wqll�.NNNEMRVVEM
imp NEUIMNNN■Iull�— MNE■■■KSNEM
0
5' (n
ne Length
not sure yes ,-ono
gs: not sure yes no
)rium: n/a yes Kno
yes no
Attached: yes no
ling permit may be required by:
(Scale:
1L.-
See note on
LS 1AC A- V"I-tA
back regarding River Basig

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: 0611) LGlf of 5Q/(1
Address of Property:
Agent's Name #:
Agent's phone #:
' Lr,il BE1151
A/15 t
(Lot or Street #, Street or Road, ity & County)
Mailing Address:
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.
I 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. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. 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.) RECEIVED
v L,4�— I do wish to waive the 15' setback requirement. DCM WILMINGTON, NC
A/I1� MAY 0 8 2013
A I do not wish to waive the 15' setback requirement.
(Property Owner Information)
roe ?-1
Signature
Do AZ /--- E 15 v enl
Print or rype Name
'YOQ &F711-Zd/rjr /r
Mailing Address 1 9199
(Adjacent Property Owner Information)
Signature
t �
Print or Type Name
Mailing Address

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER' NOTIFICATION/WAIVER FORM
t)o"
Name of Property Owner: 4F- VreGse"
Address of Property: 4 o 4 &/ ' " ii�-c 1-t, P I
(Lot or Street #, Street or Road, City & County)
Agent's Name #: Mailing 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 are proposing. A description or drawing with dimensions must be provided with this letter.
04--S I 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. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. 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, moorin pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of rom my f riparian access unless waived b me. �If y �
wish to waive the setback, u must initial th appropriate blank below.) �!
_ DCM WILMINGTON, NI
k-S I do wish to waive t e setback requirement.
MAY 0 8 2013
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
" Y, [,)A 7)XVAT '
Signature
DON L &1fJ 4--5'e v
Print or Type Name
Div k�'7i� l,4JrP ��� k R&D
Mailinq Address
(Adjacent roperty wner Information)
Signature
Print or Type Name
q q o Al - L 9ke �A ►� %
Mailing Address

', Division of Coastal Mgt. Habitat impact Computer Sheet
)licant: 0 V% F. Gr{
e: I0 // 3
Permit #: 6 / � -3U
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
)itat Name
DISTURB TYPE
Choose One
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
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)
2 2
2 U
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 ❑

5659
)ON F. GREESON 66-46/53'
EM J. GREESON 0000232017636S�
SON RENT ACCOUNT DATE
EE
NORTH LAKE PARK BLVD.
IOLINA BEACH, NC 28428 I s UD
n 4- �T DOLLARS
lL T ,0-�-------