62655D - Greytok

--AMA / ❑' DREDGE & FILL Q 621
EN ERAL PERMIT Previous permit '#
Jew []Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ted by the State of North Carolina, Department of Environment and Natural Resources
Pastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
f f ❑ RuI attached.
Name -'' © Project Location: County
r
/ - Street Address/ State Road/ Lot #(s)
�! State !`/ -Zl P `-At
)�i bey—� Fax # (} Subdivis�ffi"
�V
J Agent rC Cityio /'�'S %;/P ZIP 71 s5 q�
❑ CW ❑ EW ,❑ PTA ❑ ES ❑ PTS Phone # ( River Basin
❑ OEA ❑ HHF IH ❑ UBA ❑ N/A �,
Adj. Wtr. Body �`�/ll (nat> r
❑ PWS: ❑ FC:
:s / PNA yes / no Crit.Hab. yes / no
Closest Maj. Wtr. Body
'roject/ Activity
"�T-v Ll
! rl
(Scale: f ��
:) length
i
,th
ber
Riprap length
listance offshore
distance offshore
nnel
yards
V Boatlift
dozing _
Length , ' ' )e°
not sure yes no
JY 7
not sure yes
m: n/a yes no'ti
yes nd
tached: yes no
permit may be required by:
❑ See note on back regarding River Basin n

oplir ant:
ate. I I— Z 13
�ss� To 1\ Permit #: G Z6 S�
ascribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ind in your Habitat code sheet.
bitat 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 im acts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other MR(�
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 ❑

4175
OVERBECK MARINE CONSTRUCTION INC.
3506 TALL PINE CT
WILMINGTON, NC 28409 66-46/531
DATE��
DOLLARS
G ��lo Z�LSJ�
TRUST ACH RT 061000104
/� t.� � /"---------- -- -- - ---- --- -NP
100004 L75u■ i:053 L00465I: L000 L49438 L93110

A��
�G^n
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue Braxton C. Davis Dee Freeman
Governor Director Secretary
AGENT AUTHORIZATION FORM
Date: It % I I. / 13
Jame of Property Owner Applying for Permit: Name of Authorized Agent for this project:
E2iC, 6 acY rroK .4�!AAJI- -::�tFIRLEJ
iwners Mailing Address: Agent's Mailing Address:
4 3 5 H (". L r+L S k/s 350(.2 7-AL.L- PI& E cT
NAi4 P S5 z-sti� , A/ C:- Z S' 443 GylLA,,., [ ZU 1 . /ti ,
'hone Number ���7' R��� Phone Number(0c ) 384�
certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
)r and obtaining `all CAMA Permits necessary to install or construct the following (activity):
S(a / I itI J% I\ Lti `)72+Lt- iv / X Z CJ,
or my property located at 455 1-t u (., �+ E S A is HAiti i) > aw & . Ai L-
his certification is valid thru (date)
Drnnarfv Mwnar Qin nr Date

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: EP: I (; CO l: L V 7-0
Address of Property: 435 HUG,I+t7S R6 /t/4/�'ri'SZ7�rS ,� PCA,1 `,`
(Lot or Street #, Street or Road. City & County)
Agent's Name #:
64& 1tl._ S Hi IR L y
Mailing Address: _S Sc (o
7AJt _. P/,,jE er-
Agent's phone #:
`1 -?.Sly 3c S
Cti , c .�i , A- L % S
xyC, r!
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 drawino 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 (OCMn
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive ) i
Imington, 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.)
_-ALA- I do wish to waive the 15' setback requirement.
A A-_ I do not wish to waive the 15' setback requirement.
(Property Owner In ormation)
Signature
C: /� r C.. (v 12.G-mil T-(
Print or Type Name
4. S ii LAC.t,�S Rl)
(Adjacent Owner Information)
Signature
RE RAi RJr LyNGtf UK,
Print or Type Name
yap Pi

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner LL /; / L 6- i? C-'-1 r-C /<
Address of Property: 4 "S "C4 l HC5 R,) HA, 4,► 6
(Lot or Street # Street or Road. City & County)
Agent's Name #: _ /�k�l,-mot _ S�i,�Lt y Mailing Address: 35c' (I 7A+/4 E7;AVt G
Agent's phone #: 05
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 drawino with dimensions must be provided with this letter.
X 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 15from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
�— I do wish to waive the 15' setback requirement.
_- /A- I do not wish to waive the 15' setback requirement.
(Prope Owner Information)
Signature
E/-' I C 6 iZ-f `-17-c- K
Print or Type Name
4 3 S t>u (ttt S Rl,
Mailing Address
(Adjacent Property Owner Information)
ignature
n�l�ttNE 5CR2/3utZ�,,,t 4;�
Print or Type Name
y 3?- o /4 �-e5 12vA0
AA.,.lo-- A. A-