61569D - Hodges

CAMA / DREDGE & FILL
3ENERAL PERMIT ji11 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 �n
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC i 2wa
f j,`Mules attached.
it Name Gei,, [ �" �{�{ tj Project Location: County *lk
-ee ! _ `' _ /Ay-e Street Address/ State Road/ Lot #(s)
l" State.N,/ ZIP 13—eAe A6 h Zx-ti-/
( _) `. Fax # Subdivision
�� ��
!ed Agent lr1<}�y I/ f�,rfi 7 City— tV1 l �N, s-i ZIP /.
J
CW EW PTA ES = PTS Phone # River Basin C e
OEA HHF IH ^ UBA 7 N/A
PWS: __ FC:
yes / no PNA yes NO Crit.Hab. yes / no
�f Project/ Activity /LP
iock)length
•m(s)
pier(s)
length
camber
;ad/ Riprap length
wg distance offshore
nax distance offshore
channel
ubic yards
amp
wse;'Boadift.r /t
Bulldozing
ne Length !
not sure yes
o
igs: not sure yes
,rium: n/a yes
yes
n
Attached: yes
ling permit may be requirec
Adj. Wtr. Body n#",' nat
Closest Maj. Wtr. Body / -<A/11-1
. < d//"Li / - //.1
(Scale: / �/

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F;;UPi- . J `iI MM9 Nortih ,viC r V - V �=►� ��. - 910?556 7 Mar. • -23 01: s `tl P2
heresy c�h Y trot I own,o,arty adjacent
iNotna o/ Pr 4wttw'}
Property boahld 91 ��5._--;-�=' (� Blaok. Read, 4ta.1
ty
(C)ityrTa" andlor COur
rne, as a►wtim pelu�v, the d rebptfilnt proPased at the above taestlan, .
T11e aDplttaitlt !►as de3aibea tb J
I have no ofq c iwt to this v0po" (�
i have Awdom to this MPOSS1•
D9Fr,-d vom A OIOR pRAt lx* Vr �
�t,�dfvldinl a �"9 devimpmont must 01In dslod
n be1oN �' e� a site *owing)
W
l RECEIVED
t DCM WIWINGTO,N, NC
MAR 2 12013
irh. or �raln must oe
i ur�farata�d tlult a pion, duck, rnborinp DohBS+ brosiaKater�oathousa, cG �
t++ MUM dl�ouc* of 5, frot he epProP� adar, atom A �utia4e uroiveti by ma. (1i you With to WNVe
the Setback, y
t do wish to wCve tho 15' W.bgk tvgWry iert
` I do Mort wioh to wawe the .i 6' sstbsck r"aram4 t,
lydorm60A)
3
(Adjacent ProP" Qvinw IfftMINON
e-
3'�!.- 78�g7oo
boat
fRevi 0&i&20lZt

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to , en2 c- 140 ice s I
(Name of Prope(ty Owner)
property located at L�, ,
(Address, tot, Block, Road, etc.)
on !�a so.�, ha:� S� ..� o� , in N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
�o,7v sus `yam to laces 7��e rt x; sI-/11
1, 13S % L
RECEIVE
DCM WILMINGTOI
MAR 2 12013
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
ninimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive
he setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Property Owner Information) (Adjacent Property Owner In ion)
(�
tg t Stgna r �Z,,., 2 fl�m/
� JtTLJ
'ri t or Type N f e Print r ype N ne

utvision at t;oastali m9t. Habitat impact Computer Sheet
)licant:GF
rnr �715 Permit #:
`.e.
12
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
�w
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
Dredge ❑ Fill ❑ Both ❑ Other
( / Y
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 ❑

TAL MARINE PIERS & BULKHEADS LLC
6314 WRIGHTSVILLE AVE 910-256-6357
WILMINGTON, NC 28403
18776
66.21/530 10141
2086170208961
DATE '2 4w
v� {
Fargo Bank, N.A.
Carolina
argo.com
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