61587D - Hutchings

' CAl ❑ DREDGE & FILL Y
GENERAL PERMIT
❑New Modification ❑Complete Reissue ❑Partial Reissue
NOO 61
Previous permit #
Date previous permit issued
prized by the State of North Carolina, Department of Environment and Natural Resources r
Coastal Resources Commission iP an hrea of environmental concern 1.pursuant to 15A NCAC �� I � U
` ❑ Rul attached.
nt Name �. �� �1( J Project Location: County���
s z lk VVW Street Address/ State Road/ Lot #(s)
State ZIP i 01, I N i� P7% L (�l
'2Zj
# O Subdivision
zed Agent{ City GI�Sf f I /�[ -TT` ZIP 7 L
❑ CW I[�iEW "L] PTA
❑ OEA ❑ HHF ❑ IH
❑ PWS: ❑ FC:
❑ ES ❑ PTS Phone # ( ) ' River Basin
UBA ❑ N/A �D ` ( (nat C
Adj. Wtr. Body
Clt Maj. WtBd~1 �(
yes; no 1 PNA yes / no Crit.Hab. yes / no osesr. oy1
►f Project/ Activity > r717>Pt✓- E '-F /N,,5
�V
(Scale: '
ock) length
f W
ength
umber
ad/ Riprap length_
✓g distance offshore
iax distance offshore
:hannel
jbic yards
Imp����
uje/ Boatli ( 2
3ulldozing
— --- � :
ne Length aPi
not sure yes no
gs: not sure yes o
rium: n/a yesC. --'o
yes no
Attached: yes no
ling permit may be required by: �� (91 G� c e.� . ❑ See note on back regarding River Basin

pplicant: 'C %I
ate:
Permit #: � I 5 3 �- n
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
DISTURB TYPE
bltat Name Choose One
TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet
(Applied for. (Anticipated final (Applied for.
Disturbance total disturbance. Disturbance
includes any Excludes any total includes
anticipated restoration any anticipated
restoration or and/or temp restoration or
temp impacts) impact temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
V LA; Dredge ❑ Fill ❑ Both ❑ Other
^amount)
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 ❑

CONTRACTORS, LLC
0-367-2159
-lAROLD CT.
fEAD, NC 28443
K c7
t�
58 ?8u■ 1:0 5 3000
Bank of America
ACH R/T 053000196
08-03
L9611: 00068L,?43?38u■
5878
66 19/530 NC
58754
00
C
0
$
,qo
DOLLARS 8
AUTHORIZED SIGNATURE

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to A t-tG - is
(Name of Property caner)
property located at 13 Ca -ram.- 61-j-eP
(Lot, Block, Road, etc.)
on %�<,,.,,�, �� , in b `C , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 3�� SAS wiling Address: CWS+C6� e
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 pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (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.)
I do not wish to waive
��_ I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
b
(Information for Property Owner Applying
for Permit)
W " ) K-^ re'A..'o
(Riparian Property Owner Information)
3 (.�, 2 D S��in.-to„, e,9
Mailing Address
Signature

4-01
t33o cluolift.'r4,

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date T-1- 13
Name of Property Owner Applying for Permit:
Mailing Address:
3(oz.,f� zo-o
I certify that I have authorized (agent) 1� Ce4 � ���` to act n my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) it (�7-1 leen�-
at (my property located at)
This certification is valid thru (date)
Tz-31- 13
Property Owner Signature Date