61614D - Hutton

s� CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
M
I Previous permit #
KNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
prized 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
_rr q
nt Name T6 C'6 4T 1 �'4 1 i1
11 Rules attached.
Project Location: County
s i r°)C' ' '�t-�
Street Address/ State Road/ Lot #(s)
1(-tL,rl Statef, "I ZIP 22135
(161) �A5- 4q I "I Fax #( )
Subdivision (' ([�; f t�� 1(y r-
zed Agent Y)(iOCy1 a-{-fy Al(k >rii . u-
City LJ,-A L� ZIP
❑' CW DEW L'} PTA ❑ ES _ PTS
Phone # (� ) 3 �+�k River Basin LV M I
C OEA ❑ HHF —1H ❑ UBA ❑ N/A
%���
Adj. Wtr. Body
C PWS: ` FC:
yes / no PNA yes / no Crit.Hab. yes / no
Closest Maj. Wtr. Body w 1'
if Project/ Activity
- J
` (Scale:
ock)length `Jx IU�
m(s) it , Hnr. li"x
ength
umber
ad/ Riprap length
ig distance offshore
iax distance offshore
:hannel
ibic yards
mp
use/ Boatlift IZ� IZ
3ulldozing
ne Length
not sure yes no, i
7
gs: not sure. yes no
;
rium: n/a yes no 1( K
yes no
I M Eli
Attached: yes / P n _ — L —
ling permit may be required by: 1/ N -41 CIL, t Vol ❑ See note on back regarding River Basin i
I � --- =-. - .I I i I) r'A fi , . A L A 1 /. J—.A 1 10--r R ,1 C L 1 _ A , _ A .i , A , — / , , .

)8/2013 10:14 FAX
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)8i2013 10:14 FAX
PAX NO. :
W
Ma.y. 07 2013 04:04PM P1
.A DJA►UENT RIPARIAN PR.QPEICYY OWNER STATEMENT
(FOR A PI`ERJ,(idC?[),IR.rNG PH -[NOS BOA�T.t.jFTJBOA,/THOUS£)
I hereby certify that 1 awn property adjacent to !C f� �a� /Yl � e j `s
(Manse of Property Owner)
property Jocatrd at--z2...�-f 7 MAd,
(Lot, Block, Road, era)
on '�',Ge� , in /'e/ rw N.C.
Materbody) f f (Town "&or County)
Applicant's pion -V !!C% I Mailing Addreas:_AV -.�
Ho has dewAbed to mc. as shown below, the devak ment he is proposing at that location, and, I
have nd *eetions to his p opafal. I understand that a pier/ma oring piling I boattiit I boathouse
must W act back a min m ra distance of fiftn fbat (151 from rrry area of riparian access un Ims
waived by nw. (If you wisb to waive the setback, you Most Initial the appropriate blank
below.)
f da UQI wish to waive
.— - -- 142 wish to wive that setback requ%ement.
-
(To b je flZed ih ,by bmdiWdrra1 praposfng development)
f
ail �x 1� � �� o� T 1"U f
See
(Infot'11 at min for Property Chvnw Affiymg (Riparian Pati►P" Omer I srtiOn)
for Permit)
Malting Address Se
+Cicy�S
Telephone N ms g
J
print or Type b 4aw
��1- 7 9-: o

i8/2013 10:14 FAX _ 1@ 005
(FOR A PIF..8*OORINC PIL.INCn', IBOATLIFTIBOAI'HUV.YE)
I hereby certify that I own propeKty adjacent to
(Name of Property Owner)
property at
(Lot, Block, Road, etc.)
N.C.
on (Waterbody) ' ` (Town and/or County)
d,,qV y Mailing Address• '
Applicant's phone #:
14
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 I boatlift / boathouse
must be setback a minimum distance of fifteen. feet (15') from my area of riparian access unless
waived by M. (if you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
1 to wish to Nvaive that setback requirement.
_-----------
DESCk&TION AND/OR DRAWING OF yRO POSED DEVELOPM19NT.
(Tv befilled in by individual proposing develvpment)
� e.-Q- k v-c'-t-�\ri�
(Information for Property owner Applying
for Permit)
Mailing Address
�cs-
kA
City/State/ ip
Rio-qu�.- .�U� _,
`Ceephone Number
(Riparian ]property Owner Information)
Signature
3i.kce—
Print or Type Name
? /o - S-q2 - k?,Y Z-
Telephone Number
1-3

)8/2013 10:13 FAX [a 001
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q A) -Q- 14,0-, /44
6a,4u)e,4,,ee Mar if
;�, f,. a 1"'e—.
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)8'2013 10:13 FAX
Z 002
North Carolina Department of Etvironmept and Natural ReSources
Division of-CoastN-Mariagement
gevedy Eaves Perdue James H. Gm9son
Govemor Dheclor
Dee Freer
Seo'e
A ENT AUTHORIZATION F RM
[late: -a () l<
Name of Property owner Applying for Permit Name of Authorized Agent for this project:
owners AMalling Address:
Phone Number ` ,(` C ( r
Agent's Mailing Address'
Phone Plumber 6-)1 D) �A 4
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity)'
(my property located) at
'` C-A-
This certification is valid thru (date) T _ 1
PrX—��
operty pvvrter Signature / ` hate
L
DECEIVED

41

pplicant:
M
Permit #:
ate:
=_scribe below the HABITAT disturbances for the application. All values should match the
name, and units of measurement
and in your Habitat code sheet.
TOTAL Sq. Ft.
FINALS q. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
{Anticipated final
(Applied for.
(Anticipated final
bitat Name DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Choose One
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)
CIO Dredge ❑ Fill ❑ Both ❑ Other
g
l
C"v 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 ❑
x = 15o CW
5x 74-16' Rio

e
ERMBRIN6S0084RUTION INC
KD(91)2
SUPPLY, NC 28462
1184
66-112/531
Date
$ 719<3.01
Dollars 8 0
BRANCH BANKING AND TRUST COMPANY
1_=IKANK BBT BBT.com
, > 19 rpl.11.lj.n