61648D - Jones

ICAYVIA / iL DREDGE & FILL
'ENERAL PERMIT 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 ' /
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC —] 44
//P Rules attached.
t Name Vf0L j .pit S Project Location: County �ti15,.aw"
/S6 S • 6-0 41A 7 r%t ar� ✓6 Street Address/ State Road/ Lot #(s)
'NR�Syi df +G- State_ 1t, ZIP Z25-3
T�
Fax # O Subdivision
:ed Agent reel 1`-- r .y City Sy / G,—CkN ZIPZ-Kq�
CW ❑EW PTA �-IES ❑PTS Phone # ( )! River Basin—
OEA HHF IH _ UBA ❑ N/A
PWS: ❑ FC: Adj. Wtr. Body v/ G
yes / no PNA yes / no Crit.Hab. yes Closest Maj. Wtr. Body Sov
f Project/ Activity LA>>'�, J at,
(Scale: (/Os;
ck) length 3 x 7-0
,(s) W X %S'
,ier(s) S "`(2o-O r
!ngth
mber
i Riprap length Q r
g distance offshoreZr
ix distance offshore Z
,annel
bic yards
np
Org=-WDrz' x 12
ulldozing
S O
ie Length 4
not sure
yes
6
:s: not sure
yes
6.
-ium: n/a
yes
(.n
yes
Attached:
Ae'l'%
no
ing permit may be requir

cant:
Permit #: � / � t `
-ibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
I in your Habitat code sheet.
DISTURB TYPE
it Name Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft. TOTAL Feet FINAL Feet
(Anticipated final (Applied for. (Anticipated final
disturbance. Disturbance disturbance.
Excludes any total includes Excludes any
restoration any anticipated restoration and/or
and/or temp restoration or temp impact
impact amount) temp impacts) amount)
b'V Dredge ❑ Fill ❑ Both ❑ Other ❑
3 v
Dredge [IFill ❑ Both ❑ Other ❑
7 Z
7 zx�-
Dredge ❑ Fill'§Z Both ❑ Other ❑
Q
a
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 ❑

IOUSE MARINE CONSTRUCTION INC
PO BOX 2532
SURF CITY NC 28445-0028
DATE
r '�L
4597
66-19/530 NC
58754

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4 6"/ ro- To yl e
"70 3 3 71 ti
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Y)ew
11,V^

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PLER/MOORIIVG PILINGSBOATLIFTBOATHOUSE)
Lavr4
I hereby certify that I own property adjacent to 7:SpNES is
(Nalne of Property Owner)
property located at
Ib 3 S- % +h S'i'(�k-
(Lot, Block, Road, etc.)
(fi
on G/ +h ih
5 (c.E�E7 5-wic-r Cr�.�+A�, in _ (L&- C ( —L j , , N.C.
(Waterbody) (Town and/or ounty)
Applicant's phone #:
Mailing Address:
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
v I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
Mailing Address
/ 5 G S z4,,,,A, ti cjv� Ilrz
CitvNtate/7.in
(Riparian Property Owner Information)
Signature
�e►✓l � S G. CPt,C�O � I
Print or Tvne Name

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHO//USE)
I hereby certify that I own property adjacent to AIJ I4ad /4d -c 's
(Name of Property Owner)
property located at .2 ©3 I �z 1� 5 7� _
n� (Lot, Block, Road, etc.) /
on l s`�� , in Sy C,`1-� n 5 � -e-V , N.C.
(Waterbody) (Town add/or County)
Applicant's phone #:T/0a1(> Mailing Address:
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)
---------------------------------------
(Information for Property Owner Applying
for Permit)
OLIX aD
X4
sea -WA(
S-{t"'
-7o -5
---------------------------------------------------------
(Riparian Property Owner Information)
-
is, s_
Mailing Address
Signature

�,
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary
Date q 3
Name of Property Owner Applying for Permit:
-30 VI -e
Mailing Address:
/ 5, 5. Cl.,,, � G/v 1
I certify that I have authorized (agent) �1`� r)of Z %4 pt L to act on my
behalf, for the purpose of applying for and obtaining all CA.NLA Permits necessary to
install or construct (activity
at (my property located at)
This certification is valid thru (date)
eale,s c�)