61652D - Lyons

�CAMA % '. ] DREDGE & FILL S ° `
3"ENERAL PERMIT Previous permit#
New ElModification ❑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 j (•W
Rules attach d.
t Name ' r Project Location: County
Q 17 f Street Address/ State Road/ Lot #(s)
} State �'r jv
�
Fax # ( ) Subdivision
/ � f m/ /
:ed Agent �b A C S�1 Gl !J\ City Y'' ®�' d .,cX ZIP
❑ CW p,EW PTA ❑ ES ❑ PTS Phone # ( ) River Basin
❑ OEA ❑ HHF ❑ IH C UBA ❑ N/A j
Adj. Wtr. Body 4w Ate, "M."
❑ PWS: ❑ FC:
es / no PNA es no Crit.Hab. yes / no Closest Maj. Wtr. Body L' .
ick) length �( A- 2
ri(s) l� t'-!
)ier(s) 3105,f .6
!ngth
amber
td/ Riprap length
g distance offshore
ax distance offshore
hannel
ibic yards
mp
us atlift ,Z., X 1-2.'
Length
not sure yes notsureyes s
um: n/a yes / no'
yes
kttached: (99N� no '—
ig permit may be .required b�
- .. - 11 i
rKAA
4 6

be below the HABITAT disturbances for the application. All values should match the name, and units of measurement
in your Habitat code sheet.
DISTURB TYPE
t Name Choose One
TOTAL Sq. Ft. FINAL Sq. Ft.FDisturbance
(Applied for. (Anticipated finallied
Disturbance total disturbance.
includes any Excludes anyincludes
anticipated restoration
restoration or and/or temp
temp impacts) impact amount)
AL Feet
for.
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
' Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Othe ❑
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 ❑
z

OxIcy ORD MR
#1
/30/13
PAYABLE THROUGH 75-15'
North American Banking co"'""' MN 912
328252970
M.O.#328252070
:U2CkC]D0LSC)C]CTS
TWO HUNDRED AND 00/100 DOLLARS
f NOT VALID VERFNE HUNDRED DOLLARS $500.00)
CASHIER • READ REVERSE SIDE BEFORE
CASHING
L�
700 3 213 2 5 2 9 70110

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i-13-'13 04:25 FROM- TEKA BUILDING DEU 423-32B-0346 T-053 P0001J0001 F-1'
North Carolina Department of Environment and Natural Resources
Qivislon of Coastal Management
Severly Eaves Perdue James H. Gregson Doe Freeman
Governor Director Secretary
AGENT AUTHORIZATION FORM
Date: J�
Name of Property Owner Applying for Permit: Name of Authorized Agent for this ject:
Owner's Malling Address:
71 1)
Phone Number &!!2) 76 7 =2Y6
Agent's Malli'ng Address:
A P. zzfL zyz •_ Gym
,J ry
Phone Number( 9�0) ^' 97..
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all LAMA Permits necessary to install or construct the following (activity):
(my property located) at
This certification is lid t u (date)
ooerty caner Signature Date

1013 •20:54
#3436 P.001/(
ADJACENT I!IE i►RIAN PROPERTY OWNER STATIEMCNI
I hereby certify that I own property adjacent to �y12A-J'
,g
Namk of P Owner)
property located at a O /`7/f�df ��� - -
(Address, Lot, Block, Road, etc.)
on Kf Iv ,�,ry r, plL . in N 7P.40i /�z /- , N.C-
(Wat ubody) (City/Town andlor County)
The applicant has described to me, as shown below, the development proposed at the above
lion.
I have no objection to this proposal.
I ha%W.objec0gns tpthis proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
{Individual proposing development must fill In description below or attach a site drawing}
WAIVERSECTIO
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 aowss unless waived by me. (if you
wish to waive the setback, you must initial the appropriate blank below.)
G I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
• • :. � _ , ; `. t • �' FTiT� / •T ice. �•/r ` .
i. +�

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
0 17y,,7v
A. Sign Wdn
X ❑ Agent
❑ Addressee
B. Rected Name) C. Date of Delivery
�I V'
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
J. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Tansfer from service label) 7 012 2920 0001 3989 9431
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
/so
a Icy
A. Aeckved
X ❑ Agent
❑ Addressee
B.y (Pto Na C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
MAY 16 ?013
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7 012 2920 0001 --- 9 4-
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 1n9FA5-n9-M-ice

<, 71
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60,02' r
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VICINITY M,
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PHILLIP A TRIPP i+
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K.E. JONES
DB 2019, PG 681 ;
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NOTES
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;
1. This plot plan is of an
+Z
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00i
existing parcel of land.
i
2. Subject to restrictive
MON
CA
i
covenants, easements of
Q` +
N
'�J
record, zoning ordinance, &
w
+
underground utilities, N any.
3. No title search by surveyor.
(31
i
4. References; MB 31, PG 4
V) i
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W
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5. Flood Zone - AE
W i
o
Community Panel #370466 4277,
✓� ` Z
rr /—
6. Zone - R-20 - NORTH TOPSAIL B
+
Setbacks:
Front - 30'
� � <
Side - VY
Rear - 10'
Corner Side - 20'
7. Wetlands information taken from
Plat Book 31, Pg 4
LOT
23
1.13
AC
.EGEND: i
I3
0- 1/2" SET IRON ROD, SIR
Q- EXISTING IRON ROD, EIR
Q- EXISTING IRON PIPE, EIP
- INCHED PIPE A �� h. S- F
D - PIPE OR ROD DISTURBED �� �� 59,3, ••, 0
0- NO POINT SET
EP - EDGE OF PAVEMENT `� Q� yE oP 36.2
EPK - EXISTING PK NAIL I `�f
i �� +-«N j
CC - CONTROL CORNER ��AB-ABOVEGROUND i �1,3 —1N-115,2Q'�N
BG-BELOW GROUND i 11'W S
C/L - CENTER LINE S `46
\ . , 166, 56
R/W - RIGHT OF WAY + \
RWM - RIGHT OF WAY MOMUMENT + MICHAEL MASSOOD, JR
PP- POWER/UTIUTY POLE _DB�4}$, PG 648
A 1r,<-- , ---