60717D - Michael

NO. 6O
LAMA / DREDGE & FILL
6
E N E RAL PERMIT
INA Previous permit #
,New Modification ; J'Complete Reissue -Partial
Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC/1
C1Rules attached.
t Name D0,JlN1S 'iYl 1 t;•MeQ_,.
Project Location: County )5A: t i IV3 Vl/ i
E_ bo ( 1 Z-02—
Street Address/ State Road/ Lot #(s)
n�1c 1 S►_ t-0 State (, ZIP7ig(o
14 jC'1 C . Y/�_'' t 7 Oi. '
( ) J065 Fax # ( )
Subdivision
zedAgient IP!:N151, 1;Cutl"A'
City Of`"•C / S1 t*VO - ZIP
d CW EW OA =: Es 7 PT5
Phone # ( ) River Basin
OEA -' HHF -1H _ UBA _'N/A
Adj. Wtr. Body /4 W'tV
PWS: . ' FC:
yes / (0 PNA ,Vie_ / no Crit.Hab. yes / no
Closest Maj. Wtr. Body 1 �1 L�
Df Project/ Activity (3iC i v AT'G a lit �J%
;;-tin L4 11r7Z)f? M
(Scale: f ��
lock) length I'-I)3'Y/i',,(iD rr)luFr2M 1D k STA,LIJttM A-V LIAR
ne Length
not sure yes no j _-
cgs: not sure yes �o _ "�
>rium: n/a yes /° ( 0 <i� r
yes
Attached: yes no
ling permit may be required by: /�L�`l//) ❑ See note on back regarding River Basin
5 b
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41

BRUNSWICK COUNTY
NORTH CAROLINA
1, L. SCOTT BAGGIE, CERTIFY THAT THIS
PRELIMINARY SITE PLAN WAS FIELD LOCATED
AND DRAWN UNDER MY DIRECT SUPERVISION;
THE SUBJECT PARCEL IS REFERENCED IN
THE BRUNSWICK COUNTY REGISTER OF
DEEDS IN DEED BOOK 3115, PAGE 502;
THAT THE BOUNDARIES NOT SURVEYED ARE
SHOWN AS BROKEN LINES FROM REFERENCED
RECORD INFORMATION; THAT THIS SURVEY
DOES NOT MEET NCGS 47-30 STANDARDS
AND IS NOT FOR RECORDATION, CONVEYANCE
OR SALES.
N.C. PROFESSIONAL SURVEYOR L-3450
- IMPERVIOUS -
LOT=10,515 SO. FT.
30%=3,155 SO. FT
RESIDENCE=1,991.8 SQ. FT.
DRIVEWAY= 175.2 SQ. FT.
TOTAL=2,167 SQ. FT. /
AEC=4.702 S0. FT
30X=1.410.6 SQ, FT. /
RESIDENCE IN AEC=656.7 SO. FT
I
i
,I
Kara /
2' C
i
lCONTROL
/ CORNER
IRF
% N77
MUTE
1. ALL DISTANCES SHOWN ARE HORIZONTAL
GROUND DISTANCES IN U.S. SURVEY FEET.
2. ALL BEARINGS ARE BASED ON MAP BOOK 68.
PAGE 65. BCRD.
J. THIS SURVEY PERFORMED AND MAP PREPARED
WITHOUT THE BENEFIT OF A TITLE REPORT. THIS
SURVEY IS SUBJECT TO ANY FACTS AND
EASEMENTS WHICH MAY BE DISCLOSED BY A
FULL AND ACCURATE TIRE SEARCH.
4. PARCEL /235LA017
5. PROPERTY ADDRESS IS:
4306 EAST YACHT DRIVE
OAK ISLAND, NORTH CAROLINA 28465
- REFERENCES -
(BRUNSWICK COUNTY REGISTER OF DEEDS)
1. DEED BOOK 3115, PAGE 502
2. MAP BOOK 5, PAGE 70170A
J. MAP BOOK 27, PAGE 362
4. DEED BOOK 2561, PAGE 432
5. MAP BOOK 27, PAGE 362
6. MAP BOOK 68, PAGE 65
INTRACOASTAL WA TER WA Y
SOUTHERN R/W LINE
o0,0a.
A TLANT7C
ti
INTRACOASTAL
W
WATERWAY
ti
O
y
ti
— 2
• SITE 4i
IPF
IRF
IRS
PKF
PKS
MNF
MNS
PI
R/W
0
0
1 �`
EAST YACHT DR
H VE
- NOMTY MAP -
(NOT TO XNE)
- LEGEND -
IRON PIPE FOUND
IRON ROD FOUND
IRON ROD SET
PK NAIL FOUND
PK NAIL SET
MAG NAIL FOUND
MAG NAIL SET
POINT OF INTERSECTION
RIGHT-OF-WAY
CENTERLINE
CONCRETE
DECKING
GRAVEL

LFIXA
A=(WA
01
AM.
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
'at McCrory Braxton C. Davis John E. Skvarl
Governor Director Secretary
AGENT AUTHORIZATION FORM
Date: -
ime of Property Owner Applying for Permit: Name of Authoriz
;qeA Agent for this project:
vner's Mailing Address:
'Po i30X, t 2-C2-
OA- e - I SLR, N L Zg4�cs
one Number V�4 Z?k- LfOb!�7
Agent's Mailing Address:
Phone Number 8 ; of - r 9 `
3?-5S l-7G
Brtify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
and obtaining all C MA Permits necessary to install or constpupt the following (activity):
r my property located at
Zgy.(4�5—
is certification is valid thru (date)
Property Owner Signature Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to SSA Is
(Name of Property Owner)
property located at
on
(Waterbody)
in
, Lot,
own and/or County)
N.C.
The applicant has described to me, as shown below, the development proposed at the above loca
I have no objection to this proposal.
I have objections to this proposal.
utbURIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawini
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set ba
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to w
the 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.
(Pr rty Owner Information) (A a ent P erty Owner Information)
nature Signa r
of or. a Name Print or y e Na e

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Alp s
property
p y LA�12 \� �r _ ► {Name of Property Owner)
ro ert located at 4 l k
(Addtess, Lot, Bock d, etc.
on in Ro N.C.
(Waterbody) (City/Town an /or County)
The applicant has described to me, as shown below, the development proposed at the above local
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set ba,
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to w,
the setback, you must initial the appropriate blank below.)
QU.
✓ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pr erty Owner Information) (Adjacent Property Owner Information)
�nature Si ature _
A A Y © S�LiYI
ant or.te Name Print or Type Name

pplicant:n Permit #: I
ate: VV� (vo -7(7
3�zo/ i 3
:scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
ibitat Name
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
tempimpacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
I
O V v
Dredge ❑ Fill ❑ Both ❑ Other Ell"
5 �) ?—
LNLEDredgeFill
❑ Both ❑ Other
� oFill
❑ 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 0 Both ❑ Other ❑

✓IICHAEL y 66-7143/2531 1002
IC 28465 � DATE
DOLLARS
°r
3ANK �.
165
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