61567D - Moore

„',CAMA / 7 DREDGE & FILL.
3ENERAL PERMIT Previous permit#
'New` -Modification —]Complete Reissue - Partial Reissue Date previous permit issued
prized by the State of North Carolina, Department of Environment and Natural Resources _
Zoastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
Q ❑ Rul attached.
it Name d Project Location: County P/M
V”, �O� Street Address/ State Road/ Lot #(s)
QI'
2 State ZIP Z�S r yJ t%(i d Wl S i� E
t (b )� —64()--'Fax # ( ) Subdivision
:ed Agent ?j t E2 A\Pgt(M City 0Say i e o,ek ZIP z'G Lf'4
❑ CW N JEW �, PTA ❑ ES ❑ PTS Phone # (j 10 )5L/0 — Imo( 3 5"River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body T6 5A SO U
ElPWS: ElFC: c
fr
yes / no`, PNA yes / no Crit.Hab. yes / Closest Maj. Wtr. Body SA f SO v/1
f Project/ Activity
f
,ck) length
,(s)
iier(s)
ngth
tuber
d/ Riprap length
g distance offshore
uc distance offshore
iannel
bic yards
np
is Boa li z
ulldozing
e Length
-t-� 7� ,
not sure yes ( _no
s: not sure yes
ium: n/a yes`
yes (nO .) --
>ttached: 'r no
ig permit may be required by: _
r 'If iv
(Scale: I ff
❑ See note on back regarding River Basin n

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date �7—li /,�
Name of Property Owner Applying for Permit:
Mailing Address:
r 1
s
j✓
I certify that I have authorized (agent) , ;-'eq ,/� /� to act on my
behalf, for the purpose of applyin for and obtaining all CAMA Permits necessary to
install or construct (activity)
p !JJ
at (my property located at)
This certification is valid thru (date) C ` 1-r',
'? -/ ,-/- /
Property Owner Signature Date

DUG-®9-cLllc 09:40 From: Ito- ] r � - � To:5329G481 2.i?�2
URT.XZD IL.:RE7URN.agU1PTREUE$TED
DIVISION OF COASTAL MANAGeMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property;
c��✓ i .vc; i r' I0.1le-
Ic
(I.a1 or 8, Street or Road, City a County)
Agent's Name #: I Mailing Address:
Agent's phone #;
I hereby certify that I own property adjacent to the above referenced property. The Individual
applying for this permit has described to me as shown on the attached drawingthe development
they are proposing, A 01scriptioa gr drawing.with „dimengions,.mult 4q 2rovided with th&Mer,
1 havo no objcctlons to this proposal. 1 have objections to this proposal,
If you have of octlons to what is bolt proposoo, you must notify tho Division of Coastal Merlapemonf (ACM) In
writing within 10 days of recalpt of this not/Co, t:orrssponoonco should be malted to 197 Cardinal Drive Est
M/mington. NC, 284OW848. DCM roprosentetives can also be contFCtrd at [phone], No msportso Is
considarodd the same) as rt�Lggion If youhave been notified qOW-0ai �Mar11.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
beck a minlmum distance of 15' from my area of riparlen access unless waived by me, (If you
wish to waive the setback, you �l the appropriate blank below.)
1� Z- I do wish to walve the 15' setback requirement,
I do not wish to waive the 1 F eetback requirement.
(Property
or ryp
/S'U ✓N YJ� �CXL
Mailing address
Qw"t Information)
Print or Type Name
M000 Add/Oft
f/// - - .4lC'

Allied Marine Contractors, L.L.C.
92 Harold Ct.
Hampstead, NC 28443
NCGCL#60992
Fully Insured
Randy Mosley Hal Fogleman
[phone] [phone]
2-14-13
Dock Agreement for Harry Neil Moore and Mary F. Stevens
To Whom It May Concern:
Mary Stevens, of 136 Bridgers Ave. Topsail Beach, plans to replace her pier in the
coming months. The current end of the pier is situated 8.1 feet off of the riparian line
between her property and the Moore property at 138 Bridgers Ave. This number comes
from a survey dated October 8, 2012 by Weston Lyall, PE, PLS, PLLC.
Mrs. Stevens would like to replace the dock according to the attached drawing so that the
distance between her pier and the line will be 10 feet or greater at any point. This is 5
feet into the CAMA 15' setback.
In exchange for your agreement to this proposal, Mrs. Stevens agrees to approve an equal
encroachment of your new pier into the 15' CAMA setback. At no point will any part of
your structure be within 10 feet of the agreed upon Riparian Line, which can be
determined using the above mentioned survey and the existing pier at 136 Bridgers.
Signed:
Mary F. Stevens
Date:
3//* / 13
Harry / v Neil Moore �T 4----

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLI"O THOUSE)
I hereby certify that I own property adjacent to 1, f/ e I� 's
(Nam of Property Owner)
property located at U
on
(Waterbody)
Applicant's phone #:
i r.e/1
Block, Road, etc.)
in / 6,0Sa [ 6-C a c- L , N.C.
(Town and/or County)
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
WIt'� II 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
-�y
(Riparian Property Owner
mation)
2y S;
;�JC�/Ule
T__•-a __ T_-_ 1T_-__

71
Go

I
pplicant: �r
ate:
3 1 13
G2c oo '-�
Permit #: S
ascribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
bitat 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
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Othe
4o 0p
�p0 G
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 ❑

INTERNATIONAL MONEY ORDER
WoneyGramm �
Money Orders m To Validate: Touch the stop sign.
then watch it fade and reappear l _
PAY TO THE
ORDER OF:/ �n I
PAGAR A LAwm"
U
ORDEN DE:
T-:SEF,$ K'f EFORE CASHING
W
z=
IkINCYOU
._.. PURCHR / COMPRADOR FIRMADEL LiSIZADORPURCHASER,
BE�TO TTHE SERVICE CHARGGE AA�N!`DD OOTTHER TERMS ON THE REVERSE SIDE-
MONEY ORDER: ADDRESS / GIFTCERTIFICATE: RECIPIENT
-
Payable Through ISSUER/DRAWER:
- - -
- -
Wells.FargoBank N.A.MONEYGRAMPAYMENT SYSTEMS, INC.
3
Faribault, MN --'--•-^•-
...... -

0cjr ; a4nnel
r