61619D - Nowell

'-'LAMA / ❑ DREDGE & FILL MG M 61
GENERAL PERMIT Previous permit #
bNew Modification Complete Reissue ❑Partial Reissue Date previous permit issued
orized by the State of North Carolina, Department of Environment and Natural Resources /!} / / 2 4l�74
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC (%
L _ ❑ Rules a� �hed.
nt Name / �!� f UQ lw, r Project Location: County�,�Aty
s &. C"A / I;&e
State_ VC ZIP Z,4Y
Fax #w-----
ized AgentyQ✓7 h
d L CW F-4W ,Q PTA ❑ ES L PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
- PWS: ❑ FC:
yes / no PNA yes //(io/ Crit.Hab. yes / no
A Project/ Activity
ock) length
m(s)
pier(s)
length
umber
ad/ Riprap length /
vg distance offshore
iax distance offshore
-hannel
ubic yards
imp
ws oatlift���
Bulldozing
ne Length J u
i
not sure yes �o
gs: not sure yes Co
mum: n/a yes 00[
. yes D I -
Attached: yes no
ling permit may be required by:
Street Address/ State Road/ Lot #(s)
/e%' 3 C tom, Me
Subdivision
City l - 4,11P �l �►r; 13-00�'rt- ZIP Z4
Phone # ( ) River Basin 0�
,�}�
Adj. Wtr. Bodyl ���f�' t�� �r'oyt �� ."7 (nat,
Closest Maj. Wtr. Body fL%J'
'4"
J
i ' .A
(Scale: 0
!/f+vn A 1� (G2'�if�iSl�lr , ❑ See note on back regarding River Basin

A
�' •kv"�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
it McCrory Braxton C. Davis John E. Skvaria, III
'overnor Director Secretary
AGENT AUTHORIZATION FORM
Date:
ne of Property Owner A'p/plving for Permit: Name of Authorized Agent for four( this project:
ner's Mailing Address:
o o- 6 ki&
)ne Number (V) 3&5-4 �9Ze 2—
Agent's Mailing Address:
6 6/`// 11 cIle
Phone Number (0/0) ' 3 / -
,rtify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
and obtaining all CAMA Permits
r my property located at
s certification is valid thru (date)
the following (activity):
Property Owner Signature Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORIIVG PILIIVGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to A �� �Q/&4�/ / �/Y / 's
/ (Name of Prope O er)
�operty located at �l �2/r`"�/9s �f �-0�- J%(%3 G',�1A / , ,
(Lot Bloc Road, etc.)
ISQ n d , in G�,�-2e�'&&�e A — atil t , N.C.
(Waterbody) (Town and/or County)
has described to me, as shown below, the development he is proposing at that location, and, I have
Objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set
ck 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 indjvidual proposing development)
/g
r---------------------------
formation for Property Owner/Applicant
Applying for
/permit)
/
iling Address
OL' X-7�9-o
J
pxa f ���
1x+ ;:1i 6
ith
MMI, I
;fi
- -0
/State/Zip
-J 'IC2
Print or 1�w Name

�v
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to Af j h;e,
p/ (Name of Pro brty Q ner)
•operty located at ,�mf /2.i4 �:D/rI1� oZOA bell
�
(Lot, Block, Road, etc.)+�
1,17-JIe�-
1 4 CAROII �ti !� _ �u'`%M �iY�Pn , N.C.
(Waterbody) (Town and/or County)
e has described to me, as shown below, the development he is proposing at that location, and, I have
► objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set
Lek 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 nrnnn_dna.&,w1nnmvnt)
J9, r
formation for Property Owner/Applicant
Applying for permit)
fe 6&+ `�6 & y-6
iling Address
�Liz/4�
y/State/Zip
/V
� � I
Ft' I
Property Owner Information)
Siggnna� e
/V-S
Print or Type Name
f
14e

ILA uivasion oa c:oastal m9t. Habitat Impact Computer Sheet
)plicant:
ate:
5////3
A f, Ke- N©( I
Permit #: 6 /( / %
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ind in your Habitat code sheet.
bitat Name
D%
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 [IBoth [I Other
Other LEI
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 ❑

MARINE PIERS & BULKHEADS LLC
6314 WRIGHTSVILLE AVE 910-256-6357
WILMINGTON, NC 28403
L-�v 0<
nk N.A.
n /
0 �88 L Lii' i:0 5 3000 2 91: 208 6
r::
6-21/530 10141
/� / 20 8967'
DATE -[ ` 6
i ? 08 6 Lii'