61550D - Pugh

CAMA / DREDGE & FILL
ENERAL PERMIT Previous permit#
'New -Modification `Complete Reissue ❑Partial Reissue Date previous permit issued
irized by the State of North Carolina, Department of Environment and Natural Resources L ``
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC T } 1 � '
q��� Rules attached.
rt Name ,; (� `' i�11G1a1 1'"i,.11�� Project Location: County jV`0�'50y 11
—..
Street Address/ State Road/ Lot #(s)
State i\f �. ZIP } � It. � tY C Y F t�'
e ( ) Fax # ( ) Subdivision ✓ % V F
:ed Agent City �WWiled V'xA i ZIP—,;- Lji
Cw Ew PTA —ES C PTS Phone # 't Z� River Basin I �V
❑ YY
OEA HHF IH C UBA N/A Adj. Wtr. Body �• l ( ti nat
PWS FC: 11 ,11I`,f
yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body r I t v
�f Project/ Activity ; ; �� V 1 � "4 L i t' L it
(Scale: ,
lock) length, ,
•m(s) ; x 1-4 , �� K IV
pier(s)
length
umber
!ad/ Riprap length
vg distance offshore
iax distance offshore
channel
ubic yards
imp
)use/ Boatlift
Bulldozing
K/*� /tit P 4 X 14
IN 11=11"dv ■ ��
■��rpiw=■ ■■■■■■■■�■■■�■n�
■=■
l ■■■■■■■A ■E 111i
ling permit may be required by Yl G-t I �r6l C iv n See note on back re¢ardine River Basin
-- --:�U 1%r,f\ A,AP1 n i I (IVA E,1' 1 K711 e-L. ► , n.,%I LJ, , t L '6,.11 --L,"

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CERTIFIED N1AD —RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Name of Property Owner:
Address of Property: I " I )Wordki Shh fin✓, j at n 4N.U('n -tr yKLj.11 e�
n (Lot or Street #, treet or Road, City & County—)
Applicant's phone 33 -'1-1 Mailing Address:
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 drawing the development they are proposing. A description of drawing,
with dimensions, must be provided with d;is letter.
x
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM)
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certified Mail.
I understand that a pier, dock, mooring pilings,
15' from my area of riparian access unless wai
appro mate blank below.)
KI do wish to waive the 15' set back require
WAIVER SECTION
breakwater, boathouse,
ved by me. (If you wish
went.
I do not wish to waive the 15' set back requirement.
Information)
41
PrinArTypeNari
Ig Qrd S�, e
Mailing Address
�0)dmlach .
City / State ! Zip
or lift must be set back a minimum distance of
to waive the setback, you must initial the
Y (Riparian Property Owner Information)
/\ t!l�
Signature
6 z L-
Print or Tipe Name
Mailing Address —
)(�
City / State Zip
p

lb aU-4V*A-
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PMWOORING PIL.INGSBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to R�l PU b- 4 's
(Name of Property Owner)
property located at R3-3 F�i S 11 19 . 4oQ0s) 6-1-- Psr- w �X
(Lot, Block, Road, etc.)
on in lA C:� tJ�iA� �- , N.C.
(Waterbody) (Town and/or County)
Applicant's phone # �� r �� "� Mailing Address: i � 1 51n� oR�� SA
".,A & Stan 1Iu
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
d __ I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
r ,
i �
(Information for Property Owner Applying
for Permit)
1q,
5
(Riparian Property Owner Information)
Signature
waling Address
1J.

1
applicant:
)ate:
3� Zo�i;3
Permit #: � l SS O D
)escribe below the HABITAT disturbances for'the application. All values should match the name, and units of measurement
)und in your Habitat code sheet.
TOTAL Sq. Ft.
(Applied for.
abitat Name DISTURB TYPE Disturbance total
Choose One 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)
j
OW Dredge ❑ Fill ❑ Both ❑ Other
CW Dredge ❑ Fill ❑ Both ❑ Other
52
52
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 ❑

5014
{URGE PUGH 66-112/531
125
flNG AND TRUST COMPANY BBIk WORK
SANK BBT BBT.00m /"'?,

CAMA / DREDGE & FILL
'AENERAL PERMIT Previous permit#
New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources r' `I
oastal Resources Commission in an area of environmen I concern pursuant to 15A NCAC . -La
�
"I �T �t rA Rules attached
Name K t.
r
d it uk State K C. ZIP
(_ 1 I a j
;dent
*WEW PTA ❑ ES ❑ PTS
❑OEA ❑HHF IH ❑UBA ❑N/A
❑ PWS: ❑FC:
,es (no PNA, yes / no
Project/ Activity
k) length '
S> 12�IZ; bx I�c
tr(s)
gth
fiber
Riprap length
distance offshore
distance offshore
i
nnel
c yards
� I
z/ Boadift I?) 13
Idozing
AMIP �x14
Length
not sure yes no
Crit.Hab. yes /
Project Location: County � �0 051 'itt"
fiftet Address/ State Road/ Lot #(s)
I C ti' (Y c Y PIL
Subd'nn ionV�i;( y
Cityo�flf, ��y(4 ( L zip 2� r
Phone # 1( River Basin
Adj. Wtr. Body ' 1.1 1 Get nat
Closest Maj. Wtr. Body �—V, YJ
not sure yes no A
im: n/a yes i �T
no
cached: �Y7
k%
permit may be required by: I G1,� Y' L4 I tip,. ��? f !( LI.
— -- . --)I I i7..r, A.,..1 n i ( hU. I ► il_ 1 n-..,1
❑ See note on back regarding River Basin rule-
1-J. —f I ,.,J—. '... ,.