61662D - Rhodes

Td
61
CAMA / El DREDGE &FILL
3EN ERAL PERMIT Previous permit #
-]New [-]Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
)rized by the State of North Carolina, Department of Environment and Natural Resources II�� j
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC V i ( 1100
1 Ru
les attached._
it Name Vi'�.+ _,'' Project Location: County
V Ll
& 1;_ Street Address/ State Road/ Lot #(s)
State_ ZI P � �1t` ql'
47 0 , 77" _Fax,+#( )
red Agent PA✓/? ,t°/r .u
I ❑ CW 0 EW 0 PTA ❑ ES ❑ PTS
❑ OEA ❑ HHF "El IH ❑ USA ❑ N/A
❑ PWS: ❑ FC:
yes("9 PNA yes L Crit.Hab. yes / no ,
f Project/ Activity
)ck) length
:ngth
ember
id/ Riprap length_
,g distance offshore
ax distance offshore
:hannel
Subdivision
City /v i { C-:l ZIP -a
Phone # River Basin
Adj. Wtr. Body 5s,�., l .QJV A h (nat._
Closest Maj. Wtr. Body � (-I''"
I LI
(Scale:
❑ See note on back regarding River Basin

,pplicant: r e e es Permit
late: #:
l� � w
escribe 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
ew
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 ❑
Other
Dredge ❑
Fill ❑
Both El
Other El
Dredge ❑
Fill ❑
Both El
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 ❑

SOUSE MARIINoE CONSTRUCTION INC
SURF CITY NC 28445-0028
D E-A)/z--
nerica -iw
64611■
1:0 5 3000 19 61:
DATE 7� 1 - ` 3
2370054IS1313 I'
4646
66-19l530 NC
58754
OLLARS 8 Z °

May. 28. 2013 9:52AM COASTAL BANK & TRUST (Proposed) No. 2036 P. 2
4 - `_ 94—,✓d 1,t�
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIER/MOONNG PILINGSBOATLIFTB OATMO USE)
1
I hereby certify that I own property adjacent to 's
(Name of Property Owner)
property located at D 940
Clot, Block, Road, etc,)
on , in C4-�VN.C.
(Waterbody) (Town and/or I
County)
Applicant's phone #: 6'05N 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
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
TYoposeo
---- -5a----------------
--------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
-w?w
Mailing Address Signature

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 's
1 �}-1. j- a of Proper Owner
property located at ` h 9"-�
(Lot, Block, Road, etc.)
on coan , in C.
(Watei`body) 2 (Town and/or Co nty)
Applicant's phone #: C'i0 -� ,5q6 -�.DMailing Address:
He has described to me, as shown below, the development he is proposing aVthat locaMn, 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
I 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)
?mx a
Maili g Address
(Riparian Property Owner Information)
Si ature
WA