62590D - Rourk

KCAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
New ❑Modification ❑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 - ' ,q V
les attached.
it Name kftA C tt __Project Location: County �y I ksy'l 1 C. c
'street Address/ State Road/ Lot #(s)
zed
( Agent Fax C' #
j ❑ CW ytwPTA
ElOEA ElHHF NIH
❑ PWS: ?K:
yes,•f no PNA yes / no
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes ( no
Phone # _� D )' 1 y River Basin UM
M
Adj. Wtr. Body � ` 0& (nat
Closest Maj. Wtr. Body A I WO
if Project/ Activity , j _��Qc,� C4CZ U ►'� \ `T� i
i
ock) leenngth t
m(s) '1 /� 1 Z X
pier(s)
ength
umber
ad/ Riprap length
og distance offshore
iax distance offshore
:hannel
(Scale: !-
ling permit maybe required b1y:3 UA, � P3U i [] See note ``an back regarding River Basin 1 .. i J, . - i � 0, J i —A,

Applicant:
Permit #:
Date:
zz
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated fina
DISTURB TYPE Disturbance total
Habitat Name
disturbance.
Disturbance
disturbance.
Choose One includes any
Excludes any
total includes
Excludes any
anticipated
restoration
I
any anticipated
restoration andA
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts)
amount)
ODredge
❑ Fill ❑ Both ❑ Other
I
L l
(
Dredge ❑ Fill ❑ Both ❑ Other �D
I LALJ
Dredge ❑ Fill ❑ Both ❑ Other ❑
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1 Article Addressed to:
4/0w
Po &�x �►6a
Cr�pel 4171 NC a7575-
2. Article Number
A. Signature
X ❑ Agent
❑ Addressee
B. Receiv y (Printed Name) C Date of Delivery
9' 8 -M 13
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ In'surO4 Mail , ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
(Transfer from service /ai 7 011 0110 0000 8670 5838
PS Form 3811. February 2004 Domestic Return Receipt
I 1 , . - .. . . 102595-02-Mnsan
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Bath ❑ Other ❑

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
el F. Easley, Governor Charles S. Jones, Director
Authorized Agent Consent Agreement
William G. Ross Jr., Sec,
is hereby authorized to act on my behal
(Printed Name of Agent)
:r to obtain any CAMA permit(s) required for the property listed below. The authorization is limited to tl
c activities described in the attached sketch.
TION OF PROJECT:
q P&l 5 u & ai- 6:59
ERTY OWNER MAILING ADDRESS: eourk
17
DRIZED AGENT MAILING ADDRESS:
►i?a�. r' Lek C:54 BPS
fl�s. LL6
�I'lA�'ii M P Wal
Nc ag4t0q
ago- s7s- 4
PHONE NO. SO-7 - a.e5, 9
PHONE NO. Yld I/y3-- q-Z q-�—
GCd L C
/lam t" 0,4 Ae -..Z - e - A,2

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: _% Kpyk, k4�.
Address of Property: L0 n
P �'� 1",P�li(1SJGt a+
(Lot or Street #, Street or Road)
(City and County)
I hereby certify that I own property adjacent to the above -referenced property. The individi
applying for this permit has described to me as shown on the attached drawing the development tr
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coast
Management, 127 Cardinal Drive Extension, Wilmington, NC 23405 or call 910-395-39
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be s
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If y(
wish to waive 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.
e'o uR /C.YY -
.47
lbtloc ! 2 f 1�1 C'
1
Sign Name D e
�l/rl 10h %�1 • Ze,A C.G . i Almr-w-WA

sape
July 31, 2013
PIN: 107517110604 PARCELID:257EB009 OWNER: ROURK ASSOCIATES LLC
1 = 50 Feet ADDRESS1: ADDRESS2: 6287 MARITIME WAY CITY: OCEAN ISLE BEACH STATE: NC ZIPCODE: 28469
N PARCELDESC: L-9 PENINSULA AT OCEAN ISLE BEACH PL 35/525 DEEDDATE: 9/26/2011 DEEDBOOK: 3204 DEEDPAGE: 1306 PLATBC
u,��: PLATPAGE: 0525 PLATDATE: 7/22/2006 ACREAGE: null TOWNSHIP- SHAI I (-)TTF IIFFFRRFIIVAI • n

,d 41+pcy.-). ti y (9
O Q
fi�Wve t
�11 Ah .2.r --2a
0 , -")AQ 7 Z) x Z
J56
-�Jsl -f-"
Z1