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CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
KNew Modification ElComplete 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 15A NCAC k
ules attached.
,it Name Project Location: County 1 �'L--
Street Address/ State Road/ Lot #(s)
�Iddc State�ZIPJA&I —�F � l t /yi.1';iAI D Vy ' t Isla ki
O '" Fax # O Subdivision {�1
zed Agent City n\ f l �i (.� ZIP-«� 4
i ❑ CW CHEW ),PTA ❑ ES ❑ PTS Phone # (�) - River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA C N/A
❑ PWS: ❑FQ
yes / no. PNA yes / no
if Project/ Activity
it i
xk)length 1 11 kd
-n(s) `
pier(s)
ength
umber
ad/ Riprap length
ig distance offshore
iax distance offshore
:hannel
i
i
ibic yards
mp
use/ Boatlift
3 Idozing
KAn) Y IT
/
ne Length — �b
not sure yes Eno
gs: not sure yes
mum: .n/a ' es no
`Yes no
Attached: yes now
Adj. Wtr. Body na
Crit.Hab. ves / no,l Closest Maj. Wtr. Body ►�' 'NZ
(Scale:
ling permit may be required by: I ()LAffi L•� SUJt�J V6(C( (+ �, ❑ See note on back regarding River Basin.
— ... 111 k-i1\(Nn.,.A nP! [`U I 1 111-7 t �:1�1�n,,./1 I-'� AP .,I ".,I -1,,
Applicant: � "� ► (/l� �aV fir'`
Date:
I�
Permit
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
habitat Name DISTURB TYPE Disturbance total
disturbance.
Disturbance
disturbance.
Choose One includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
tem im acts)
impact amount)
temp impacts)
amount)
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other 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 ❑
E CONSTRUCTION OF BRUNSWICK
COUNTY INC 79-9095
6618 BDR SW BS 910-5
OCEANEACH ISLE BEACH. NC 28469-4710
[MANCH BANKING AND TRUST rOMPANY
1 -800-BANK BBT BBT-COM
DATE
s
J:0
53lojj2j,:0005j99 9 26. 5 .... 2 ., q .. .... . ... w� .......
9165
66-112/531
s t
B-2013 12:59P FROM:TOWN SUNSET BEA 9105791840 TO:3953969 P.�1��++
LAMA / ❑ DREDGE & FILL N° 626(
GENERAL PERMIT Previous permit #
New OModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
prized by the State of North Carolina, Department of Environment and Natural Resources j +�
Coastal R purees Commis n In an f environmental concern pursuant to 15A NCAC i- U
_ attached.
nt �ame W Project Location: County66ncZd-�
j , // 4 s' Street Address/ State Road/ Lot #(s)
i 1/11 / Cl. t11�1.� r c._._I 1 ' �ie�/�'JY 1 .. 1 (a' 1 1 Il !►A /b i Y/i ►l d 1 nA laml
Adj. Wtr. Body
Closest Mal. Wtr. Body
A Project/ Activity
River Basin
(Scale:
rl_
,
.t
piers)
length
11
F_.) ._,j. t
t .. t ..
r-
-4 -j-
-?'"�-
lumber
,ad/ Riprap, length
vg distance offshore
max distance offshore-.
Is
t
r r -i :
_
It -'
-
_
-
+
"
'I S
channel
i"" I
!
t
� _
; i
i
.ubic yards
amp
i
I h
-i - I
, _ .. _. 1 ......... ._.
. " _y .
i L
Ouse/ Boatlift
j
�
N
{
F
I
Bylldozing
KAMEWY
line Length - f
not sure yet / ^o) L -' �--1- �.•_
AP: not sure yes n0
:orium: n!a es no
s
�_,_
I
i
-
Wing permit may be required by: 1 ❑See noes on back regarding River Bastnnil
:s/ Staeclai Conditions �� _� il rL6 4LA
A
WCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management Dee Free
James H. Gregson Secr(
Beverly Eaves Perdue Director
Governor
AGENT AUTHORIZATION FORM
Date: 0 �
Owner Applying for Permit: ame of Authorized Agent for his project:
Name of Property
Owner's Mailing Address:
i
Phone Number (330) 3
ent's Mailing Aaares :'l.1
Phone Number L ��
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
located at
(my property )
This certification is valid thru (date)
10 'S� / 1,21,�26 J3
HAND DELIVER
ADYACENT RIPARIAN PRQPERTy OWNER STATEMENT
(FORA PIER/MOORING PILINGSIBOATLXFT/BOATHOUSE)
I hereby certify that I own property adjacent to _�
s
r II (Name of Pro erty�Owner)
property located at l Q l� �� VIC
(Lot, Block, Road, etc.)
in
Vaterbody) '—
(Town and/or County)
Applicant's phone #: 330-603-8ydl
MailingAd&.�v %/fr.101441
bvRpSw�,S?11, Oti �H,zBI
He has described tome, as shown below, the development he is proposing at that ;;_ 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 (I 5') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
157- I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DLVELOPMENT:
(To be filled in by individual proposing developmeni)
-------------------- - - - -- --------- --- -- --- ------
(Information for Property Owner Applying Prope--------------- ------ -- ------ - -- ----
fnr Perrnit` (Riparian Property Owner Information)
Al
Fria; or 7) ;�e ;•�,-,.�r.
33v- ��3_ gy3� _
,PC 0+
Telephone +um_ e!
Date -- ------
HAND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PMRWOORING PILINCYSTOATL,TF)BOATHOUSE)
I hereby certify that I own property adjacent to r n;. n'-; is
(Name -of Property Owner) .
property located at 04;
(Lot, Block, Roa(L etc.)
on %mot bl s in 54AV e r l&' P, /-, , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 3 3o - 6o3 911-26 Mang Address: day %/Xlw op, rx"11`
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 (15D 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 DEV.OPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
Mailing Address
(Riparian Property Owner Information)
Signature
Print or Type Name
23
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