62518D - Shaver

CAMA / '❑ DREDGE & FILL f N9 62
GENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
rued by the State of North Carolina, Department of Environment and Natural Resources '4
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
ules attached.
Y"
t Name Project Location: County V� Pt�Y�iI LA
s Wq I Street Address/ State Road/ Lot #(s)
StateN_ ZIP��
L Fax # O Subdivision
ized Agent ki City. � (�, r (,l �� ZIP__
d Elcw �Ew1 PTA Es ❑ PTs Phone # O River Basin
❑ OEA b HHF IH UBA L-1 N/A � �
❑ PwS: ❑FC: Adj. Wtr. Body C y,L t a (ng(
yes / no PNA yes (—no Crit.Hab. yes �no Closest Maj. Wtr. Body IM, J-1.i 1
A Project/ Activity --�
ock) length f .
m(s)—
pier(s)
length
umber
ad/ Riprap length
vg distance offshore
iax distance offshore
:hannel
ubic yards
imp
Use/ Boatlift
13�lldozing
ttilp
ne Length
notsure
yes
no
gs: not sure
yes
no
mum: n/a
yes
no
yes
no
Attached:
yes
no
ling permit may be requires
(scale: 1 "

pplicant: ��iw <� 1Q�L1�' S(
Permit #: GzS1 (�
ate: vv
J11-2
-scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
Name DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.F(Appliedfor.
(Anticipated final
disturbance.nce
Excludes anyudes
restoration
and/or tempon
impactaamount)acts)
Feet FINAL Feet
for. (Anticipated finalbitat
disturbance.
Excludes any
ipated restoration and/or
or temp impact
amount)
V� Dredge ❑ Fill ❑ Both ❑ Other
l O
I V
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 ❑
Dre�EOFill❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

SON 5356
CTION
66-112/531
Date

ul.01.2013 07:41 AM Richardson Const & Marine 9108425597
PACE. 1
0NLAMA / 0DREDGE & FILL N° 62518b
ENERAL PERMIT Previous permit#
ow OModfilcatlon ©Complete Reissue ❑Partial Reissrae Date previous permit lsaued
ftrized by the State of North Carolina. Department of Environment and Natural Resources '
hQ Coastal Resources Commission In an area of environmental concem pursuant to 15A NCAC
1!s auxhaub
d.
Project Location: County
Street Addrim-� Stato Road/ Lot #(s)_
'�, G OEA HHF 17.711H I_l USA 1 _i WA
s):
L Fws:. .... .- .. _ UK: -
yea ( no) PNA yes ( no ) C t.Heb, yes( no
s of Projectl Actil lty
(dock) I&Vv .. (,or
f .. .
form s
pr pter(n)
in length _
numbw
�hwdj Alprop Iength
avg distance ottsixsro�
max distance offshore
n, channel
cubic yards
t ramp
ch
or
A#
ZIP Z�—
tI.Q ks River Pas{n �r
Adj. Wtr. Body__ .ei_Q (na9n�/un n)
Closest Maj. Wtr. Body kww
(Scale: I fl zdr )
131111
1Rol 0 SOMMko-M so ME
+ ■■ ■■■■ ■°'Y:�' ■
41pillMi■� r*AM■■■..■■.,■■■ ■■■■■■
AVEMUM .to

'un.29.2013 03:13 PM Richardson Const & Marine 9108425597
06/24/2813 11:13 17406673354 C(10VILLE LIBRARY
-IM— 2A.2C13 10;�2 AM Ris:l:axdson Const & Marine 913942_!p7
Al"A"NT AIPAXA(V PROPERTY OWNER STAn-MEND,
I hereby certify that f ownproperty rdjaceni to gay V
r� (lame of Property Owutr)
property Imatrd At Los�I &Oal,_
nc _ _ . , in
(Waterlx)d .« ..`.'ft -.� —.,_ ...• N.C.
x) _ (Town andlur County+
Applicant's phone a;,��-� Mo►�i»� Addrer:: Y
laid ]� 3$4fpA
He has 4e44atilwd tome, is sh,,%v :>rloty, slta deveitrppttnt hq iK pro ipsittg at ttrnr Iocetic.:, a.�d I
have no objeceofts to his prwmal, f undMtena treat a pisrhnaodn# piiings 1 F.0at4ift r facratho+rse
rnusr be set bac4c a trim,. distAt;ce c1 fithen 4�ct r2 S') tk+tr my >Z>ra of ,iparian a'ta6 un,esa
waived b? -,W, (if yoN WiSh to waivQ the aerbaek, I-ou must initial the apptopriata black
below•-)
Idug %io, to waive
T-ni-toA VL& .I 42 wish tu'waite thautflb" r qaix mmtk....._^'�........,.... 1
• lATSC'YtYP'I1OI�.�Yli!Ult URAW1�l(; U.p'P>at4)EWb'�.p >aEVTLQIPM�;v"t �'.•.....�
(To beRled to 0 txrlE'POR41 prop Sms dere fopwmo
(Taft+rmatt<ou fbt M'uperty Owner Applying (Ripariap Pr,)pert3, Owcser,[++tnrRtAtiolk)
for i'arn►it)
�}al dav� ns
S1 ,a ute . !7artr
p'y�e
O'free;Lum K,,Lm- e-
j'u r,
PAGE. 4
PAGE 01

un.24.2013 03:13 PM Richardson Const & Marine 9108425597 PAGE.
Jun.19.2013 07:0.5f AM Richardson Const & Marine 9108425597 PAGE. 2J 3
ADJACENT RIPAARUN PROPS, XIT OWNER STATEMENT
("AA PlEWfOORWOPILING"OATUPTIBOATHOVSR)
I hcccby acrrify thet I own properly t jacent to _ Z1'Q,1lt
(!`lame of Prop" Droner)
property located at
/� -`` (L t, Block, Road, etc.)
on l_QJrit)..t to 11::k1j;;jJJffi.�_ , N.C•
(Water•body) (Yawn Find/Or Counts
.Appllennt's phone :�� � Ka ling Addra�:.�.� ,i. TLkVn!?t�► t
He has describsd to me, as shown below, the deveieptnent he is proposing at that loantion, ar4,1
have no oblecdons tD hls preposai. I undafst W that a pier/mooring pilings 1 bostilft / boatl►oose
trust be 4d back a minimum distance of ft#t m feet (IT) ftm nV area of riparian aocess unless
waived b u role/h to waive the vetbaelr, you must Initial the appropriate biank
W. )i�
14210 not Wish ft waive
f OR Wish to waive that setback req iremertt.
""sf ^ _ �_ , ....._.............. __ ..... ......... . ...
DESCRI,PnON AMOR DRAWING 0? PROPOSED lDE'VNLOPMENT:
(To be f iaf to by lndMdual proposing ddevetopmeao
4A,AL &40AUCO 1�Yorw ihq
Y,-..�...,,....... ....,...... .. —........................
(Ym formation for Proporty Omer Applying (Riparian Property OWntr lnfornuation)
for Permit) % ,�n
- I.a.l___ ;twoar, - r%%� � �i �M _I6 � (
Mailing Addrasd Signattue
CityBtatO/Zip - T print or Typn *lame
Q ,_ 7__---0335'
81R T �� -- .�� Cnlcphon� t`luiubrt

'un.24.2013 03:12 PM Richardson Const & Marine 9108425597
06/1912013� 09:57 9100462408 MARTrA LEE REALTY
PAGE. 2
PAGE 01/01
1�x 3300 pixels) - Scaled (2 i %)
W
KEWR
`�Cflll <N �Tw De «rent of f=t':°.!".^ n,9 �''! i+lafi�r i �i"5t111rrx?
Division of Cnasid Managarnent
Govattwr Lavoo
A.nFr4T AI.rrHQpjWj 10N FORM
op".
i',Ivr.n of Dro;" C Wner Adpivinp fm Permit;
Yor
60+ mer Clmsau Ph -
Owners McPlinXAddre_ D - !
,ai MA —'row ,,, � 2 24
http&:/!mail-attachment.>
LIM rreamBn
vOfi1 t~. K+.q l
Nome of Authomea Agent ror me prgw;t.
Age,-i 5 Nssikn ttoorew-
A a 3 ,a5l�+Nta ��rJ
�h•v+n ,nnhnr! W f� a �' � �� .. Phone Number!
^_etify th9t i have sa i1tw9din4.1 the a Mnt lMOd alhMO 10 WA art MY behalf. for the purpose of apptong
fnr end obrxlnina aA CAMA pwmits nese#ssary to inatall or ci"WUcr me loo0wing tacuvit1j,
;;, , s:��a~ :;�at�siAd; at t � f . i �✓ oor► S�:- 4-�a1 loan , �a,dc�,� �' .. o��to.�....
This 00rtlf)Utian is V0110 thru J"S) ..._ j y ..�...
0—perty uW""rt:$le

un.24.2013 03:13 PM Richardson Const & Marine 9108425597
PAGE. 3
djacent Property owner
loyd Wright
!3 Tarpon Dr
17'
Owner: Brent Shaver
121 Tarpon Dr
Holden Beach NO 28462
336-451-9441
Adjacent Property owner
MAS Properties
119 Tarpon Dr
Contractor:
Richardson Construction
Scope Of Work: II
Replace existing float and ramp in same location as existing float.