61577D - Stevens

%
_ CAMA DREDGE & FILL
y
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 15A NCAC ' J Zc> C14
f, ❑ Rules attached.
nt Name
1
Project Location: County C -e.
Street Address/ State Road/ Lot #(s)
f State` ZIP.-kd
(_ ) Fax # ( )
Subdivision
ized Agent
t1�A-JC-
Ciy JG, ZIP,r'`L�'
d CW EW PTA _ ES PTS
Phone # ("" River Basin �7
OEA HHF = IH _ UBA ❑ N/A
Adj. Wtr. Body a [ }� (nat
PWS: FC:
—VAN
yes / no PNA yes / no Crit.Hab. yes / no
Closest Maj. Wtr. Body ��� rL
A Project/ Activity
lock) length LP
'm(s) l I S12 U"
pier(s)
length
umber
!ad/ Riprap length
vg distance offshore
lax distance offshore
channel
ubic yards
amp
use/ Boatlift
BuidpzingL
ne Length
---- --- .... ...
not sure yes Arno _
igs: not sure yes rho
arium: n/a yes t no
yes (no
Attached: yes } no
ling permit may be required by:
(Scale:111W
❑ See note on back regarding River Basin
/J ,

plicant: MCA '✓ v CIA S Permit #:
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
litat Name 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 ❑
q a
f I
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

:ONTRACTORS, LLC
367-2159
IROLD CT.
AD, NC 28443
08-03
Bank of America
ACH R/T 053000196
2$ of i s 0 5 3 0 0 0 L 9 6 �: p 0 0 6 8 4 7 4 3 7 AUTHORIZED SIGNATURE
5828
66-19/530 NC
58754
6- i,?-/3 1
DOLLARS 8
m

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
Ila ry SJ�S
Mailing Address:
I certify that I have authorized (agent) i tee ���`�°O"�"'� to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) WD C-K ,
at (my property located at) - l3
This certification is valid thru (date)
r,
/ / ,�- / � 3
Property Owner Signature Date

Allied Marine Contractors, L.L.C.
92 Harold Ct.
Hampstead, NC 28443
NCGCL#60992
Fully Insured
Randy Mosley Hal Fogleman
[phone] [phone]
2-14-13
Dock Agreement for Harry Neil Moore and Mary F. Stevens
To Whom It May Concern:
Mary 'Stevens, of 136 Bridgers Ave. Topsail Beach, plans to replace her pier in the
coming months. The current end of the pier is situated 8.1 feet off of the riparian line
between her property and the Moore property at 138 Bridgers Ave. This number comes
from a survey dated October 8, 2012 by Weston Lyall, PE, PLS, PLLC.
Mrs. Stevens would like to replace the dock according to the attached drawing so that the
distance between her pier and the line will be 10 feet or greater at any point. This is 5
feet into the CAMA 15' setback.
In exchange for your agreement to this proposal, Mrs. Stevens agrees to approve an equal
encroachment of your new pier into the 15' CAMA setback. At no point will any part of
your structure be within 10 feet of the agreed upon Riparian Line, which can be
determined using the above mentioned survey and the existing pier at 136 Bridgers.
Signed:
Mary IF-'. Stevens
Date:
Harry ]veil Moore
a �zu ter,
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE) p—
I hereby certify that I own property had_acent to
(Name of Property Ow r)
property located at I
on
(Waterbody)
Applicant's phone #:
—,in A, N.C.
(Town and/or County)
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.)
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 (Riparian
for Permit) /
Mailing Address
Owner Information)
Signature
d- T

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 117-I r l �, S.le✓'t,s 's
(Name of Property Owner)
property located at
r,Ae fs /¢V e-
, Block, Road, etc.)
on 7/-10/54 ff / 5c> , in %�p5a• % &" ���'r` r 6 , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #:
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)
(Information for Property Owner Applying
for Permit)
Po (fox 3o i 7
Mailing Address
(Riparian Property Owner Information)
A�--1 A-111-
/{/ Signature
114rrrea(