62584D - Smith

C:AMAV DREDGE & FILL jr �/n� `62
INENERAL PERMIT Previous permit # A
ew ❑Modification ❑•Complete Reissue ❑Partial Reissue Date previous permit issued
)rized by the State of North Carolina, Department of Environment and Natural Resources t
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC a
Iles attached.
it Name . t (AA 11 Project Location: County i'Ky } Y' ! (,11
j'-4
zed Agent
I ❑ CW !�EW 7 PTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
71 PWS: ❑M
,f Project/ Activity
)ck) length
n(s)
pier(s)
ength
ember
ad/ Riprap length
fg distance offshore
iax distance offshore
IV
nelX ' 4 ' x '
6It 'Y --
ibicyards
mp
use/ Boatlift
3ulldozing
ie Length V L
not sure yes no
,s: not sure yes +
rium: �.a yes no t _./ yes
Attached: yes n
Street Address/ State Road/ Lot #(s)_
�� t�ul(�i►s r�i
Subdivision
'Gityjr i{CQj.I i,l iSl � fG a— ZIP �(O
P ne # (�)Z 1 -10, River Basin
Adj. Wtr. Body OAV--, t& - (nat
Closest Maj. Wtr. Body 4AIW
ling permit may be required by: N in ❑ See note on back regarding River Basin
. — .. — ... `III ,....I n f11 n I P.. 1 ., ci � l . r, J 1 i . --I i _. ,

Applicant: - - .
Permit #:
Date:
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 fins
Habitat Name DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration andh
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts)
amount)
RbD re d-g�N,i Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Otherx
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 ❑

Bank of America Advantage'
1059
W 15� NL Z��� 1 Date 35-2/1130 TX
5445
►ILE 1N
do Dollars
!�
4880 L 2084966ii- L059

CAMS► / 6REDGE & FILL -
ENERAL PERMIT Previous permit#
:New El Modification -Complete Reissue Partial Reissue Date previous permit issued
orized 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
�t rr�� __ �� &w-f,
(bkvt'&ie4,-4
Rules attached.
nt Name N i,t. 4 roject Location: County
s Street Address/ State Road/ Lot #(s)
#� ` 1 1�IQL�" _ State N't, ZIP2 .59,me.
p Fax # Subdivision rJ
(� � 7-' tab �' ()---
zed Agent City .56b �►,e ZIP
Cw 0w �PI A ES PTS Phone # ( ) River Basin \}1M
OEA HHF _ IH UBA = N/A Adj. Wtr. Body nat
PWS: = FC:
y% �no PNA yes no Crit.Hab. yer/no,Closest Maj. Wtr. Body
4 Project/ Activity a cQ 'L�t-
Aki"W n (Scale: !!
ock) length
m(s)
ength
umber
ad/ Riprap length _ j
+g distance offshore I
iax distance offshore
•hanyel JZA Z_Z
ibic yards 3
mp --- �C
use/ Boatlift ,
3ulldozing
ie Length
not sure yes
gs: not sure yes no '
rium: n/a yes no
yes '
Attached:`
� a
AuF�ori�ed; vnw'
�Ucc4va#�"aK Fljpg
�x ny�tA�
i
yes no - - -yv i0 +i
ing permit may be require
�y � tpk
•- - n_I1 IGn A..I AAl cl�. -1I
See note on back regarding River Basin i
(,1_ _A ,-,...I. 1 - . - - _1

HAND DELIVER
ADJACCrn A•IPARIAN PROPERTY OWNER STATEMENT
{Z.,`yr tti tLa 3 . .1) _ 1 r H,
I hereby certify that I own .prop,rty adjacent to _ __ � fi hl5! � 0 ; b A1LL PaoT 's
(Nume orProperty Owner)
dim (':MfLw••u1.c
property located
(Lot, Mock, Road, etc.)
on C RN It l._ * j �i , in rUC.t_ s , f y LrE P; . (r "w 1 N.C.
Msterbod;f) (Town and/or County)
Applicant's phoneb: �3� 23�`�1`a `� MnilingAddress: 210
Fie has described to nie, as shown b0ow, the development he is proposing at that location, and, I
have no objections to his proposal.
DCSCRTMON .AND/OR DRAWMG OF PROPOSED DEVULOPMENT:
(To be oiled In by property owner proposing development)
`MP.t,iAvi -L 'LJQti.I�..Git t* QF .. k.%�,tiTiN(S '<,LSP'd>
Lo c h'T lr r, P.-'7 ' lO A: i i
(Information for Pi-oper(p Owner Applying (Riparian Properly Owner information)
for Permit)
Mailing Address Signature
City/Statel7.ip Print or Type Name
_�� 21,, r4 _moo �9 Iosp©
Telephone: Number Telephone Number

NAND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Qtc t, A2.t� �. '�i m tikl
I hereby certify that I owil property adjacent to {rib F �s
(Name of Property Owncr)
�ct:At� I�►.� F,�nc.Ey. Ivy_ 2.�,�-t�°�
property located at °)L ac-[, —
(Lot, Block, Road, etc.)
on C NIJ N L. �k� _ __,in tJ{J:, 1 r=J 1', lri:<_
(Wa(erbody) (Town and/or County)
Applicant's phone N: 7 3 ?- 7 31. �`� 3 Mailing Address: id IZI:"�-•-
���t;Al•r
Flo lips described to nie, as shown below, the development lie is proposing at that location, and, I
have no objections to his proposal.
...................................................................
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be flUer1 In by properly owner proposing development)
................ .....------------------ .--------------------- ....
(Lnformatlon for Property Owner Applying (Riparian Property Owner Information)
for Permit)
Mailing Address Signature
Z`J #col ri
�� c.t l=. t� I ; �.0 - A 1 F N "—Pri or Ypc Name
City/State/Zip \\