61601D - Strobel

CAMA / DREDGE & FILL n�
IENERAL PERMIT / V1 Previous permit#
Vew ❑Modification Complete Reissue -Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources
)astal Resources Commission in an area of environmental concern pursuant to I SA NCAC _4 "f j j • �rJC
Rules attached.
Name U�►'\ t Project Location: CountyUYtSVv' (lam
Street Address/ State�Road/ Lot #(s) LCA I
`
SVUC4\ _State A ZIP �c L� Y- SL VAh 151Y ��►�rL+,
r �" fax # () Subdivision �G \/ i ✓ V�y t r
d Agent C 4 � _ W f kA-- 76C.iittly .� ZIP 2�q
El CW � EW u PTA ❑ ES ❑ PTS F�f�onet# ( j� )z5i 4 Z S River Basin U rn
❑ OEA Cl HHF ❑ IH ❑ UBA ❑ N/A y1(A �,1 G f/.'
%<1 S: ❑ FC:
'es no PNA yes no Crit.Hab. yes no
Project/ Activity
k) length V x
:r(s) 1V k --
gth
fiber
� Riprap length 1 I
distance offshore
c distance offshore
annel
is yards
p
;e/ Boatlift X ! 3
illdozing
Adl. Mr. Body • A , �("T
Closest Maj. Wtr. Body
( a A AA (i 60v tlA r 1,
Lengthnotsureyes nF
not sure yes no
um: n/a yes no
Oyes
_..._.. r..... —
,ttached: yes ig permit may be required by: V* U �5`ti1 C cz)u V)±,
i 1 1 1 i. n `1_I 1• rf. i 1 f i , LP. • I .. I
(Scale:
❑ See note on back regarding River Basin r
� L a A 1 4_1 , „ / ". _. 1, L

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M,9
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l8 13 02:54p P•1
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James 1-I. Gregsen Dee Freeman
Go,/error Director Secrelary
AGENT AUTHORIZATION FORM
Date: _; 1"12.0
Name Property Owner Applying for Permit: Name of Authorized Agent for this project:
Qwner's Mailing Address:
Ito -x
Agent's Mailing Address:
Phone Number ;Zd.4i �?��a..r. Phone Number
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):
,.
(rny property locales) at 5-y\%gti-lfe,- _ _, L,, p v �,r t,� .0 .
This certification is valid thiu (date)
Property Owner Signature Date

r 18 13 02:54p
p.2
ffc� .l - LC-1 . v:.,
AD. ACE.+Yrx,PARI Av,�,�c1f�z:xcvc�tivtvrksr�T tiu�:�i�•
1 lt�t eby Ccf-i* that ! own property adj:tccat ;,,, - ! Oh Pt__5 �(1�3 j�• C _ _'s
{Name of Property Chvuel
355Z
Lat, Iltnck, l2aatl, cic.)
�,�, ShAII��IC' � YP� �•
ffmvn end/or County)
Applicant's phone H:4%QSiIN.lailinK Aficln cx:_-_e/y�� Z_+�11I4NjlC �d
Ile tuts &-scrihed to mt;, as 4htr»n belo%k, the dcvel0pt:twtt he is prlrxtsiug :u that lue:stiun, and. i
have nu ohjectinns to his proposal.
- -----------------------•-----------------•------- ....---•---------------------
.Y
DES(JUPTION ANWOR 1)x,i.NVINC OFPROPOSED J)F:VVj,f)P'wlF.NT: -'
("Ter be/illerl in by prgperly owner propositt, developinent)
(Information for Property Owner Applying (ltytarian Properly t')wuer Tnf<�nnalin
for Permit)
1114 �t- egAACIA(e__t om_--
Mailing Address; /- - i •naauc
,
to f- 0-A 1 5 �((( 3-� 0 #a-._._J�.-nX o
Cily/Statk!7it� Print or Type Name
CZ�?-_ vS
Telephone . ber
tii nature l ;,i,.
0-rd 0
I'clephone l�umtx r
mate

it 18 13 02:54p P•3
�fRAJL� b#.wv4A-
ADJACENT RIPARIAN P12(')PFRTI' OWN1:11 STATEMENT
(FORA PIIiRINOORING PtLItY(:S.'BO.f ri.ii "i'wo il7lotiSF)
1 hereby certify that 1 uwn r0 erty ad scent to _e�O�N
p p _ m ej_..._. '�
(Vatne of Property C)wncr)
property located ut.---3552 J1 13 Lcr>` ! g___
(Lof, BI()CL, Road, etc.)
(5't'aterhudy) r
Applicant's Pht,ne:.t riling Address: �I Z�iA�+✓dA� %�I
15-21 Z
fit; has &scribal to wc, .:s slhiwrl hclow, the dcWtopment he is proposing at that locntion, and, I
have no Objections to his proposal. I understand that a Pict/il,wring pilings ! b„atlift ? 1xiatilotise
must be set back a min: mtun distance of fifteen test (15`j from my area of riparian access unless
waived by nn.. Of YOU wish to' give live setlpock, )•uu must inifi:tl the appr(,priate blank -
below.)
J,JA.K I do not wish to waive
11 . -1 du wish 10 waivo that salbac'k requirement.
---------------------------------------------------- ---------------------------- ----------
DESCRIPTION AM1J) OR DRA«'I.NG OV 1'ftOI'O51?.I)
(T'r, bcTlled in by inn iviti—I rrailoeim deveh, p»rarrl)
See 0-' e-Iej dQ,au,"/
--.--- ------------------------------------- -------.-----...
Onformation for• Property Owlier :applying (Riparinu I'ruperty ('timer Information)
L,r Permit)
1?L to .ofilt._1�+,_ _
Mailing Address
C,t J. Stt,u7.tp
iCiephti;re trnhcr
Signature
Print or Type Nam,!
F10-6 a e - a 5-17�i'
rinPholle Number
1" - ..

J
�V� , %.
% rw�2 uvA -Z #^�

pplicant:
ate:
Permit #: I ( r„ b ` E)
ascribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
DISTURB TYPE
bitat Name 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 X
—4 os
❑ Both ❑ Other �ill
EDredgeill
❑ Both ❑ Other
12, -
Z�-s
Dredge ❑ Fill Both ❑ Other ❑
�5 /bs
>�
Dredge ❑ Fill Both ❑ Other ❑
O
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 0 Fill ❑ Both ❑ Other ❑

IETT CONSTRUCTION 3957
ANDY HEWETT 66-112/531
17 /
Y RD SW egh
b o
3462-6037
Date
Ll C Dfiy K-G s (Y-) ,
Dollars
ANCH BANKING AND TRUST COMPANY
7-800-BANK BBT BBT.com