61680D - Throndson

CAMA / DREDGE & FILL
GENERAL PERMIT
New Modification Complete Reissue ❑Partial Reissue
Previous permit #
Date previous permit issued
)rized by the State of North Carolina, Department of Environment and Natural Resources 7 1 %
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 4 t
ii Rules attached.
it Name 1 -1l Project Location: County I t SW I(i '
cargkif- Dive, Street Address/ State Road/ Lot #(s)
I 1 State _ ZIP Z-4tt 15 �1 � U buYk&A""k `fir"
V _`3 Fax # ( ) Subdivision N ,A
zed Agent VayoltM1SuaS 4 &lk, wits City�O {11 t'}�GG� ZIP
i ❑ CW 5 EW 'A PTA ❑ ES ❑ PTS Phone # ( ��) River Basin pit
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body l,�Yi (� (Half
❑ PWS: ❑FC:
Body —
yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body 1
if Project/ Activity
(Scale: I //
xk) length
r(s)
pier(s)
ength
ember
ad/ Riprap length
ig distance offshore
iax distance offshore
:hannel
jbic yards
imp ! L
r
use/ Boatlift 7�
Bulldozing
ne Length
! aqr
not sure
yes no
gs: not sure_
yes no
>rium: /n/a i
yes no
yes no
Attached:
no
ling permit may be requires

applicant: /n���(� �Permit #: Q
fate:
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
iund in your Habitat code sheet.
abitat Name DISTURB TYPE
Choose One
TOTAL Sq. Ft. FINAL Sq. Ft.
(Applied for. (Anticipated final
Disturbance total disturbance.
includes any Excludes any
anticipated restoration
restoration or and/or temp
temp impacts) impact amount)
TOTAL Feet FINAL Feet
(Applied for. (Anticipated final
Disturbance disturbance.
total includes Excludes any
any anticipated restoration and/or
restoration or temp impact
temp impacts) amount)
V V'J Dredge ❑ Fill ❑ Both ❑ Othery
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 ❑

S & BULKHEADS INC
ER BUCK ESTATES
-Y, NC 28462
-755-6861
c:s
RUST COMPANY
ee .00l lP 66 � Y6"hGi 7v
030 i:05310112P:000521579"28
6703
r J 66-1121531
DATE tiLJO

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-7q3-7 Capstone Dr,
t-
13 X l3
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/�a1�5h tUc �7�15_
n5 docl/
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY QWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: Mr. —TKr Sl)-
Address of Property: 110 LkLV haffl 5+ r
(Lot or Street #, Street or Road)
l (,IX VI 1Z c L l (, CIO,
(City and County)
I hereby certify that I own property adjacent to the above -referenced property. The individi
applying for this permit has described to me as shown on the attached drawing the development th
are proposing. A description or drawing, with dimensions, should be provided with this letter.
L�) I S I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coasl
Management, 127 Cardinal Drive Extension, Wilmington, NC 23405 or call 910-395-39�
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be s
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If y(
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
La fta�7L
X6139:1VA

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: ffl r. , h ran d 50 rl
Address of Property:_ I It) Cot ho M � }- �-�-
(Lot or Street #, Street or Road)
/C%D Lac.j G"�c ay./'c r
(City and County)
I hereby certify that I own property adjacent to the above -referenced property. The individ
applying for this permit has described to me as shown on the attached drawing the development t]
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coas
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-35
within 10 days of receipt of this notice. No response is considered the same as no objectioi
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If y
wish to waive the setback, you must initial the appropriate blank below.)
Sixfi Name
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement_
Date
Print Name

TA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Govemor Charles S. Jones, Director jili m G. Ross Jr., Secretary
Authorized Agent Consent Agreement
aMthV Vat-rna rn is hereby authorized to act on my behalf
T ;Pr ded None of AgG M;
in order to obtain any CAMA permit(s) required for the property listed below. -he authorization is limited to the
specific activities described in the attached sketch.
LOCATION OF PROJECT:
I t Q!rm s+ i �Pn (�rctch 1JC
PROPERTY OWNER MAILING ADDRESS:
mc— Qr161S PHONE NO. 19-830 " �p
{344
AUTHORIZED AGENT MAILING ADDRESS:
�I PC a�ilo�
!I
PHONE NO. W " `/41_? — t{l 9--
Signature of Property Owner: J
Signature of Authorized Agent.
Date: (0 _.
127 Cardinal Drive Ext., ftwgton, "forth Carolina 28405-3845
?hone: 910-, W72'.5 i FAX [phone]'•. Intemet www.^,cr-lastaimanagernent.net
An Eaeal CopowmAy', Afkm v* Action Eff#oyer -511% Recided h 1 A qos4 C hnumer Paper