61688D - Walters

a 1
CAMA / ` DF EDGE & FILL
3EN ERAL PERMIT Previous permit #
I -New JModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
{ ` ules attached.
t Name
•+ J Aao %*7 A*460/-'5 Project Location: County �/'�
f J -e/°nfZ'"4 e1 {"!✓� Street Address/ State Road/ Lot'
/r 07 State_ ZIP
3C'G7 Fax # O Subdivision
;edAgent�City ZIP
❑ CW WtW L-4-PTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
yes / PNA yes /J�<
f Project/ A/ccttivity _ h �fd+
ck) length
Z
ngth
tuber
d/ Riprap length
distance offshore
a distance offshore
cannel
)ic yards
rip
se/ Boatlift
ulldozing
i
Length
not sure yes
s: not sure yes
ium: n/a yes
yes
lttached: yes ;no
Crit.Hab. yes no,
//,t /`1,
Phone # ( ) 4 River Basin
Adj. Wtr. Body%`//S11 L���+n/1l (natA
Closest Maj. Wtr. Body
00
(Scale:
ig permit may be required by: ZJ It I '� %y.G�lr! h • . 1❑ See note on back regarding River Basin n
ILJ o'% e)

pplicant: �l wit Permit
ate:
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
bitat 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
2
2
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 ❑

%RINE CONTRACTORS INC.
I. BOX 868 TEL [phone]
33HTSVILLE BEACH, NC 28480
3117
// 15-3/540
DATE �J 893
mm
DOLLARS
'II' 1:0 540000 301: S321.914922112

?SIC earth
VAZ IVIW&

P� 14-2810 Oe: 7,2 Fr uro: To : 9102563Q62 P. 1
V-A
�++
Han Pt i Resources
North Carolina Department of Environment and Natura
Division of Coastal Management
James H, Gregson
Bevarty Eaves Perdue oirector
Govemor
Dee Reel
Secre
AGENT AUTWOR1ZATlON PORN(
Data; �)Imefi AJ
pyvner Applying for Permit Name of Authorized Ardent for this prcect
Name of ProQorty. '
Owners Mailing Address
l.✓�� v�ll� AG
Phone Number -- ----
Agent's Maiiinrd dc 640w4
sv
Phone Number
i certify that l have authorized tha agent i,sted above to act on MY beha
lf. for the purpose of applying
for and s necessary
to install or construct the fotlov�+ng (activity)
obtair�g ail CA � Permit
my property Located) at
1\ This
n is valid thru (date)
Property Owner Signature
Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FOI
Name of individual applying for permit jll, ly l�✓�,-/ ��
Address of property l5 A-4.U1) 4 ��1 �-)!i &o'
I hereby certify that I own property adjacent to the above referenced property. '
individual applying for this permit has described to me as shown on the attach,
drawing the development they are proposing. A description or drawing, with
dimensions should be provided with this letter of notification.
Please_!niW below if you have no objections.
7)yrj ��
I have no objections to this proposal. A bl)oA
If you have objections to what is being proposed, please write the Division of Ca
Management, 127 Cardinal Drive Extension, Wilmington, N. C. 28405 or call 9'
395-3W within 10 days of receipt of this notice. No response is considered tt
same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater,boat house,lift or
sandbags must be set back a minimum of 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 wish to waive the 15' setback requirement.
I DO NOT wish to waive the 15' setback requirement.
DCM WILMINGTON, I
Signature & Dafe JUN 0 3 2013

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION R WAIVER FOi
Name of individual applying for permit f'&& !✓
Address of property / 5
I hereby certify that 1 own property adjacent to the above referenced property.
individual applying for this permit has described to me as shown on the attach
drawing the development they are proposing. A description or drawing, with
dimensions should be provided with this letter of notification.
Please initial below if you have no objections.
I have no objections to this proposal. A 'if��,�lS�r�
If you have objections to what is being proposed, please write the Division of Co
Management, 127 Cardinal Drive Extension, Wilmington, N. C. 28405 or call 9
.395-3W within 10 days of receipt of this notice. No response is considered tl
i, same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater,boat house,lift or
sandbags must be set back a minimum of 15' from my area of riparian access
unless waived by me.(lf you 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.
Z
RECEIVED
NA IAltl nninVI-Tnni