62599D - Whitaker

CAMA P DREDGE & FILL
E N E RAL PERMIT Previous permit #
New Modification ❑Complete Reissue El 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 I SA NCAC
RuI ttached.
t Name Project Location: County
s "J �21ri_'1t cm —
Street Street Address/ State Road/ Lot # s
State �- ZIP L-?SDn
# (` �)=23-:33 Fax # ( ) Subdivision
zed Agent - -- . - - City ( Cc (Lik �W2� �( U'V ZIP
_ CW ❑ EW - PTA TES PTS Phone # ( )� J' f River Basin
OEA HHF IH ❑ UBA N/A Adj. Wtr. Bod(nat
yes / no PNA yes % no :� Crit.Hab. yes ( no Closest Maj. Wtr. Body AJ
if Project/ Activity ;vt 2� V�m V
(Scale:
'll
ock) length
m(s)
ength
umber
i
ad/ Riprap length
✓g`distance offshore
cax distance offshore
-hannel
jbic yards
imp
,use/ Boatlift
Bulldozing?
�,�JWiG L
ne Length
notsure yes no
gs: not sure yes no
,rium: n/a y no
yens) no
Attached: yes (no
ling permit may be requirec
/ SDecial Conditions 1

Applicant: I 1 /1 /, n n
�`�� Permit #:
Date:
1oZ5��1 D
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ound in your Habitat code sheet.
DISTURB TYPE
abitat Name Choose One
TOTAL Sq. Ft
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated renal
(Applied for.
(Anticipated final
Disturbance total
disturbance.
Disturbance
disturbance.
includes any
Excludes any
total includes
Excludes any
restoration or
tem im acts)
and/or temp restoration or temp impact
impact amount) temp impacts) amount)
Dredge ❑ Fill
Both ❑ Other ❑
�D
Dredge ❑
Fill
Both ❑ Other ❑
b
O
Dredge El
Fill [I Both El Other
C
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 El Other ElDredge
❑
Fill ElBoth
[I Other ❑

66-7704/2531
•333-2333 5003
� 1 l
$ �v �' „
edit U moo
nio
DOLLARSF- .
Carolina
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2938045?n.
- 500 3.

US MAIL
CERTIFIED MAIL RETUIt4 RFCFIPT RF, )VESTED
DIVISION OF COAST AL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hLreby certify that I own property adjacent to
_ (Name of Property Owner)
property located at
f (LqBlock, Road, etc.)/�
on I( ,AL J VQV L— L/ �L. , in U=� RSA 1� t.i+ , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: L 23 3 3 _ Maili s: �� J f`'N G 1
C_ 15 ��
He/She has described to me as shown below the development he/she is proposin;; at that location,
and I have no objections to the proposal.
---------- ------------------------------------ ---------------------- --------- ----
DESCRIPTION AND/Olt DRAWING OF PROPOSED DEVELOPMENT:
(Individual proposing development must_ill in description below or attach a site drawing)
C A- rJ
L /\- VJ A 1,( ,
�-C /uv a v t A-CJ 0 9,6- P L`4
S c: t)— W Ac- ,
Pit - a
If you have objections to what is being proposed, you must notify the Division of Coastal ;Management (DCM) in writing
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext. Wilmington, NC
DCM representatives can also be contacted at [phone].
o res onse is considered the same as no objection if you have been notified by Certified Mail
(Pr ty Owner L�formation)
Signature
Print or Type Name
(Riparian Property Owner Information)
Si
Print or Type Name
Mailing Address n(,F-At,j 6G/h-c-/N
Mailing Address

HAND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
6Rl A � to a/x KG 1�-
I hereby certify that I own property adjacent to Property Owner)
(Xi m of p y
property located at
(Lot, Block, Road, etc.)
on 0 AT J it A(L, - � �
LA-LJ , in O�-ai' � S u= , N.C.
- (Waterbody) (Town and/or County)
Applicant's phone H:_ _L�'�_� 3 2� �l'ng Address:
riG 2sg6q
Ile has described to nee, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
------ ------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
C)k �-3 /\- (,-
5-4
----------------- ----------------------------- ----- ---5 - --; -------------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
56 /l't.� S� Signature
Mailing Address
--�.1 is �,�- t��iat-1-+ YJ � C � ►� � �� S � �vf��2
o - - % - Print or 1 vpe Name

I
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INN* Alp
t
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