62562D - Young

C/pIMA / DREDGE &FILL
GENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue ❑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
L les attached.
nt Name Project Location: County )r1W1 0(--
s� i
s 3�� G i l I
,,,, nt Street Address/ State Road/ Lot #(s)
K Y� Statd — ZIP- ` ( / ti W V (:i r" ✓t t
# ( ) 994-�;1`zz Fax # ( )
ized Agent Ui,1d ,,,, ,V rVL-fit
d CW EW )N PTA ❑ ES ❑ PTS
OEA HHF ❑ IH ❑ UBA ❑ N/A
PWS: ❑FC:
yes / no PNA yes t Crit.Hab. yes / no
A Project/ Activity
lock) length W.
'm(S) X
pier(s)
length
umber
:ad/ Riprap length
vg distance offshore
iax distance offshore
channel
ubic yards
imp
)use/ Boatlift T3 %r
Bulldoxin
k- x
ne Length
not sure
yes no
igs: not sure
yes no
>rium: r�
xes no
Subdivision' A
City _TU (A C 11, ZIP Z �
JA
Phone # ( (b ) River Basin
Adj. Wtr. Body C&JA %J. (nat
Closest Maj. Wtr. Body ti
(Scale:
Attached:
ling permit may be required by: I GHO L1 `f—Rl jCVA--�, I C( C&,- ❑ See note on back regarding River Basin

Applicant: Permit #:
Date:
1-2
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq.Aimpacts)
L Feet
FINAL Feet
(Applied for.
(Anticipated
lied for.
(Anticipated final
labitat Name
DISTURB TYPE
Disturbance total
disturbancrbance
disturbance.
Choose One
includes any
Excludes acludes
Excludes any
anticipated
restorationticipated
restoration and/o
restoration or
and/or temation
or
temp impact
l
Dredge
temp impacts)
impact amoupacts)
amount)
❑ Fill ❑ Both ❑ Other
DDredge
❑ 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 ❑
I

ARY GURGANUS LAND SURVEYING 66-456-531 19 0
1108 SWORD ST SW 9
SUPPLY, NORTH CAROLINA 2846 QL9-10�F.
2 "". b ,
[phone] DATE.
$266 1 610
DOLLARS 19,
RSY BANK
)"Gal: 0??100233311- 01clo
90

EWA
R'�'OUEWR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
'at McCrory Braxton C. Davis
Govemor Director
John E. Skvarla, II
Secretary
AGENT AUTHORIZATION FORM
Date: - -7" 1 3
&me of Property Owner Applying for Permit: Name of Authorized Agent for this project:
_:_5_A,r1C5 "�out, l�'a►�NT S EnA (4"ArJ
wner's Mailing Address:
393 Z Snff"Ef.-n 90AA
ELo,, tj6 -Z124y
lone NumberL�6 may— $IZZ
Agent's Mailing Address:
1343 ' PINTAIL- /Jv6 Sw
5LA PPL 1, f,3G Z S3 4t
Phone Number (9'61 5 i Z - 513 S
,ertify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
r and obtaining all CAMA Permits necessary to install or construct the following (activity):
5-01'n-Dr- MY j�)a K - PAei F •- FU A-ri, 4r bo t r� A,.�,"*, uN w JtV a
[30,^T L + FT
)r my property located at )" C.Lbc�j 13(wr1, Al L
its certification is valid thru (da e)
U —VaProperty Own signature to

DMSION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner Tk^FS PA MECA You,J4
AddressofProperty: 14L flARuri DRc-iE HaLoE,J Q�GM _
(Lot or Street 1f, Street or Rood, City b County)
Agent's Name : U A PJ#+`f SPA Iek( tJ Making Address: 1 a`13 NIZA (L AJ C
Agerrt's phone tf 910 51Z - Sd:S S appt,Ya t`►C 28y62
I hereby certify that I own property adjacent to the above referenced property. The Individual
applying for this permit has described to me as shown on the attached drawir the development
they are proposing.
I have no objections to this proposal. I have objections to this proposal.
# you he" objections to what /s bofiW propoescf: you fimO notMy"Div*kn o/ Cold AhmwgwpaM
(OM In 01019 wWdn 10 dsys o1 rrc+sr�t or oWs no&t& Conrct kftnnmom for DCH aks@ is•w0sblrs at . - - -- or by 0 0 148 RCOiAST. No
WAIVER SECTION
I undera" that a pier, dock, mooring plus, breakwater, boadxxm, IM, or groin must be set
balk a minirrxun distance of 15' from my arse of riparian access unless waived by me. (K you
wish to the setback, You MmI WN the appropriate bunk below.)
-4-1 1 do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(p7r Owner Informatlon)
aGE�?
Sigma um
S"InEs y'o<•Ay'
Print or Type Name
( Ow m IMbnaodon)
igna
Prat[ or 7y1s Name
3932 .5 K E(' ► M IQa►6
p Addrew
1419 114 A L, t rabizloc
Mle ty Adldmm

July 17, 2013
Cleve & Nancy Wagstaff
309 Wagstaff Carver Road
Roxboro, NC 27573
This letter is to inform you that I have applied for a CAMA Permit for a
dock and boat lift on property at 146 Marlin Drive, in Brunswick County, town
of Holden Beach, N.C. and owned by James & Pamela Young. I have enclosed a
copy of the drawing of my proposed project.
Please initial the appropriate blank and return a copy of the form to me at
the address below.
If you have any comments on my proposed project, please contact the
Coastal Representative listed below. No response within ten (10) days is the
same as no objection when you have been notified by Certified Mail.
Holley Snider
127 Cardinal Drive Ext
Wilmington, N.C. 28405
[phone]
Sincerely,
Danny Sparkman
1843 Pintail Ave SW
c,iinn1v Kip 9AAA9

s�
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oAw- - -
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-
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