76568D - Biggers

I CAMA / ❑ DREDGE & FILL
31ENERAL PERMIT
New ❑Modification El Complete Reissue El Partial Reissue
N° 76568 A B
Previous permit #
Date previous permit issued_
^ized by the State of North Carolina, Department of Environmental Quality
;oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC n
rr \ ?les attached.
t Name N6, e Project Location: County
Street Address/ State Road/ Lot #(s) �(oc)
State( C- ZIP 2 nUlS .�ti ( Vf
E-Mail (u M Subdivision_
edAgent ILJ6.0 C.,I .cam V 1 City '^Sc( Q� c k ZIP Z �Y(,�
© Cw ❑ EW ?T PTA ❑ ES ❑ PTS Phone # ( ) River Basin ( - L
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ Pws: Adj. Wtr. Body �� � (�/r
yes / ro-1 PNA yes / n Closest Maj. Wtr. Body '� fe
Project/ Activity
(Scale: %J '
=k)length t �(
rtform(s)
Platform(s) 9 X� !
1
igth
nber
i/ Riprap length_
distance offshore
x distance offshore
cannel
)ic yards_
rp
se/ Boatlift
illdozing
i
LengthJU
not sure yes
fn
............ .
um: n/a yes
yes .
Jn
........._ ....attached: yes
ig permit may be required by: IN Sr� o n L�l
_ocal Planning Jurisdiction) _ ✓
A
❑ See note on back regarding River Basin rL

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
Email Address:
�o30
d\Y-Y�:s\
V(1
Gil , C-o"
I certify that I have authorized CZYk4-Uaj 6n ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: r
CG14\c C 0 CAL V Q zl�a '-�
at my property located at I (00q C0.YNC�a of NY e -
in�'� 4Y-SW "CJC- County.
/ furthermore certify that i am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
rnnt or I ype Name
Title
f'- I ---N

20 Zimbra
CERTIFIER MAIL - RETURN RECEIPT RgQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property OwnercMcJ1 CeES
Address of Property: �W CD-�k l� y�Ll r�SQ , , (15W ICV -Cnw)
(Lot or Street #, Street or Road, City & County)_ --
Agent's Name Malling Address:WM �Ch cat -
Agent's phone #: ` nD- rJ`�G' 9V9 � to �� N( Z-6 q
M
1 hereby certify that I own property adjacent to the above referenced property. The individual applying for
C this rmit has described to me as Shown on the attached rewt the development they are proposing.
Q '� 1 hnve no nhjections to this proposstL _ I hnve ohj�ctions w this proposal.
a If you have objections to what is being proposed, you must notify the Divi ' f? of Coastal
r Management (DCM) In writing within 10 days of receipt of this notice. Cor e,should be
—'l mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28.405-3845, DCM repress Main also be
contacted at [phone]. No response /s considered the same as no objection #yfrf!`'lgpw•Deen
notified by Certified Mail,
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
QJ minimum distance of 1.5' from my area of riparian access unless waived by me. (if you wish to waive the
setback, you must inittat the appropriate blank below.)
II do wish to waive the 15' setback requirement.
Itdo not wish to waive the 15' setback requirement.
(Property Owner Information)
���&o m� q ��
,Signuturc
1\C�Qka
Print or Type Name
M 0(_&��
Mailing Address
ciry rate bpr `� . _ ( 2& 7��3
Telephone Number
Date
( dja tit P pert OWrier Information)
ALI
ticgnaltdrr
Print or Type Name
cl�v 0
Mailing Address
rcCICOt� CL i llt2�vj�t_
Citylstatelzip
Toleplone Number
Revised 6/1W012

C1
.-Cl
PU
► ? t, a A .. , • .151-4129
DIVISION OP POASTAL MANAGEMENT
ADJACENT RIPARIAN PROPL1RTY OWNER NOTIFICATION/WAIVER FORM
M_,A,. ,...1 1-2.
Name of Property Owner:
Address of Property:
Agent's Name #:1..3 r +ct (Is r)Ar LtJii ()
Agent's phone #:
Melling Address:CQtp ItC�1
I hereby certify that I own prc4erty 1djacent to the above referenced property. The Individual applying f
this permit has described to me as shown on the attached drawing the development they are proposin
?�V-11-1
I have no objections to this proposal _ I have objections to this proposal
Cr 1f you have objections to what is being proposed, you must notify the Dl n of Coast
Management (DCM) In writing within 10 days of receipt of this notice. Co should I
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM rspr" also I
contacted at [phone]. No response Is considered the same as no ob/ectMn "
notified by Certified Mall.
•^r w
q� WAIVER SECTION
Vi I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance 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.
'"'4 1 do not wish to waive the 15' setback requirement.
���
(Property Owner Information)
Signature
ftc\-O PA C�Ct PR`S
gPHnt or
Type Name
UdV VMelling Address
rr• u �lC ��-7 ..
c4vstatealp Ili
(Adjacent Property Owner Infonrattion)
9 ,Signature
Z�94 h lkxlvl��
Print or Type Name
(o i L&✓►acJit �r
Melling Address
city/statsaip
-7N4- 101, —A-2,QU 0/G) 21c�z - 11114-)

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or on the front if space permits.
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mmmm Jhn \)1Q
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IIIIIIIIIII III IIIIIIIIIIIIIII III II I 111111111111
9590 9402 2219 6193 1038 30
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C
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Merchandi:
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