60671D - Barker

(CAMA / r�,DREDGE & FILL
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3ENERAL PERMIT
Previous permit#
(New --Modification Complete Reissue ❑Partial Reissue Date previous permit issued
irized by the State of North Carolina, Department of Environment and
Natural Resources " l f 6 )
1
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Rules attached.
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it Name l.��Yil ��. i!((I�
Project Location: County 3(owsivi Gt..,
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Street Address/ State Road/ Lot #(s)
StateZIPZYu5_
15� T ju Drem,
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t tQ) Fax # O
Subdivisio f `►
ted Agent 1
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City ' �1, ZIP - c^ , 1
El CW EW _ PTA ; TES ❑ PTS
Phone # A l U � V �oS) O River Basin 4✓'i,
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body Ogw A (,_ (nat �
❑ PWS: ❑ FC:
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yes no PNA yes 1 no� Crit.Hab. yes /, no
Closest Maj. Wtr. Body

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s�a.� is hereby au hadmd to ad an i
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dwftoicniarm
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OPER I V OWNER MA1LING ADOREM: Urrit
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CEATIME RD LKAIL Rll!'t U ost-r1PT"REOU19STED
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The purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual or
individuals listed below, The CAMA General Permit application prcccdures require that applitan13 provide tba Division
Coastal Management confirmation that a written statement has been obained s
indicating that they have no objection to the proposed work os that the adjacentgnad by the adjacent riparian property ow
by certified mail of theese _ riparian pr�rty owners have beets motif
contractor or other individuals acting an aauthorizedoagent on behaam lf foorthe apthe pliicaanj riparian property owners by ° mt
This form was sent to you by the following indlvIdual or company deslenated by the applicant as na
authorized agent:
Agent's Signature
Date
Name of Individual Applying For Permit;
Address of Property_
(Lot or Street, Street or Road) �~
(City and County)
I hereby certify that I own property adjacent to the above -referenced property. The individual applYing for this p
has described to me as shown on the attgched drawing the development they are proposing. A description or dra,
with dimensions, should be provided with this letter,
I have no objections to this proposal,
tt you have objections to what is being proposed, please write the Divbion of Coastal �laaagement
Curdinul Drive Extension, Wilmington, NC 28405 or call 910-796-7215 within 10 days of receipt of this n
No response is considered the same ss no objection if you have been natiflied by Certified Mail.
WAIVER SECTION
t understand that u pier, dock mooring pilings, breakwater. boat house or bout lift must be set bi
minimum db'tance or 15' from my area or riparian ttccess -_unless waived by me. (If you wish to wain
setback, you must initial the appropriate blank below.)
��.. I do wish to waive the I S' setback requirement.
t Ao nQI wish to waive the 1 S' setback requirement. AWWAL

IG-03-2007 10:02 From: To:84298%
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4ZINAIM 11 MMEM MlNik 0=111 TRZ [01112 FA��". " 4,06 IN
The purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual of
individuals lived below, The CAMA General Permit application pr..ccdures roquire that applieams provide the Aivi:
Coastal Management confnnittion that it written Moment has been obcuned signed by ttte adjacent riparian proper
indicating that they have no objection to the proposed work S that the adjacent riparian property owners have beets r+
by certified mail of the proposed work Often time forms arc submitted to the adjacent riparian property owners by i
contractor or odor individuals acting as an authorized agent on behalf of the applicant.
This form was sent to you by the fallowing individual or company destnated by the appik ant as as
authorized agent_
Name of Individual Applying For Permit: __ aequ-'-e-••--
Address of Property: _ � S- �J M
(Lot or Street it, Street or Road)
-L m l � -ems.. &A. c L
(City and County)
I hereby certify that I own property adjacent to the above-rekmitced property. The individual applying for
has described to me as shown on the attgched drawing the development they are proposing. A description c
with dimensions, should be provided with this letter,
I have no objections to this proposal,
If 'you have objections to what is being proposed. plea" write the Division of Coastal Manage
Cardinal Drive Extension, Wilmington. NC 28405 or call 910-796-7215 within 10 days of receipt of
No response is considered the same as no objection if you have been aotifled by Certified IM2iL
WAIVER SECTION
t underMad that a pier. dock mooring piling, breakwater. boat house or bout lift must be
minimum distance of 15' from my area of riparian access -.uahm waived by me. (U you wish t3
setback, you most initial the appropriate blank below.)
/ I do wish to waive the 1 S' setback requirement.
AMWA

escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
tbitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet
(Applied for. (Anticipated final (Applied for. (Anticipated final
Disturbance total disturbance. Disturbance disturbance.
includes any Excludes any total includes Excludes any
anticipated restoration any anticipated restoration and/or
restoration or and/or temp restoration or temp impact
temp impacts) impact amount) temp impacts) amount)
Dredge ❑ Fill ❑ Both ❑ Other ❑
15c
�SO
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 ❑