57527D - Britt

-,CAMA / DREDGE & FILL
►"ENERAL 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 15A NCAC CJ
Rules rttached.
it Names _- t l / r i f'f- �'rP"' Project Location: County
State ,JG ZIP
ed Agent >,''.�+ �^�"� CJ� G.ykt_A�
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❑ PWS: ❑FC:
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City_ �77// 1 ZIP
Phone # �) S 7� ` S -,River Basin
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ding permit may be required by: .�� See note on back regarding River Basin

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
15 13. 6-N and & 0, 51-ar If'(19
Mailing Address:
I certify that I have authorized (agent)y f l3 M'ri'n e DUI 51 /ZcGhCa�t on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) 5 e-a, (, a l / ,
at (my property located at) �tv d �4 lG °yt Jure Cl+e/_ Ak, zp
This certification is valid thru (date)
rroperty owner signature Late

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM
Name of Property Owner: J�Dr15 & OrJi
Address of Property. `k'7J 49 9t-eel56trFCtAzNC j(y4g5
(Lot or Street #, Street or Road, City & County)
Applicant phone #: 9�� -Y� 3' 3a � Mailing Address: 13- 6146
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 drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
G / I have no objections to this proposal. I have objections to this proposal.
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. Contact information for DCM offices is
available at www.nccoastalmangement.neticontact_dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
r�` 5 r3: er,'lf
Print or Type Name
(Rip rian Property Owner Information)
Signature
-�-- 7-91 G-, M,,Pd L
Print or Type Name
Mailinn drill acc

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
r;
-5 urr-
(Lot or Street #, Street or Road, City & County)
rieh g
// C) �J Mailing Address: �� T r7
Applicant phone #: ��� —1/ 0 � / `)y�� ��
ti P,* e%' !I t? A& AfJt 2-
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 drawing_the development
they are proposing. A description or drawing with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
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. Contact information for DCM offices is
available at www.nccoastalmangement.net/contact_dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
iature
Print or Type Nam
�. Aa /�
(RiparianPropertyOwner Information)
n� a n�►►n
Si at
tt/o Q/
Print or Typeame
Mailina Address

2012 03:07P FROM:
Q
) F-
910-326-SS92
TO:91910395396457546336P.1

icant; �� ✓ / S /�/'
Permit #: 577 Z7
;vibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
d in your Habitat code sheet. .
tat 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
Dredge ❑ Fill, Both ❑ Other ❑
�( O
l
I /O
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 0 Both ❑ Other ❑