59184D - Burger

=1 CAMA / 0 DREDGE & FILL
3ENEAAL PERMIT Previous permit#
New [�]Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
)rizdd by the State of North Carolina, Department of Environment and Natural Resources '1 V. I I a
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC j
' Rules attached.
it Nw-ne , LKQ 6 ✓ v �11ti� E r Project Location: County 6%,115W L 14,
t' 6y l iris l_ i C u Street Address/ State Road/ Lot #(s)
i " f Y'SJbWn stateMD ZIP �04-ia NI. Ntu'l 13 . SW
E (Z u) JA% - Wo15 Fax # ( ) Subdivision fJ A
Eed Agent (, &A%t a -4 City V C(' MA. IS[( [-�eAcC k ZIP IZ� Ll lO
❑ Cw Ew ] PTA !�S ❑ PTS Phone # (� I�) 3-35 River Basin �, omi
OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body iki Lv�� (naatt lI
❑ PWS: ❑FC: N I I�ULJ
yes I -no PNA yes no) Crit.Hab. yes %no Closest Maj. Wtr. Body t�
1,
f Project/ Activity t lyi--Ya v
)ck) length
n(s)
angth
amber
A/ Riprap length
g distance offshore 0
ax distance offshore
hannel
bic yards
.np
ise/ Boatlift
iulldozing
6-TV1200 APtA
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■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
G,4rzL4,.uo W4
113 a /VOrwaad S�- S W
&"W/.I�
aPY4
❑ Agent
❑ Addressee
C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
Service Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number (Transfer from service label)—___7009 1410 0001 8701 5279
PS Form 3811, February 2004 Domestic Retlrrt Receipt 102595-02-M-1540
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ th this card to the back of the mailpiece,
the front if space permits.
1. Addressed to: 1
A 40
3 12 wyNN V"'v
aVoN4/L1 Es�A , &A,
3aao.2
A. Signature
-�y , / J'Gl�f'�f--�• ❑Agent
t, A ressee
B. Received by (Printed Name) C. Da /delivery
D. Is delivery address different from Rem 1? El Yes
If YES, enter delivery address below: ONO
Service Type
Certified Mail ❑ Express Mail °
❑ Registered ❑ Retum Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7009 1410 0001 8701 5286
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102 95-02_M-754n

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to Joe &4 rY,l e ►�' s
(Name of Property Owner)
property located at 1,14A Norwood 546W
(Address, Lot, Block, Road, etc.)
on in 6�e.4/y Lfle %��.4c� �i'uNsw>GK N.C.
(Waterbody) (City/Town and/or County)
Agent's Name#: SeSSC 51mm0N5 Mailing Address: PCB OX 7
Agent's phone #: G D —.2 7 q- 3 (o 3 5 1 A 1.10 4e , AI C Z y y S9
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must Fill in description below or attach a site drawing)
I- epl,Fce ex(s�jA c 75' /wovD OQt-1<4"D w;4L
N e� v r u y I
SCe A44km&, s
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.
(Property Owner Information) (Riparian Property Owner Information)
Signature
Joe &uLQPr
Print or Type Name
130541 AlAwkl,vs ell'-elr
Mailing Address
1�4CE/1JS TDcuN_ AAA .2 / 7 ye2
Signature
:J& 0 —<5�f,4.-100
Print or Type Name
Mailing Address
,Q Vw nat-j. s .(,A. 'QW2-

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to Joe & ✓Cd e r 's
/ L / (Name of Property Owner)
property located at Ci y /yarwooC�
(Address, Lot, Block, Road, etc.)
on Z,C C-t�A-fEl2wr�y —_,in Cee,4,4j T&le- g(-qc11Y11a4,.SW1i1<1N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #: SeSSC S lM rnONS Mailing Address: PCB 13 ox 7
Agent's phone #: A 10 —v� 7 a - 3 Co 3 5 �SA A 1 /o 4e ,]VC z yy .5-q
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
I- ep[Ace ex(*s4a� 75' w000 3uoK+"-D wt4L
Ne►.J V t'Ny I h�,lktit -
S c e Q44Ack nn e� �S
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 noted by Certified Mail.
(Property Owner Information) (Riparian Property Owner Information)
Signature
Joe &KQer
Print or Type Name
1305q 0,4wkl,v5 Fire/e
Mailing Address 14
Signature
624" u D 0JACD
Print or Type Name
1' 1 3 � l\I0QwOoL T-Sw
Mailing Address
tO,-k�;4u—R�Iw4-,n4ell-, Z214&'27

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Ray Anchor,
System
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1942 Norwood St.
Pier 110'

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date l - S-- i 2.
Name
of Property Owner Applying for Permit:
Mailing Address:
1 305 q 1 4wkt'lf C../re-1
I certify that I have authorized (agent) �5.5r-o WtW to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) 4jgW(,4C0 (AdpKA6w h Ad /VoU l
at (my property located at) I R L% Nai 5-1 6ne 4 -Tr1 Z-A-- 4-
This certification is valid thru (date) ( Q — 30—
Property Owner Signature ( ) Date

pplicant:
ate:
Permit #: Sq I �t4 1)
2
ascribe 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.
(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)
4
Dredge ❑ Fill ❑ Both ❑ Other ❑
43
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other
-Zcj
t IZS
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 ❑
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