59289D - Carter

CAMA / ❑ DREDGE & FILL
ENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
1
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
� Rules attached.
t Name ❑()Lt(�1 ` ❑i�t (�{ { Q (�[�r Project Location: County �>(v Y1SW �C
;Y1YG
State NC ZIP
)141C Afo Fax # ( )
zed Agent
CW C! EW ❑ PTA
- OEA HHF IH
PWS: I FC:
yes / no' PNA yes / no
1 Project/ Activity
ES C PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Street "Address/ State Road/ Lot #(s)
l L,1 5L, // JO a hi i CG N Jet
Subdivision N
Cityl.OLA tS� Ack ZIP T01
A I
Phone # (1 1v ) River BasinY�/1
Adj. Wtr. Body L nat
Closest Maj. Wtr. Body
(Scale:
ack) length � _
nX �Ir(s) y[�(J,
ength
ember
ad/ Riprap length
ig distance offshore
iax distance offshore
:hannel
ibic yards
imp
use/ Boatlift X
3ul ozing
khime
IAx IV,
ne Length
notsure yes no
gs: not sure yes ... )
mum: n/a yes no
yes no
Attached: yes no
ling permit may be required by: ' VW� �c �(i�b115L b[ L ❑ See note on back regarding River Basin

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 's
ame of Property Owner)
property located at
U
(Lot, Block, Road, etc.)
O
on — in T
��aa) lc Geaa, , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Applicant Information) (Riparian Pro r ner InCation

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson Dee Freeman
Governor Director Secretary
AGENT AUTHORIZATION FORM
Date: 1Z 1Z
Name of Property Owner Applying for Permit: Name of Authorized Agent for this project:
✓ 1) OCILVIQ
Owner's Mailing Address:
Ti —ott V.1U O M374-
Phone Number (910 } G5_,'{0
Agent's Mailing Address:
6ukkk Ise
Phone Number -AW
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
(my property located) at UO 5-L 50 t� (�� Srtt� 0' k - 9---,
This certification is valid thru (date)
Property Owner Signature
Date

CAROLINA BLUEWATER CONSTRU010N
Custom Beach, Mainland, and Golf Course Homes
Complete Design / Engineering / Building
6934-9 Beach Dr. 5W, Ocean 151e Beach, North Carolina 28469 [phone]
Canal 8
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CAMA PMM bu*&
eRn" per 1 a404
27'-6"
5' Walkway
S 20°00'00" E 80.00'
30' CAMA Buffer Per Town of ocean
u' opd,,
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emebp per iJ0.04 Drawip
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CAROLINA BLUEWATER CONSTRUCT ON
Custom Beach, Mainland, and Golf Course Homes
Complete Design / Engineering / Building
6934-9 Beach Dr. 5W, Ocean Isle Beach, North Carolina 28469 [phone]
Canal 8

PAY
TO THE
ORDER
Carolina Bluewater Construction, Inc.
Aftah, 6934-9 Beach Dr SW
Ocean Isle Beach, NC 28469
910-575-7100
(,Pk W -
pwei
DATE

t
plicant: � n � 4 � Gj j �' Permit
te:
Vl � 1 N.� .�f' CGS I�-�-e
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet FINAL Feet
(Applied for.
(Anticipated final
(Applied for. (Anticipated final
iitat Name
DISTURB TYPE
Disturbance total
disturbance.
Disturbance disturbance.
Choose One
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
!
3U H
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
■ 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 to the back of the mailpiece,
or on if space permits.
i. nnioie nq"sea+o:
Rdol�► Nearo�
l�easkr, PA I`16o1
A.
B.7
. 0",v Idby Name) C. DVof
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. 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 7 010 3090 0001 1221 6061
I (Transfer from service lab-,
PS Form 3811, February 2004 Domestic Return Receipt 102595-0244-1540
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑