60621D - Foy

LAMA / } . DREDGE & FILL / No. 60
GENERAL PERMIT Previous permit #
Mew DModification Complete Reissue -Partial Reissue Date previous permit issued
orized by the State of North Carolina, Department of Environment and Natural Resources 7 l
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 1 i l 1 L C) U
ules attached.
nt Name Project Location: County ] t1f A 1 ( kL
' ,tC ( Sl_ State ZIP
# ►�.) " - („O 1 Fax # ( )
Ized Agent Ot'f) r CdTO iNJPjkL OajSr
d CH CW ❑ EWA ❑ ES PT i
OEA HHF ❑ IH UBA ❑ N/A
❑ PWS: ❑ FC:
Street Address/ State Road/ Lot #(s)
I G j J W° (p,'- : r,
Subdivision
City- t 5C n f�J -- ZIP
Phone # () - `S River Basin
Adj. Wtr. Body Ii tOy C OV /IZ, at
yes /inp PNA r / no Crit.Hab. yes / no Closest Maj. Wtr. Body A, w I/1)
A Project/ Activityi-i -jrc f LL I—LY
L
(Scale: '
ock) length
m(s)_
ength
umber_
ad/ Riprap length
✓g distance offshore
iax distance offshore
:hannel
ibic yards__
imp
,use/ atlift I x (v
Bulldozing
ne Length
not sure yes
(_^%
gs: not sure yes
V
rium: n/a yes
o
yes
Attached: yes
o
ling permit maybe required by: I sL-"f N 0 ❑ See note on back regarding River Basin
i C --- :-I 11-r r /� , n 1 n . -rn fin 1 (C n.,_ _, Ll F i �,1 ! ^ i' .,J � � : b } 7 �' 4;

Divysion of Coastal Mgt. Habitat Impact Computer Sheet
licant:Permit
7/Z7/iZ
cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
id in your Habitat code sheet.
itat 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 fina
disturbance.
Excludes any
restoration and/c
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other P
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 0 Fill ❑ Both ❑ Other ❑

u
American Asn Company
)outnoort. North Carolina 2846 1
Finad AF(0360110aol com
\/1 S C'ic,na)
M".,o+C E P-10
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ntutNrc
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F Easley, Gevem James H. Gregson, Director William G Ross
Authorized Agent Consent Agreement
is hereby authorized to act cn rr;-,
fP nted Name o Agent)
in order to obtain any CAMA ermit(s) required for the property listed below. The authorization is m;
specific activities described in the attached sketch.
LOCATION OF PROJECT:
I a 15 • v 1, b -rl^ 'S+ - -
C� aC 45
PROPERTY OWNER MAILING ADDRESS:
Xa i s W 0V\ <gZA Is IMA
-
AUTHORIZED AGENT MAILING ADDRESS:
3icnature of Property Owner:
4
PHONE NO (d - 2:n -f,, (,5 1-
PHONE NO. Q 1p -qq3--7Qt4S
ncnature of Ai ithnri-7oH �kll—

s 7G"s i
A.DJACENT Rlp AtAN pBOPEg V OWNER NO ICATJ-QNAVAIVr R f GR-N,
Tame of Individual Applying For Permit: �Lc'y © _
address of Property �� 5•v1J--
,L.ot or Street i�, Street or Road)
'.City and County)
hereby certify that I own property adjacent to the above•referercea propct-y. The individual
applying for this permit has described to me as shown oa the aaachea drawing the developmcntthev
are ptorosine. A description or drawing, with dimensions, should be provided with this 1t4e'r
have no objections co this propesa!
It' you have objections to what is being proposed, please ware the pig isiun of Cobstat
N, Jaaaeement, 127 Cardinal Drivo Extension, Wilmine on, INC 28405 or c:!il 41`� 79b 7215
within 10 days of recaip.tofthis notice. No response is considered the some as no objectionif
you huge been notified by Certified Mail,
WAIVER SECTION
I uaderstand that a pier, dock., mooring pilings, brenkwoter, bon( mouse or boat I if t must btset
bck a minimum distance or 15' from my area of riparian access • unless waived b� me. elf you
wish to N► the setback, you must initial the appropriate blank below
do wish to waive the 1 4' setback reouire--l.
j ?Jame
do not 1sh to wnivc the 1 setback
, A , ��nC - ,
LJ
• ��
ice'. •

07-23-2012 16:55 AtERICAPFISFICO 910457653I
I
a
Nam- of :rdivicua Applying For Permit: k t
Addmss of P"per-. �,r/, ttt
CLC: or Street A, jtreer or Road', —
Doi _ ems.
-iry end Courtyi
hereby cer'iiy that 1 ewr. property adiecent to the abpve•refere^cez r-opt.-., Tee tndiViduai
epplyirg fot t,:is Permit i,as desct^bee to me u shown on the rttacr::, dra mr, :ne deveiogrncor ri•,ry
are Ptopos'ng. A211-Q:
'n or drawing, with dirnetuiors. with th+s letter
have no objections toL'1'.S protr^sr',
lt' }ou have objections to whet is kiting proposod, please wrntr me U,.,;,._n of Co6sta�-
Xguagement, 1Z? Cardinal Drivo Extension, Wilmington, NC non$ or '� 1 :-.796 716
witb�n 16 days of receipt of this notice, No response :s considered the lame a; ^o objection if
Ycu ne.•e beer notitled by Certined Mail.
WAIVER 5LC"-?"'O
i ueaersmns teat a pier, dock, mooring pilings, broniovater, hoot use t,r as t; i; t n►�ttbc set
- bci: a minimum distance or il, from my area of riparian jcctss . bm me tlfyou
;ski ro %caive rile s:tback, you must initial tno ap proprtarc bla, k beia,.
Oo wi4.'1 trtt waive this 15 WbOCK
:a og w:sh tc %vallvs -he -5' lc:b_tn .:o_...
7 Z7 ( N--
. c�5Ln)c
'.••'rift \'err.± ��T1'� '�
CAW, 20, ` o0,9 NCIDENR