60698D - Furman

<CAMA / DREDGE & FILL
/ N O . 60
"ENERAL PERMIT
`/ Previous permit#
New ❑Modification ❑Complete Reissue i Partial Reissue
Date previous permit issued
irized by the State of North Carolina, Department of Environment and Natural Resources
-oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
It it
411anCyl-
v ules attached.
Project Location: County T�1` (V-0.S1niti--
mjbc,—��"
Street Address/ State Road/_ILot #(s)
wwr�77GC(
V, G 1 State � mac.. ZIP G$ 2.11
Fax # ()
Subdivision
ted Agent (A
CityEb C&IN 1Sb Vae[LC . ZIP 28141,4
C CW Xi Y�'PTA ❑ ES ❑ PTS
Phone # (� O ) �3 � rJ0/10Z River Basin �V
❑ OEA /❑ HHF ` IH = UBA N/A
Adj. Wtr. Body Can aX (nat �
❑ PWS: ❑ FC:
yes no PNA yes no Crit.Hab. yes /
Closest Maj. Wtr. Body �
f Project/ Activity
(Scale: 1
ock) length it
n(s)
�VAer(s)
mgth
amber F
�d/ Riprap length
g distance offshore -
ax distance offshore
I
hannel
bic yards
np
ise/ Boatlift
Ildozing
ie Length
not sure yes no
IS: not sure yes no -
•ium: n/a no
yeS ) n,4-
Attached: yes (no.-, i- --
ng permit may be required by:
Af
lei
❑ See note on back regarding River Basin r
T',t\ A All .411 A

I I RichmorJ S+rett 6.1-13
NL

Doug Furman 704-367-1905
North Carolina Department of Environrrierit and Natural tRa-:�3ources
Division of Coastal Management
Beverly Eaves Perdue Braxton C. Davis j Dee Freeman
Governor
fOiredor Secretary
AGENT AUTHOAIZA— M.N. FORM
Date: !o 1 L
Nam
e of Property Owtw Applying for Permit Na a of
' bf; this r�ijeEt:
Owner's Mailing Address-'
GKft2w �� � n!G o•?��11
Phone Number i LYi `iS7 .-. -3Z_91
I certify That I have authorized the agent fisted above to act or' my behalf; for the POMWO bf applYing
for and obtaining all LAMA Permits necessary to install or cons�xuct the faHo*r�g ( activity):
For my property located at _ /!� 2icsV^na.V ,r;:, OGc-JgV st.� /��"r9C41, _ s✓G
This curt lcation is valid thni (date)
Propedy Owner 'gnauwa Date
P.2

Ive's
oof

Doug Furman 704-367-1905
HANG DELIVER
ADJACENT RIPARIAN PROPERTY OWNER 3TAi'E;11ENT
t'iF•i lby certify that 1 own q �u* !ae.jacatit to •f' �'U- �!l'_ /rtRn�'s
(NAM toipripe-fty Ovi-J! W,
lor!'Block, Owl)
n� is•4ir%L� fll �_ van% ...[..5 t_AE- (. --=J' `F,r'
yi.3._-. _. ....�—.w _—z—. _•--. _._..__._ Z
'�pii:�lnt�sph��e�; 7o`I-q� 73Z`f/3�aitisxgA��:=��rs.,�Z(vo_J��n.•���-�?,li.�1 .�i.�-c�
fle hat din. -Si 16ed to i-ae, a3 ihoA.?i 1`fiiaw; the d-mil 1pR?isii+, ha is pfopoishia a !`hat Icie4ti6li; d;td,
l;az ilo � ecdors to Eels 4"rodo}Elt. I iledsnt' ad t6t a vilhapp i b6z.tlft ! bawhowe
4.
rhui s`.i 53t l�:iCi4 3 s1t?}rtE2T![!i i'3i�1^��ii+a Fix ?iiCTi iY9t� �';?t a?y% 15�E3 3 C=s'1$ t ZSB tit�l�
; kwe 11" (Ifyott Wish to r,<give thi Subaak; rut UDI!St! 1111da3 Che app,-'Optbiw bl iiiit_
belm.) /
t AA wish ski .S'4.vt
- -- - ! Elti wish t Waive i`fa« J,e6a .k, regt iittrieni.
. «_sa_.���yL..is3e:r.fiJ<___rri=<siirJJ:a:�a=�:r:�Y::YUY�rLfJ r_J3L_�•==-3YJ¢+tl::f �J<ieJ_. _—. Jf �YJ _3. f.,..f__
D>" Style WIN AKD10A DILIMNIl; OV i 10A) "D ti-LML 01 M,
ir,j W filled 1h tv in?fs:�ldr;ir, tnrFa t� lr+. a ;t>ltin-r���rij
=.r_3...<i===<
(IAtar;haiioil al` Property ©lin&r Applybig (i ip rids 2'topC* f�tUi;i�! �j�f§t<tiiatirfti�
rb.r Hermit)
WC-

WD DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 00061+ go !/ 1. Fu rim ow
(NMne of Proper Owner)
property located at , ' ` 1 r' 5t1eG t
/1
(Lot, Blocks, Road, etc.))+ y�
on C 14W o�-L , in L% "Lci4N J. Sle apals c-L , N.C.
(Waterbody) (Town and/or County)
g573.�9/ 2l0o Suw�erJo�..�J l%�e.
Applicant's phone #: 90* Mailing Address:
L:Aa=eiot'te , #Ie, Apt I1
Fie 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 (I Y) from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
X I do not wish to waive
I do wish to waive that setback requirement.
---------------------------------------------------------------------------------------------------------- - -
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
--------------------------------------------------------
(Information for Property Owner Applying
for Permit)
17 /1�Q;G^�'YION�
Mailing Address
fideJ400 rs fe
-------------------------------------------------------
(Riparian Property Owner Information)
Signature
ec w qrd up. 3-owes Te p

oplicant:lln5'
ate:
to/L�
Permit
ascribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ind in your Habitat code sheet.
bitat Name
TOTAL Sq. Ft.
(Applied for.
DISTURB TYPE Disturbance total
Choose One includes any
anticipated
restoration or
temp impacts)
(Anticipated fina
disturbance.ance
FINAL Sq. Ft.Xtempimpacts)
Excludes anyludes
restorationipated
and/or tempon
impact amount)acts)
Feet FINAL Feet
for. (Anticipated final
disturbance.
Excludes any
restoration and/or
or temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
I ��
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 ❑
X 4 = zq