60791D - Gray

1"CANNa, / _- DREDGE & FILL / NO. 60
9�ENEf 41- PERMIT / Previous permit #
New VModification ]Complete Reissue ❑Partial Reissue V Date previous permit issued
iorized 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.
Lnt Name +� LY l /a /j Project Location: County Ali
s , l Street Address/ State Road/ Lot #(s)
/A/A/Mfln statelX zip y/11
# () L%�/ z0•�/� Fax # ( ) Subdivision
ized Agent Ti/T/ ��� � / City _ t/1// ���t�i�/� /� zIP_ 4 '
d ❑ CW YEW QP- 4 ❑ ES ❑ PTS Phone # ( ) '' River Basin ��
OEA HHF ❑ IH ❑ UBA -- N/A Adj. Wtr. Body _ �w�Y (na'
PWS: ❑FC: �
yes / no PNA yes /A Crit.Hab. yes / �o,� Closest Maj. Wtr. Body
A Project/ Activity
s It/hh S�/i) • f Cd�n is�«,i'7`Y s'IfQ�/ (Scale: i
lock) length_
m(s)
pier(s)
length
umber_
:ad/ Riprap length
vg distance offshore
iax distance offshore
channel
ubic yards
imp
wse/ atli 13
Bulldozing /
J
ne Length
not sure yes
gs: not sure yes
>rium: n/a yes
yes
Attached: yes
Jing permit may be required by: N IT ere, . G I7S2'( (I t'�9f /7 �� • 0 See note on back regarding River Basin

f y F
November30, 2012
Gray Gables Yacht CFdb
Board of Directors
Re: 7209 Gray Gables lane
Boatiift Installation
Dear Board of Directors:
1 respectfully request approval for installation of a boatlift within the slip assigned to my properly
located at 7209 Gray Gables lane, Wilmington, North Carolina. Installation will meet all requirements
and specifications as set forth in the Gray Gables Yacht Club, Inc. dock rules.
Thank you for your consideration.
Sincerely,
12,
Doug Defieto
7209 Gray Gables lane
Wilmington, NC 28403
rjuA-'U� 0 K'
RECEIVED
DCM WILMINGTON, N
DEC 10 2012

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
/2 IZ2—
Name of Property Owner Applying for Permit:
Mailing Address:
> y ii'r'a (/
W -" �VYN:"ejAxi, � "N C. 72-jj�4'05
I certify that I have authorized (agent) _ / / ��,�itl' to act on my
behalf, for the purpose of applying for andobtainingall CAMA Permits necessary to
install or construct (activity) DLL/ Z/T 9
at (my property located at) ro 6 ze S /7 D4
RECEIVED
DCM WILMINGTON,
DEC 10 2012
This certification is valid thru (date) 1,213,/ /-20
Property Owner Signature
Date

k4P--� -1dr-y
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to - 11?1tf,+ Fle 11�il0
s
(N me of Property Owner)
property located at
r` l(-e
(Lot, Block, Road, etc.)
on l �� ,, ,/ e
(Wa�terbody) , in (2 , 41 IJ P-Z ._ , N.C.
(Town and/or County) f
Applicant's phone #: 6-L S�-' 79 Mailing Address: I' Cru cXc�/�s ,t� :
� l,' . �s
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
---------------------------- --------------- t------------------------- =------------
DESCRIPTION AND/OR DRAWING OF PROW)SED DEVELOPMENT:
(To be filled in by property owner propose::g development)
( �ee (A�Aack, Me -4)
---------------------------------------------------------
(Information for Property Owner Applying
for Permit)
97,01 G.-et., G4k1 s
Mailing Address -a
RECEIVED
DCM WILMINGTON, I
DEC 102012
(Riparian Property Owner-kiformation)
Signature
,-. 1 1

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
� G (��
Address of Property: 4Z 1 �'�L "`t���� t ��1 rn,4 'ta,.sCNk,.\) VAN
(Lot or Street #, treet or Road, City & County)
Agent's Name #: _//�/,G' (,cn��/// Mailing Address:
Agent's phone #: fea , Al' -2f'�7
I hereby certify that I own property adjacent to the above refergnmd pfoperty. The individual
applying for this permit has described to me as shown on the attac$. - Swing the development
they are proposing. A description or drawing, with dimensions, must "L, 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.nccoastaltnanagement.neticontact dc, or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you 14 we bin notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me..(tfyouu
wish to waive the setback, you must initial the appropriate blank below.) a--i11::�kLEIVEC
DCM WILMINGTON
/ I do wish to waive the 15' setback requirement. DEC j © 2012
V I do not wish to waive the 15' setback requirement.
(Property Owner Information)
st
Signature
Print or qpe Name
n.
C,(7, U G
Mailing Address
t
(Ad' cent Propert Owner Information)
Signatr
Print or Type Pame
�35- 5. hum Akf
Mailing Address
A

.❑
9L&. - 1101,7 �1C1f
$"c.22S

C Division of Coastal M0� Habitat Impact Computer Sheet
plicant: (1� ate: ra y 6 t�% 5 /a lie to Permit #:
v G
12�Ib�12
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
bitat Name
V V
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 armouu/nt
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
Both Other A
Dredge ElFill [I Bo
( o
�l0
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 ❑

MCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
I McCrory Braxton C. Davis John E. Skvarla, III
ovemor Director Secretary
AGENT AUTHORIZATION FORM
Date:
neof Property Owner Applying for Permit: Name of Authorized Agent for this project:
^
�J/� l lvlu !V 10, L
ner's Mailing Address:
3 i '� (-I(ZW-1 %PlsrSLOS �
W t l_ un k I(._Tb w N L
Agent's Mailing Address:
LL �I`� ��✓t C G`,SL�i Ile /)Jt .
me Number (t{G4si (,, 7 l 02 5 5 Phone Number (q,1 ) %13 1 - F5,1 <1
�rtify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
and obtaining all CAMA Permits necessary to install or construct the following (activity):
r my property located at
Property Owner Signature
7-1s­i3
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIERIMOORMPH-MGSBOATUFTBOATHOM)
I hereby certify that I own property adjacent to r G S. 7 c/ 's
, (Name of Property Owner)
perry located at � �
(Lot, Block, Road, etc.)
Z C L061) Pin ll-�)e i y.h — « Ll , , N.C.
(Waterbody) (Town and/or County)
has described to me, as shown below, the development he is proposing at that location, and, I have
>bjections to his proposal. I understand that a pier/mooring pilings / boallift / boathouse must be set
k a minimum distance of fifteen feet (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 not wish to waive
_V I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be flUed in by individual proposing development)
Drmation for Property Owner/Applicant
Applying for permit)
�Adilr=
(State/Zip
(Riparian Property Owner Information)
� C!
igna
t q1 Type Name

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to;-
perty located at
� C C. DC'D
(Waterbody)
ame of Property Owner)
I
(Lot, Block, Road, etc.)
in N.C.
(Town and/or ounty)
has described to me, as shown below, the development he is proposing at that location, and, I have
)bjections to his proposal. I understand that a pier/mooring pilings / boadift / boathouse must be set
k a minimum distance of fifteen feet (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 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)
Formation for Property Owner/Applicant
Applying for permit)
ling Address �y
dstate/Zip
-e 0
rr#C,v
(Riparian Property Owner Information)
signs
ie., Doo)elv
Print or Type Name

ro .Ste earth feet zoo
meters, � 60
;�o( ,� C-i'�i f i sal ; �� to aqi �vS
3 (' 0
le 5 .