60771D - Harris

JCAMA / DREDGE & FILL NO. 60'
"ENERAL PERMIT 1I Previous permit#y,
New ]Modification (Complete Reissue Partial Reissue Date previous permit issued N
rized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of envir mental concern pursuant to 15A NCAC _7
? l �1 Rules attached.
1
it Name 6 V 7 A '� % S �`d/!w� ��'(4' � Project Location: County �` D-W,
sDa h 5yez*- Street Address/ State Road/ Lot #!(s)
I e e ty f State ZI P0-) -119 5l/44-'V f
`TJZO ^ b;i Fax # (_) // Subdivision y/
:ed Agent A C ✓tor 1 AAOky1',,1C C..OA9 . City No✓ 1N Td,OSa' l ZIP �`f(�
�_ CW )4EW A PTA _1 ES PTS Phone # t f V ) River Basin
OEA -IHHF —1H _ . UBA N/A
Adj. Wtr. Body ::5"4z4AP 50v/tG'' nat
PWS: - FC:
�� Closest Maj. Wtr. Body u�
'7 no PNA ye�/ no Crit.Hab. yes K!��
f Project/ Activity
W ltM 1� f 4 S f OJ RL,l ✓ 1
)ck) length
n(s)
1 I
Aer(s)
ember -
id/ Riprap length
• • I__
g distance offshore
ax distance offshore
--_!
hannel
ibic yards_ _
mp
use/ Boatlift _ 1 1 t
111dozing
w1� 1 H r1 ow. 4)
oe Length
not sure yes-
gs: not sure yes
,rium: n/a yes n
yes no
Attached: yes no
ling permit may be required by: No ✓ / T&,(�
(Scale:
�Jr4
❑ See note on back regardin� River Basin

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
AUJAtoCIM 1 ihCfrJv►KIAN t- KUVt:K i Y CiWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner. V G 1X Y-I- 4
T
Address of Property: QYYY01 (, 01-FAA (At' - l 1 vi S ,) 4 44arr i S C1 psn"01A Dr t f6
(tot or Street #. treet or Road, City & County)
Agent's Name #: &H ►3 c v i f.sJM r)t h n,-i Mailing Address: at-5q F» ►�y.i-r ��
Agent's phone #: 1.0 Sal 34-:1 c:�_ SWOO S F-r_►_rld Kr_ 264(
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawings with dimensions must be provided with this letter.
s 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
- . _ .... - - - ,vanes should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3W. DCM representatives can also be contacted at [phone]. No response is
been notified by Certitred Mail.
WAIVER SECTiO114-
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
wish to waive the setback, you must initial the appropriate blank below.
1 Ce L-'- I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property..Owner Information)
Si ture
V' C_ ►
Print or Type Name
Marling Address
(Adjacent Property Owner Information)
r
Signature
Print or Type Name c
Ad
Mailing Address

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
HUJHlir-1V 1 MWAKIAN r-KUI't:K If
OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: k r, h.( y+ 4
Address of Property: VOXI.4f I iUrwOrde, ( I r4 S) 4 -I40Uf i S 9 Mm DC, � isi
(tot or Street #, treet or Road, City & County)
alb✓f1h TbPS&J) Delsl o vv UUAhJ
Agent's Name #: Mailing Address: aW
Agent's phone #: q10 3XI j�4"-111 Bread S Nr- 2&
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
Vl-�l 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
;; ence should be mailed to 127 Cardinal Drive Ext.,
Imington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
been notified by Certirled Mail.
WAIVER SECTIui�
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 ..a.cu ► y tit y..:
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
X.
Signature
Print or Type Name
Mailinn Arlrlrasc
(Adja::::
=--
ignaXreion)
if—
/ A{'H�s
Print or Type Name
X o k,
Mailinn Ar/riress

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Hate i 012- 31 j z
Name of Property Owner Applying for Permit:
rICAV v is �-" PC' -k*,+ [-( YK(rIS -Lvti+-
Mailing Address:
I certify that I have authorized (agent) ytp�' j �i;,��j �'1 b V1 to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) ,�f S� t jq
at (my property located at) � ('F 1 f' f, �(ot'� 4- f( 13 o e4AA., (Gfi
This certification is valid thru (date)
Z-A I t 2--
Property Owner Signature I Date

r
S i cn�-ti� re
nc0

)plicant: �%�,�,Q p �/ Permit #:
ate:
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance_
Disturbance
disturbance.
bitat Name
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 imoacts)
amount)
1AJ Dredge ❑ Fill ❑ Both ❑ Ot I
■ 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.
■ Ateh this card to the back of the mailpiece,
or the front if space permits.
1. ArtIce Addressed to:
�q Ot�d 1RML-)1L Pj
N-(-vv 4b w 0 Cr w �-t�o
A.
❑ Agent
B. Received by (Printed Name) I C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certlfled 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) _ 7 011 3500 0001 3956 4504
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1e40
—1 ■ Complete items 1, 2, and 3. Also complete A. Slgh1 tune
I item 4 if Restricted Delivery is desired. ❑ Agent
■ Print your name and address on the reverse X ❑ Addressee
—j so that we can return the card to you. y ( Printed Name) C. Date of Delivery
■Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is delivery address different from Item 1? ❑ Yes
1. Article Addressed to: If YES, enter delivery address below: 13 No