60640D - Heard

1?CAMA / _- DREDGE & FILL
GENERAL PERMIT
IZAew ❑Modification ❑Complete Reissue-lPartial Reissue
orized by the State of North Carolina, Department of Environment and Natural Resources
No. 60
Previous permit #
Date previous permit issued
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �{.f
-Rules attached.
.nt Name WI 1W A tit.61210 Project Location: County, ;Z
sCsL, ("j Street Address/ State Road/ Lot #(s)
� A &d:is -i t hoW State Nc ZIP2_% ,L-731; (% h,► . V14Z t- i O Al ? ,
# (60 Fax # ( ) Subdivision
ized Agent City f-e? zip
d Cw y, ' A ❑ ES ❑ PTS Phone # ( ) River Basin
OEA HHF — IH ❑ USA ❑ N/A Adj. Wtr. Body l I-/
PWS: FC: /
yes / no PNA yes e- Crit.Hab. yes / ye' Closest Maj. Wtr. Body Pyin
A Project/ Activity �� i? 1%) y'l E=� !/IL �; i)"f L! J r` tt -i L 1 F ( t AMIY i /LL '��Z.
I
'ne Length " j-1^
fib% _t-
not sure yes
igs: not sure yes `
)rium: n/a yes
yes �[
Attached: 4 s no
t
ling permit may be required by: �L PTA Q
❑ See note on back regarding River Basin

�P-J,b bLwVVt�
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIERIMOORING PILL.NGSIBOA2-LIITIBOAT'IOI/SE)
I hereby certify that 1 awn property adjacent to _ALq- `s
X�
(Name of Property Owner) .
property located at 3D C4GAL— -,0411/l�6MLJ5LA;-�O N-e
(Lot, Block, Road, etc.)
on fs(rRAC kT1-JLL iJA%" AY _, in _QA k rs-4A kk 1 411 . N.C,.
(Waterbody) (Town and/or County)
Applicant's phone #:33V' 56 t ' �q � Mailing Address: N A A f &M p
Pb bx') 3 t Ak.
He has described to me, as shown below, the devetopment he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift i boathouse
must be set back a minimum distance of fifteen feet (ISM 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 ANWOR DRAWING OF PROPOSED DEVELOPMENT:
(?o be felled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
a1609 E AeALIZ42_l LOQ(151
Mailing Address
(Riparian erty Owner Wormati
/91 1---�tl Signature
14.4,0 .!� L F E

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ,y's
(Name of Property weer)
C located at 230 C: % 01fl lE—. c L4na
ko f 5 •b) (Lot, Block, Road, etc.)
/I , in lYttQ ti , N. C.
(Waterbody) (Tow ancUor County)
has described to me as shown: below, the development-4ie is proposing at that location,
and, I Pave no objections to his proposal.
NEW
AL wA'(
9'D —�
ON AND/OR DRAWING OF PROPOSED DEVELOPMENT
f15P'Ht1 L I 1S(�i� NGL� ec
�W5T7�G c�aclG
OLO f
Signature 46c>
J y
Print or Type Name

RoN L*(.,s
1"Ge ttw", ll�-K�
/YJ- �V,5
p�W�► ��� �Yi 5-rir�4
BOAT
tO aac,1.6 UK�r
4'5 A
4 W ia1L� yY���
4' %9 tv t ti�

J
Division of Coastal Mgt. Habitat Impact Computer Sheet
licant: N �/ nl � Permit #: k,c W
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 Tina
disturbance.
Excludes any
restoration andh
temp impact
amount)
Dredge ❑ Fill ElBoth ElOther E,/
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 ❑