59228D - Herring

Crit.Hab. yes //no
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u es attac e .
Project Location: County YU IDS WI (,L,
Street Address/ State Road/ Lot # s)
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Subdivision O 4A
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ms09 River Basin
Adj. Wtr. Body W(naK
Closest Maj. Wtr. Body l w
;Y (Scale: ' ,
_�CAMA / _ DREDGE & FILL
GENERAL PERMIT Previous permit#
<New Modification —Complete Reissue ❑ Partial Reissue Date previous permit issued
)rized by tF!'-- State of North Carolina, Department of Environment and Natural Resources I ��
Cceastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
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`PTA _ ES PTS
❑ OEA
❑ HHF
LI IH UBA N/A
❑ BWS:
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yes 4 no ) PNA j yes I no
)f Project/ Activity
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Ruse/ Boatlift 1 x IZ

/01/2011 14:09 9105799096 GRICE CON PAGE
MiC� NJ 1.JL4
North Carolina Department of Envi nment and Natural Resources
Division of Coastal anagement
Beverly Eaves Perdue James H. G gson Dee
Governor Direc `
A ENT AU HO I TION FORM
Date: 5-Iu- 2
Name of Properry Owner Applying for Permit:
c`�,Jai t- r, i ►x
v
Owner's Malling Address:
p c�, jazjx 15-Iy
uc. Z
Phone Number Al-Cl. 2(oa Off` 6
I certify that I have authorized the agent listed above to
for and obtaining all CAMA Permits necessary to install
(my property located) at _ Ejf� �5
This certification is valid thru (date)
ime of Authorized Agent for this project:
ent's Mailing Address:
P one NumberLqiz�)
0
on my behalf, for the purpose of applying
construct the following (activity):
/2.7

Us MAIL
CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPA UAN PROPERTY OWNER STATEMENT
Name of Property Owner:
r.
Address of Property ��� J-�`Q �� %QW YL�-_w y `"
(Lot or Street #, Street or Road, City & E�t
)
Applicant's phone #: 1`� "`1� Mailing Address:��' 5R Qc-vA D v
4CV,NC
I hereby certify that I own property adjacent to the above referenced property. ine muivtuuui a1J1r1YL11r ►V,
has described to me as shown on the attached drawing the development they are proposing. A description of drav
with dimensions must be 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 (DC
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response i
considered the.same as no objection if you have been notified b Certified M it.
WAIVER SECTION
I understand that apier, dock, mooring pilings, breakwater, b9ath9use,.or lift must beset back a.minimum distant
15' from my area of riparian access unless waived by me. (lf yqu wish to waive the setback, you must initial th(
appropriate blank below.)
I do wish to waive the 15' set back requirement.
-I do not wish to waive the 15' set back requirement.
(Property Owneinformation)
Sig ature
Print or Type Name
Mailing Address
�)wv� I �AC 2-
(Riparian Property Owner Informatiou)
Sig ture
Print or Typ ame
3C
Mailing Address

US MAIL
CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROk
PERTY OWNER STATEMENT
Name of Property Owner: � 1 � (\ 1 aq
Address of Property-1
J tC� Y )CQa o -�
(Lot or Street #, Street or Road, City &
Applicant's phone AA 1� Mailing Address: �kI U &Q6 -8,"
n -fie �e R-Qq . N
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this per
has described to me as shown on the attached drawing the development they are proposing. A description of drawi
with dimensions, must be 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 (DCP
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive I
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand_ that a pier, dock, mooring pilings, breakwater,.boathouse,. or lift must beset back a minimum distance
15' from my area of riparian access unless waived by me. (If yqu wish to waive the setback, you must initial the
appropriate blank below.)
I do wish to waive the 15' set back requirement.
--- -I do not wish to waive the 15' setback requirement.
(Property Ownet information)
"f I-& - A
Sig ature
Print or Type Name
Mailing Address
(Riparian Property Owner Information)
ALgA64-4 (o. .
Signature
Print or Type N ne
Mailing Address U

c�a N I�JbIsm
p'b(

.pplicant: [� II
" �� VQ �, � r Y t � Permit #: �
late: I
• I� m
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
fund in your Habitat code sheet.
abitat Name
TOTAL Sq. Ft.
(Applied for.
DISTURB TYPE Disturbance total
Choose One includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet FINAL Feet
(Applied for. (Anticipated final
Disturbance disturbance.
total includes Excludes any
any anticipated restoration and/or
restoration or temp impact
temp impacts) amount)
I ,\
Dredge ❑ Fill ❑ Both ❑ Other
CDredge
❑ 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 ❑
�go

■ Complete items 1, 2, and 3. Also complete A. Signs re \
item 4 if Restricted Delivery is desired. i '' ❑ Agent
■ Print your name and address on the reverse c� Addressee
so that we can rettim the card to you. B. Received by( kited Name) C. Date of livery
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is deliver/address different from item 1? es
1. Article Addressed to: If YES, enter delivery address below: No
\ X fi3. Service Type
Tc'l ,� � \�r 0 Registered
Mail ❑ Express Mail
1,� � \ ` ❑egistered c2rdRetum Receipt for Merchandise
ZO� ❑ Insured Mail ❑ C.O.D.
D 4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7009 1118p 0000 2205 9601
(Transfer from servke labeq
PS Form 3811, February 2004 Domestic Return Receipt 1P2595-02-M-1540
■ 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.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
`(Ylar cl �(�� L,116
2. Article Number
/r—nef from mmlro lAha
A. Signature
X ❑ Agent
Addressee
B. Received Printed Name) C. Date of Delivery
D. is delivery addre"'r'essbelo
❑Yes
If YES, enter del❑ No
3. Service Type
-
)lertified Mail
❑ Express Mail
❑ Registered
;MPRetum Receipt for Merchandise
❑ Insured Mail
❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
96],8
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