38966D - Hope

1CAMA /� DREDGE & FILL
"ENERAL PERMIT Previous permit # N
{New —:Modification Complete Reissue Partial Reissue Date previous permit issued
jized by the State of North Carolina, Department of Environment and Natural Resources I l I / 7
-oastal Resources Commission in an area of epvironmental concern pursuant to I SA NCAC lo Cl/ f 2_oa
❑ Rul ttach-ed./
t Name - !'/%� t G( /C E'_ Project Location: County /� J �n mil/
v lips d h Street Address/ State RoaJ//.Lot #(s)
r State,
ZlP
(/ ) �'�57 Fax # () Subdivision
:ed Agent / /j ,'A" �77 1l'� yr i ZIP
❑ cw / �w qTA i s ❑ PTS Phone # ( ) River Basin
ElOEA ❑ HHF'�, ❑IH ❑ UBA ❑ N/A Adj. Wtr. Body G[ ? �U/ na
❑ PWS: ❑FC:
yeyf'3Z� PNA yes`no_�, Crit. Hab. yes Closest Maj. Wtr. Body
F Project/ Activity
1. ;"4ia
ck) length
,(s) /o
iier(s) 7�
ngth
mber
d) Riprap length 6�
g distance offshore
w distance offshore Z
cannel
bic yards
e Length
not sure yes C. 0
s: not sure yes
cum: n/a yes
yes
4ttached:
ng permit may be required by:
v
io 4X'
(Scale:
❑ See note on, back regarding River Basin r

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date Z-22 ' /�—
Name of Property Owner Applying for Permit:
Um
Mailing Address:
I certify that I have authorizedent a
(g ) i,,,, 5 to act on my
T
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) Iff
at (my property located at)
This certification is valid thru (date)

ala
ADJACENT RIPARI.A.^f PROPTRTY OWNER STATEiVMNT
(FORA PIERIAf 0 ORIXG PIZLVGS/BOATLIFTIBOATH'OUSE)
I hereby certify that I own property adjacent to l h h �/ 's
(fnLme of P pe Owner)
property located at
J/G�f � G9 (Lot,Bl_ 077 1- 5;P- '�rS N.C.
(Waterbody) (Town and/or Caunty)
He 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 (IS') from my area of riparian access unless waived by me.
(If you wish to waive the setback, you must initial the appropriate blank below.)
1�4o 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)
if you have objections to what is boing proposed, you must notify the Division or Coastal Nfanagement (DCM) in writing
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ezt. Wilmington, NC
DCM representatives can also be contacted at [phone],
No C9 o se is considered the snme nvfio ob'cefion ify.Qu hive been notified hX Certified Mail
(Information for Property Owner/Applicant (Riparian Property Owner Information)
Applying for permit)
c3I0 Ch0.l1e ` ?�.
Mailing Address Signature
Print or Typo Name
City/State/Zip 9/9 _ �79 9 3
Telephone Number pp Telep one Nu ber
Sitature �.. _�� _ Date ��1�� �—Q� Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIEB11VOORIXG PILL•YGSIBOATLIFTIBOATH'OUSE)
I hereby certify that I own property adjacent to h r- PC.4
s
(IN of Property � er)
property located at ` C1
n / (Lot, B r;t
oad et )on l h /G1 q in , N.C.
(Waterbody) (Town and or County)
He 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 (l S') 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.
...... —--------- ---------- --------- --------- ------------------------ --r
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled In by individual proposing development)
if you have objections to what Is being proposed, you must notify the Division or Coastal Nlanagement (DCM) iu writing
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ezt. Wilmington, NC
DCM representativej curt also bo contacted at [phone];
Nq re9ponse is considered the gnme iano obiection irvau have peen notified by Certified MaJI
(Information for Property Owner/Applicant
Applying for permit)
Mailing Address
KC7
City/State/Zip
Telephon Number
Ciennh,re — rN bate
(Riparian Property Owner Information)
Signaturo
G e 1
%Print or Type Name
aL;� a sts
Telephone Number
/� /,DUI7�
Data

pplicant: S�/L�9I /�✓l /
ate:.
t0
Permit #: 3 o 9 6(,
ascribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen
and in your Habitat code sheet.
tbitat 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 fina
disturbance.
Excludes any
restoration andh
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other ❑
A57/
S 1
Dredge Fill ❑ Both ❑ Other ❑
1 DU U
�� a
G(J
Dredge ❑ F' Both ❑ Other ❑
2�
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 ❑
?06
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