60773D - Jones

,LAMA /"DREDGE & FILL V1
iENERAL PERMIT
New ❑Modification El Complete Reissue El Partial Reissue
zed by the State of North Carolina, Department of Environment and Natural Resources
oastal Resources Commission in an area of environmental concern pursu
Name P%WD 0N1ES
Pag:
N E LEii, -- - State Ne- ZIP.27`Y
(0)) 3 q-757 Fax # ( )
:d Agent T" " ` //\j
❑ CW )ISW NOPTA S ❑ PTS
OEA ❑ HHF IH UBA ❑ N/A
PWS: ❑ FC:
,es /_ no PNA yes Crit.Hab. yes /er►o
G
k) length
gth
rber
Niprap length77,0�
distance offshore
distance offshore
tnnel
c yards
P
e/ Boatlift
Ildozing
Length 70
not sure yes �hq.�
not sure yes
im: n/a yes
yes
ttached: yes no
g permit may be required by:
No. 60
Previous permit # $3
Date previous permit issued P
ant to 15A NCAC % H . i 10 CG
[-IRulesattached.
Project Location: County �stw
Street Address/ State Road/ Lot #(s)
Subdivision
City ✓ F C ZIP rr�++i,�- f
Phone # r River `Basin
Adj. Wtr. Body '�L� ` -- L l��Ol i s (nat
Closest Maj. Wtr. Body ` V►V► P SyJN-b
Maf Ala,
n
(Scale: '
El See note on back regarding River Basin r

eve 74A6*%.Ij
Z'

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property: 9 D 5 L1 5 tVe nAl� ��• 1. Au T C
(Lot or Street #, Street or Road, City & County)
Applicant phone#: Q l 0 3QCI -R� 4 —1 ci Mailing Address: P it vto a( C c �S Cj
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 xvthG attached -drawing -the development -
they are proposing. A description or drawing, with dimgsions. must be provided with this letter.
G?M I have no objections to this proposal. I have objections to this proposal. .
if you have objections to what is being propose4 you must noft the Division ofCoastal Management
(DC" m writing within 10 days of receipt of this notice. Contact infomradon for DCM offices is
available at www.c Imngementnedcontact dcm.htm or by cafft 14M"RCDAST. No
response is considered the same as no obfecSon if you have been notified by Cevrified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lit must be set back a
minimum distance of 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.)
C ► y) I do wish to waive the IS setback requirement_
I do not wish to waive the 15' setback requirement.
(Property Owner Inform )
Signature
Print or Type Name
?. p- i�0 393
Mailing Address
al5v?
City/5fateop
f.. — — ..
(Riparian Property Owner Information)
Signature
Print or Type Name
INaifi►xl Address
s
city)Wateeo

CERTIFIED MAIL. • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT IRIPARIAN PROPERTY OWNEi2 NOTiFiCATIOM11MAIVER FORM-1
Name of Property Owner. `UGC
Address of Property. 5 �1 5 eUe p �T * �'� T 1. L IV C-
(Lot or Street #, Street or Road, City & County)
Applicant phone#: Q SOLJ 3g— cT Mailing Address: r"L�1ytO42c C-yYtYy�{
'52-C� a eyinvak L4,A.
Sy'-�Ucd s R v-" NsL
l 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 drawingym development
they are proposing_ A diio6 lion or drawing, with dime6sions, must be provided with this letter.
1t
I have no objections to this proposal. I have objections to this proposal.
If you have objections to ghat is being proposed, you must notify the Division of Coastal Management
(DCil,) in writing within 10 days of receipt of this notice. Contact information for DCIP offices is
available at www.nccoastaimangement net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Cerbf' ►ed �'llail.
WAiVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a
minimum distance of 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.)
g� I do wish to waive the 15' setback requirement_
i do not wish to waive the 15' setback requirement.
(Property Owner Informatio )
-' Signature
Print or Type Name
393
Mailing Address
('.itv/.StWP17in
(Riparian Property Owner Information)
Si re
Print or Type Name
' ry3d C I C.b �
Mailing Address C
C1, n to ,
riiv/Ctatal7in

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
'Ra-w d" -Tv v,,Q- S
Mailing Address:
I certify that I have authorized (agent)11 1�(r1D6 CI S;} Ci I W\I to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) �u I k iVad 4 SIC4 tSL,QJ ,
at (my property located at) - I a 5 q 5eye4k 5+. urn l ltLA
This certification is valid thru (date)
yzz/,/-�
If A
Property Owner Sig
la-Ag-101,
Date

plicant: ��/!/� / Permit #:
te: I Z
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ind in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
)itat Name DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
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 impacts)
amount)
Dredge ❑
Fill
oth ❑
Other ❑
7D
Dredge ❑
Fill ❑
Both ❑
Other ❑
% zi4 6
Fill
■ Complete items 1, 2, and 3. Also complete A. Signature
item 4 if Restricted Delivery is desired. ❑ Agent
X
■ Print your name and address on the reverse O Addressee
so that we can return the card to you. B. Received by ( Printed Name) C. Date of Delivery
■ Attach this cans to the back of the mailpiece,
or on the front if space permits. ( e-
1. Article Addressed to:
ai o c�nar cl� to
a� 3a�
D. Is delivery address d&erenf from Rem 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ camed Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
�• .,11IV1019Y111UC1 7011 3500 0001 3956 4474
(transfer from service label) -- — --_ _---- _— _�
PS Form 3811, February 2004 Domestic Return Receipt
L-J
■ Complete items 1, 2, and 3. Also complete A. Signature
C item 4 if Restricted Delivery is desired.
- ■ Print your name and address on the reverse X r
so that we can return the card to you. B. R eived (Printed Name)
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
102595-02-M-1540
1
❑ Agent
Addressee
C. Date %/ Deyvery
1. Article Addressed to: D. Is delivery address different from Rem 1? t YYes
N YFC—tor'inlivn.. �A,4--- k........ n AL.