60738D - Martin

CAMA / DREDGE & FILL / NO. 60
3ENERAL PERMIT ✓ Previous permit#
- New Modification Complete Reissue Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources ZP.. 1-2—bu
-oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
' t -- Rules attached.
t Name V A ►'� Av Project Location: County �I�L phi 1(.K,
tCI a v )i 6 Street Address/ State Road/ Lot #(s)
it State NZ (J44 vti. BUY•-� Y�e�
( ' Fax # () Subdivision _ y
ed Agent f V1 , City ' OA1 {{ 15 U Y u ZIP ZN(.e
CW EW PTA ::1 ES PTS ` �P•htone lb )�U ' W River Basin 61 oAi
OEA HHF - IH UBA L-, N/A Adj. Wtr. Bod quriA ee Vnat
P W 5: FC:
yes / no PNA ye / no1 Crit.Hab. yes / no j Closest Maj. Wtr. Body W
:)f Project/ Activity
lock) lent I
•ock 1r X
pier(s)
length
umber
!ad/ Riprap length
vg distance offshore
iax distance offshore
channel
ubic yards_
imp
)use/ Boatlift
Bulldozing
Uh, �WKD C' Lt i -
ne Length ..JV
1 1-7 MUSH
not sure yes no
not sure yes no
>riumcrt/a 1 es no�� _
h•�"�� yes no t�
4—
Attached: yes no '
ling permit may be required by: /� GW ii �j `t (,�•LAN /� IS(A C6(
(Scale:
❑ See note on back regarding River Basin

CAMA / DREDGE A FILL N0. 6073$ D
ENERAL PERMIT Pecvlouspermit#
4avt
ew ` 'Modification f !Complete Reissue .'Partial Reissue Datc provious parmlt Issued
ed bythe State of North Carolina, Oopxtmont of Environmont and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to I $A NCAC_
Applicant Name �.lian�l Ar4,w RWesbuichod --~
C� Project Location County
Address 295 Q,V i4m Ci (C,4 Streets W Address/ State Road/ Lot #(s)
1`1V _
CIty�I(jW{ State zlp'2 65 I U4 W. �111�+k—
Phone # ��� I - Max i� ( ) SubdivisionAa Y_ pp���t,• 7 ' • �p� —
Authorized ant L Cl -A I�KQ.�i�. _ZIP �6—i109 _
Affected I CW Ott )(PTA 166 PTS o�}(r l� )%D • AZ River Basin
AEC(s): I IORA iIHHP I IIH f IUDA !N/A
(, PW: ` ( IPC Ad). wtr. seas/. bid/Ao�v..►1r1 [�k. _ _(gat n
ORW: yo, no PNA yes I no Crlt.Hab, yes / no Closest Mal. Mr. Body
Typo of 1`-JO / I
R`tl':`y,. X d961n v
Pit, (dock)lon (�
flitter plorp) '
Grdn
t
number } h .i I I_.4
Bulkhead! Wprnp length
ovg distance ofrshoro ( I I
mu distance offshore
Bnen,channel } +
r 1 I Sf
cubic yards _
float ramp
Bonthowd Boadifc
Beach Bufldodng
Other } t I
Shortdlr,o Lensd,
SAY not sure ye: tw I,
sandbags not sutn yet no
Moretorlum r,/p 110
Photos yes
�V� I Ail
Wplver Attached. Y.
A bullcIng permit may bo r�oqu�tQdlby.
Notes/ Special Conditions :f'H , {2�0 n 1A d a P I n
onto Itrx Prr� N ���
py( oePletncraadcompllancostatarnontonbickcfpw:nit*• t
-2-
Apptkpdu�Foap) Ctwck# t
Lt�
lo`>j,;
(Seale: I A j
f
I
i I
,tt
1
'Jlil
p
f
40�
Ili
-1 it
• f ; Soo note
on back regarding
Nver Basin rules.
10� il�O2
LJet
mu,lnf,yr �dktl
2 1 i�i3
FxPhe enDeta
PO I�lob
Hover f'ie Nnnw

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
ly Eaves Perdue Braxton C. Davis
rnor Director
AGENT AUTHORIZATION FORM
Date:
of Property Owner Applying for Permit
fly.*j�-- T" Ar4"
's Mailing Address:
R4L 14- A
Number Arw 361 1 ' b 50,9 ZIf
Dee Freen
Secret
Name of Authorized Agent for this project:
Agent's Mailing Address:
11.8 f �ri.S 6 �6 9.o?
He Tdz--A �-zat .Az t _
Phone Number (91CA G,3
that I have authorized the agent listed above to act on my behalf, for the purpose of applying
obtaining all CAMA Permits necessary to install or construct the following (activity):
G..4?-c.iCG )XV'0Z f-I,
f property located at Ifq Q
ftification is valid thru (date) D L • . L .� .2
A) 4 12,o
Property Owner Signature D to
f-, �;z?ir—
�«�f

SAND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to & '&h,_M!•�A I
(Name of Property Owner)
property located at yy. Yd ea-rJ::L '5 '�'
(Lot, Block, Road, etc.)
on 4M Ac4-c+s a !V , in O(<aE,r�- ma's 2-t 25:g��_N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: %D 51 .�h�l �OS� `a/ Mailing Address: .7$5- -y�Ci fLL=
T3l6t.r� ,�rQ lzzs'�>C _ Az -j' 9'4as-
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 (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.)
V'� I do not wish to waive
CERTIFIED MAILT.
RECEIPT
,a -
(Domestic Mail Only; No Insurance
Coverage
Provided)
I do wish to waive that setback requiremt o
For delivery information visit
our website at
%vww.usps.comu
. I-
ry
DESCRIPTION AND/OR DRAWING C r u
$0.45
0474
ru
(To be filled in by individual
Postage
$
Certified Fee
$? • 95
11
�
O
Return Receipt Fee
-
P Here
t2.35
O
(Endorsement Required)
Restricted Delivery Feela•I�II
�
(Endorsement Required)
Er
M
Total Postage & Fees
$
$5.75
10/0212012
m
I3
Sent To
O
--------------------------------------------------------------------
Street, Apt. No.;
r%-
or PO Box No.
------------------------------------------------------------------
-------------------------------------------•-------...........------
City, State, ZIP+4
PS Form :00 August 2006
See Reverse for Instruction-.-
(Information for Property Owner Applying
for Permit)
Mailing Address
(Riparian Property Owner Information)
1 < <
Signa
13Aa %,:'I n 4 Q ni-77 Al 7RGe5 1 i, ,.� �,� "� � : �- -�� n 5

t-A; A
z 13 N (.,I Sq L
A 0; ko
6'6 1

/z pt plywood w/ 30 yr. shingle
6x6 Post
2x101
2x4
@3
12'x12'
r -i
existing band board & joist
4" straps w/ 5/4 deck boards
w/ 5/8 bolts
3'-0"
leader
M
� rails
6" h

JS MAIL '
CERTIFIED MAIL, - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
ame of Property Owner: y 11; z,,,�.t 7'►�l �g r-�-�� _ _
ddress of Property:
(L,ot or Street #, Street or Road, City & County)
pplicant's phone 4: 763 1 Mailing Address:
hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit
as described to me as shown on the attached drawing the development they are proposing. A description of drawin
ith dimensions, must be provided with this letter.
a w,,(�, I have no objections to this proposal. I have objections to this proposal.
f you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM)
i writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.
Vilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
onsidered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distance of
5' from ray area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the
ppropriate blank below.)
T m 12. I do wish to waive the 15' set back requirement.
I do not wish to waive the 15' set back requirement.
Property Owner Information) (Riparian Property Owner Information)
L
signature Sign tune
�t+sf�t(��n2+G ��Of�G1:11'c�-mrtr��
Tint or Type Name
�8.5' Ce,r ZTts /L ZG
flailing Address
Print or Type Name
Mailing Address

z pt plywood w/ 30 yr. shingle
6x6 Post
4" straps
w/ 5/8 bolts
12'x12'
existing band board & joist
w/ 5/4 deck boards
3'-0"
2x10 header
m
2x4 rails
@36"h

A
13 N4, pSqL
IL A
561
Pf C 6
il'i"
p"Llo"lu i-iA
,c ( !
Lay". llo�
�, PI At<, -SIq � <

i
6,
wzn
.�• 4"

\pplicant:
)ate:
l
Permit #: C, 0 4-J D D
lescribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
)und in your Habitat code sheet.
DISTURB TYPE
abitat Name 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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
a
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 ❑