59204D - Mason's

2CAMA / DREDGE & FILL
GENERAL
PERMIT Previous permit#
v Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
prized b`y the State of North Carolina, Department of Environment and Natural Resources ^� j
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules a ched.
nt Name Ad1 S e" Its
State Ne ZIP
(� ?3/�S/Fax # ()
zed Agent
❑ CW @ESN �; OTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
no PNA yes /t� Crit.Hab. yes / no
Project Location: County //LW///,
Street Address/ State Road/ Lot #(s)
Subdivision /4
City (i1/�' I �,'•, �vr ZIP 2P
Phone # River Basin
Adj. Wtr. Body 1-71`Y nat
Closest Maj. Wtr. Body I2741��/" H0
►f Project/ Activity / e-,- f 741 / /'-' '4— J ism
ock) length
m(s)
ength
umber
ad/ Riprap length
vg distance offshore
iax distance offshore
-hannel
ubic yards
imp
wse/ X i
Bulldozing
1
• Attached:
yes
yes
ye
(Scale: ��•�
ling permit may be required by: N A OP - See note on back regarding River Basin

!mail - Martin Prices lift
Page 1 of
Martin Prices lift
1 message
Moose <[e-mail]>
To: Jimmy North <[e-mail]>
Jimmy North <[e-mail]>
Thu, Mar 8, 2012 at 9A7 PM
To Whom it May Concern,
The homeowner association of Masons Bluff approves the installation of a boat lift for Martin and Natilyn
Price in the 5th slip from the north.To be installed by Coastal Marine,within the rules of CAMA,and similar
to other lifts currently installed.The lift must meet all covenant restrictions. Respectfully,Jeff
Howery, President, Masons Bluff HOA
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
IN Print your name and address on the reverse
so that we can return the card to you.
IN Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
r1i
c�le- sou-C L00
a Sq11
2. Article Number
(Transfer from service label)
A. Signature
X � ' ❑Agent
❑ Addressee
B. Received by ( Pri e C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
7011 1150 0000 1464 0342
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
IN Print your name and address on the reverse
so that we can return the card to you.
IN Attach this card 4o the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to
A. X s( r'Lt &- Sc4e9�
A
p Addressee
B. Received by (Printed Name) I C._Pgte of Deljyejy
D. Is delivery address different from item 1?LO Yes
If YES, enter delivery address below: ❑ No
}sag r1;Cfd 1, sou/
I ICA 1` / . l 3. Service Type

�A
,...�v�
North Carolina Department of Environment and Natural Resources
Division of Coastal Management Dee Freeman
dy Eaves Perdue James H. Gregson Secretary
3mor Director
AGENT AUTHORIZATION FORM
Date:
Owner Applying for Permit: Name of Authorized Ag nz f
e of Property or this project:
—
ier's Mailing Address:
Se, L4-,c--F- C r,
J �o r�e of G
z� 4- 1
sne Number j3 71 2 O L— 6 S 7 I
Agent's Mailing Address: ,
Phone Number (%"l�' l ✓ / �; c
;rtify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
and obtaining all CAMA Permits necessary to install or construct the following (activity):
ty property located) at E
MAR 2 9 2012
his certification is valid thru (date) DCM WILMINGTON,
Property Owner Signature Date

�/%jam/' ,
plicant: /�' 41101
le:
gi&l�l
Permit #: 527n� 47
>cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd 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
impactamount)
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)
D�/✓
Dredge ❑ Fill ❑ Both ❑ Other
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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 ❑ Fill ❑ Both ❑ Other ❑