57441D - Michael

i416AMA /D DREDGE & FILL
GENERAL PERMIT Previous permit #
-INew --Modification LAComplete Reissue El Partial Reissue Date previous permit issued
orized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NC.AC 7H, 110,D
gftles attached.
nt Name- Project Location: County C� (,'10
s Street Address/ State Road/ Lot #(s)
State zip
# 6�- 4 Fax #
-J ized Agent f, J�� ( ( fi ofy �Nk-- Cc, -
�cw 0 EW LJ PTA EES D PTS
L OEA El HHF El IH D UIBA L1 N/A
PWS: FC:
yes / % no PNA yes / no Crit.Hab. yes / no
Subdivision
city 01,41L
Phone# (—) River Basin
Adj. Wtr. Body � \,-j \AJ
Closest Maj. Wtr. Body /k A VVw
Df Project/ Activity I U VIL)K arxg-
11
(Scale:
I - ►I
-
-
0
OEM
no
'rills
FAV
ME■M
0
0
EMEMEM
length
iumber
-ad/ Riprap length
.vg distance offshore
ME
ME
WIRVIVIrewdul
IIII&II
mal-b
101
IMMER
nax distance offshore
channel
Mallu"
Mor,
I
M11
I
Viol
;;a
i; womw
1
pgm
—
�Mm
wx%
4-ar's
MANNEEM
30104
'Mft
—MENEM
:ubic yards
ninp
latiolima
IMEMMM
ONE
11
on
POWMINITI.
MIN-000
EMORPH
NOMMINE
Bulldozing
MAN
MEN
MMMMMMMIEM
waaw
ding permit may beJr'equired by: Qlhe-' ISLE IJ-0 — . F-1 See note on back regarding River Basin
..-. - - - 4-1 , A � . In I TT A 1 C' U 1 -72 1 , --r --1 ,

Division of Coastal Mgt. Habitat Impact Computer Sheet
licant: I S YV� c -L Permit #:
71 wsh-&,
cribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen
id 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
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated fina
disturbance.
Excludes any
restoration and/i
temp impact
amount)
r
Dredge ❑ Fill ❑ Both ❑ Other
!�'�l �" 1Egg
Dredge ❑ Fill ❑ Both ❑ Other
l 2 C)
t 2�
lL
�`/
IYVA
Dredge ❑ Fill ❑ Both ❑ Other 2/
4 o
q 0
C)
{ i]
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 ❑

4ichad F. Easley, Governor
�0
A" -;A&
a Am Nt.UtNK
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
James H. Gregson, Director
Authorized Agent Consent Agreement
William G. Ross Jr.
is hereby authorized to act on my b
(Printef Name of Agent)
order to obtain any &MA permit(s) required for the property listed below. The authorization is limiter
ecific activities described in the attached sketch.
)CATION OF PROJECT:
ROPERTY OWNER MAILING ADDRESS:
1
Dad. , (A c: 2 q V;-
JTHORIZED AGENT MAILING ADDRESS:
gnature of Property Owner:
PHONE NO. q 0, 2 I8 — i—IyjD�
PHONE NO.Ci LID `LS7`'SYW'8'

'dame of Individual Applying For permit:
Address of Property
!Lot or Street #, Street or Road)
'.City and County)
1 hereby certify thvt I own property adjacent to the above•referencca propc:--y, The individual
applying for this permit has described to me as shown on the aaacheci drewir.0 the developrncntff"
are prorosing. A description or drawing, with dimensions, snovlC rP p-ovided withthis le*er
e�zCt4� Z_ 7 have no objections to this proposvt
if' you have objections to what is being proposod, plense write tiie D{� of Ca9stdL
Management, 127 Cardinal Drivo Exten9ion, Wilming on, NC 28405 or call 4179b-72-6
wirbi❑ 10 days of recoipt of thls notice. No response is considered the some as nO objectionif
you have been norified by Certined Mail,
WAIVER SECTION
i understand treat a pier, dock, m.00ringpilings, breakwater, boat house or boat lift must be, set
bck a minimum distance of 1.' from my area of riparian access • unless Nvai, ed b% me• cif you
wisb to woive the setbock, you must initial the nppropriatc blank beln��
do wish to waive the lam' setback reaui'e—e1..
i don a ish to waivz the 115, sctba:k
j dn, jv r—n c
�
' ''�"4'►

a
American Fish Company
0 Sox 11 U"46
Suucnuort. North Carolina i846
r-nail AF(036044aol com
10 i5�
MwI)o_-; NO -+
'i l O i 45 7 54db
310; 157 13551 1
f7

1A e-&-rr «<
Name of • • il Applying For. t
Address of Properr` - Li sc)'- oy� L� �)d(p eak y a-CVJ
,Lot or Street 4, Street or Road)
i ��v�5 45 tic
(ICiry and County)
hereby ceruiy thlt : own property adjacent to the above. referenrca rroc-r p,r The individt
applying for this permit has described to me as shown on the amched drawir.g :he developmerstt)
are proposing. A description or drawing, with dimensions, shoald :p wO this ittter
cke-rK ____ — I have no objections to this proposa.
hart a
H' you have objections to what is being; proposed, please write thr Di%i;i.:n of COAS'
Nlaozgement, 127 Cardinal Drive Extension, Wiimind on, NC ?8405 or call 910-796-'72-
witbin 10 days of receipt ofthis notice. No response is considered the some as no objec.tror
you have been notified by Certified Mail.
WAIVER SECTION"
1 uaderstand treat a pier, dock, mooring pilings, bron'lwater, pout i.ouse or boa: (iftmWtbe-
bck a minimum distance of 15' from my area of riparian access- un;ess \\ ai. ca by me. If,
Msb to waive the setback, you must initial tho appropriate blank belo��,�,
ial-i ��� do wish to waive the 1.' setback
I do r,ot \ ish to waive the : _5 setbaci: req ,rc per.:
-oP•
u $n N
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