59262D - O'Daniell

CAMA / DREDGE & FILL '
ENERAL 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
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Ji NRules attached.
it Name 01"' lmle -,!/® Project Location: County ��z
/� 1C�/'J�7c/ %�" • Street Address/ State Road/ Lot #(s)
_ I// Ai? State /jG- ZIP 2O%G'�-I-' 146 3�
(p) ?3.'rw/ Fax # ( ) �- Subdivision
zed Agent City ��' �� ��� ZIP
CW EW —, PTA ES =: PTS
❑ OEA HHF C IH _ UBA N/A
❑ PWS: FC:
es / no PNA � / no Crit.Hab. yes / no
Project/Activity 12' Idle F' ,,t5 f
le
length
•m(s)
pier(s)
length
lumber
!ad/ Riprap length
vg distance offshore
nax distance offshore
channel
ubic yards
amp
Bulldozing
ine Length
not sure
yes
tp
igs: not sure
yes
o/
>rium: n/a
yes
¢
yes'
no
Attached:
yes
19
Phone # ( )
Adj. Wtr. Body V�'�
Closest Maj. Wtr. Body
River Basin C.C;
(Scale:
ling permit may be required by:, y� /y /� �G.+,� 717SQet'r14*,,S �d� El See note on back regarding River Basin
/ C.........1 /^��JL�.��_ // . Z i 1 GJ _ /7 /a — Yam_.. .�._ e -/ - 1 -.4 -/

-!5A
NGDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
evenly Eaves Perdue James H. Gregson
;overnor Director
AGENT AUTHORIZATION FORM
Dates_
3me of Property Owner Applying for Permit:
>b W .t /( - o—
wner's Mailing Address-.
Al
4/o
'hone Number (4:m
Dee Freeman
Secretary
Name
"off ,Authorized Agent for this project:
Agent's Mailing Address:
�flqv�
Phone Number
certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
or and oAtaining all CAMA Permits necessary to install or constru t th f Mowing (activity):
my property located) at
is valid thru (date)
perty Owner Signature
Date
DECEIVED
MAY 10 2012
®CM WILMINGTON,

CERTIFIED MAIL, — RETURN RECEIP:[ REQUESTED
DIVISION OF COASTAL :MANAGEMENT
ADJACENT RIPARIAN. PROPERTY OWNER STATENIFNT
Name of Property Owner:, -C
Address of Property: _ _•3 O
(Lot or Street !M!Street or Road, City & County)
Applicant's phone 9: �Od ` �yZ' �gd� — Mailing Address: 1S14,7 7
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this per
has described to me as shown on the attached drawing the development they are proposing. A description of drawl
with dimensions. must be provided with this letter.
1 have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCP
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive f
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no ohiection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 1-mist he set back a minimum distance
15' from my area of riparian access unless waived by me. (If you wish to waive the set ack you must initial the
appropriate blank below.) F C E I V E
I do wish to waive the 15' set back requirement. MAY 1 O 2012
4 I do not wish to waive the I S' set back requirement.
Owner Inf miation) {Riparian Property Owner Info
CAD F
At
Print or Type Name
ailing Address Q
Print or Type Name ' U
A17z�', Ae
Mailing Address

N
CERTIFIED MAIL — RETURN RECEIP'1('REOUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN_ PROPERTY OWNER STATEMENT
Name of Property Owner:.-- 0 • -C � jl%/ `� ��
Address of Property: 4301s O
(Lot or Street #!Street or Road, City && County)
Applicant's phone #:_ ��� ` 7yZ- Mailing Address:
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this per;
has described to me as shown on the attached drawing the development they are proposing. A description of drawir
with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCN
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive E
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no obieelion if you have been notified a Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distance
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.)
I do wish to waive the 15' set back requirement. MAY 1 0 2012
I do not wish to waive the I S' set back requirement.
Owner
Print or Type Name
iS'e
IV ailing Address ¢
(Ri Han Property Owne n
ii�nature
C
Print or Type Name
IsT
Mailing Address
UQ1 L11n ►14 nJ

Permit #: Ski 2
-ibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
i in your Habitat code sheet..
:at 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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑
Fill ❑
Both ❑
Other
-Z q10
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 ❑