60603D - Ratledge

CAMA / DREDGE & FILL r ,, '°10. 6C
GENERAL PERMIT V 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 I SA NCAC ZOO
❑ Rul attached.
it Name f f' Project Location: County(
✓l► Street Address/ State Road/ Lot t(s)
State Nx,- ZIP27Z/ a.._ ZY l l�j • �j�.O F'�i -
(`' )` 7 Fax # ( ) Subdivision ,
ted Agent ,4 o City ZIP12k-,
Cw '„}fW TA ❑ ES ❑ PTS Phone # ( ) River Basin iX(nat
I
OEA HHF IH ElUBA I —N/A Adj. Wtr. Body s L
PWS: El FC:
es / "o) PNA Closest Maj. Wtr. Body J u
y yes /� Crit.Hab. yes / no
Df Project/ ActivityLWf"
lock) length
length
umber —
gad/ Riprap length_
vg distance offshore
nax distance offshore
channel
ubic yards
imp
w atli
Bulldozing f i
i
(Scale:
� I i
_..
ne Length �
not sur ' yes .�
i
i I
gs: not sure yes--
rrium: n/a yes o
Attached: yes ewe•''" c
ling permit may be required by: ❑ See note on back regarding River Basin

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/IVfOORING PILINGSBOATLIFT/BO(pATHOUSE)
I hereby certify that I own property adjacent to Qt 0,e 90- f teii Is
(Name of Property vner)
property located at Z ? 1 7 5 Aa e-
�r .
`q (Lot, Block, Road, etc.)
on l w„irA �i/t�-�..f-� in / CG7 N.C,
(Waterbody) (Town a �d/or County)
Applicant's phone #: �G� ��? als'f ;Nailing Address: QdZ )khIV 'a C- _
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 ( I T) from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
1i 1 do not wish to waive
I do wish to waive that setback requirement.
---
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
_ a )�,rrlate - yo°-
Mailing Address
(Riparian Property Owner Information)
Signature
—%..Le&�- /vim Z 6 r Z
City/Stat 7_ip
Print or "type Name

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFTBOATHOUSE)
i hereby certify that I own property adjacent to J2 one��d�lj 2 s
(lName of Property Own
property located at ; i to Sow 5 "t'11&A 44.
l I i (Lot, Block, Road, etc.)
in St.� r( 1_ �,+ t+-17 , N.C.
(Waterbody) (Town a d/or County)
Applicant's phone #: �ltfdJ�(C j z(5� Mailing Address: `1 Z !�►.yl� Ct
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 'nitial the appropriate blank
below.) 511�' eta' w,�y`; t/1bt.11 -zo��C —iv Svy
t do note wish to waive eW 4/-A, t�S i
_ X_ I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
%lailiing Address
/j�
_ ,
Cit}:'Stat ip
(Riparian Property Owner Information)
Signature
— Print or l'ype Name
4, Ci Co/., 1;�fn 2 el I tl • ? 4 -r:, -21 ?

A�
� *MA.
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Govemor James H. Gregson, Director Dee Freeman, secretary
Date f ✓ 3" / z
Name of Property Owner Applying for Permit:
Mailing Address:
76r�
I certify that I have authorized (agent) (C'ons� n /�«� '� /1--1J''foR`act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) srxj l.'>r-�
at (my property located at) oZ717 6 5 Ste- ICY
7
This certification is valid thru (date) /Z/31 l3
Property Owner Signature Date

2.3'
12.5 INSIDE PIUNGS — I
-------_,___.---�
r--------
f
PROPOSED
BOAT LIFT
U)
C4
EXISTING FLOATING DOCK EXISTING YX 4.2' RAMP
°D (SHIFTED)
(mWMD)
27.1'
N36'27'19"W RIPARIAN SURVEY
EXISTING So
DOCK vi
12.7
in
-- — — — — — — — — — — — — — — —
)
T2
N36'27'57"W RIPARIAN SURVEI

r
p►icant: a✓
f� a � C-)84-"
Permit #: 6 06 o
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
Oat Name DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp mpactQ
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
mpact amourlU
TOTAL Feet FINAL Feet
(Applied for. (Anticipated final
Disturbance disturbance.
total inExcludes any
any anticipated restoration and/or
restoration or temp impact
temp impacts) amount)
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ther ❑
Dredge ❑ Fill ther ❑
4hhe
Dredge ❑ Fill her ❑Dredge
❑ Fill her ❑Dredge
❑ Fill her ❑Dredge
❑ Fill her ❑
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 ❑