60733D - Richards

No.
607
CAMA / E DREDGE & FILL
jENERAL PERMIT
, / Previous p ermit #
New JModification El Complete Reissue El Partial Reissue V Date previous permit issued
,zed by the State of North Carolina, Department of Environment and
Natural Resources , /' ��,��
oastal Resodrees Commission in an area of environmental concern pursuant to 15A NCAC I�f
Rules attached.
q�
Name K,►tC,
Project Location: County n-*g)�
e'
rfl
Street Address/ State Road/ Lot/#(s)
State_ ZIP
Vl%1%4 _
Fax # ( ) - --
Subdivision ...�..
—
( 't� h dtM
�d Agent
City �I /�'•r �n�i 7tl/� ZIP
/'
VCW V& Jj-VTA ❑ ES [-1 PTS
Phone # (_ _) ' "" River Basin
El OEA El HHF ❑ IH — UBA ❑ N/A
I /
Adj. Wtr. Body .G�TLh
a r
-.�.
® %�rf�
Closest Maj. Wtr. Body
yes )/ no PNA esno Crit.Hab. yes / no
c
e _ i
i .7
' Project/ Activity 411,�/
ck) length
i
ier(s)
ngth
tuber
d/ Riprap length_
g distance offshore_
ix distance offshore
hannel
bic yards
np
ise/ Boatlift
lulldozing
-51e
-7 :k ?
ie Length �'2 •
not sure ye
gs: not sure y<
Prium: n/a yf
Yf
Attached: I ye
(Scale:
ling permit may be required by: // H' 17.7PMFVfV ( --FfSKEZYA93--

I -PA
Aww�
HCDEHR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management Dee Freeman
Orly Eaves Perdue James H. Gregson Secretary
ernor Director
AGENT AUTHORIZATION FORM
Date: � Q �� - VL
Applyingtor r P
ie of Property Owner App��+��+y �o� � ermit: Nan of Authorized Agent for this project:
one Number A 1J — "D6
Agent's Mailing Address:
6)1'S 2
t .�, ti c=LKC(
Phone Number
ertify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
r and obtaining all CAMA Permit necessary to install or construct the following (activity):
ny property located) at
"his certification is valid thru (date)
_Y-08 I //0
�'" Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER13,1OORI,VG PILI_VGSBOATLIFTBOATHOUSE)
r
I hereby certify that I own property adjacent to �'1 tl !� is
property located at
Cj � /� 1 � � n/ ,�am e of Property Owner)
(Lot, lock, Road. etc.)
on in Yt.-Gtk' , N.C.
(Waterbody) (Town and/or County)
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 bier/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.)
I 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)
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writii
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext. Wilmington, NC
DCM representatives can also be contacted at [phone].
No response is considered the same as no olection if you have been notified by Certified Mail
(Information for Property Owner/Applicant
Applying for permit) P
2/9� Z'4" I
,1),2 -A�dll
ailing Address Li
(Riparian Property Owner Information)
i Signature
��� r��et

M-1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIEK13,100RI,VG PILI_VGSBOATUFTBDOATHOUSE)
I hereby certify that I own property adjacent to �� y r y T �k!J �r- /Y 's
Fame of Property Owner)
)roperty located at l': / /5 /W" ^i �/ %
(Lot, Block, Rod , etc.)
>n , in , _ 't ��/�C�1 , N.C.
(Waterbody) (Town and/or County)
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.)
- I 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)
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writir
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Est. Wilmington, NC
DCM representatives can also be contacted at [phone]_
No response is considered the same as no obiection if you have been notified by Certified Mail
(Information for Property Owner/Applicant
�/ Applying for permit)
,/
Mailing Address
A
City/State/Zip
(Riparian Property Owner Information)
Signature
Print or Type Name

J 1-7 r7 ,)
M-1
ry
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-rat*-'9

JC Division of Coastaf Mgt. Habitat Impact Computer Sheet
pplicant: p-05
�` 't,C -��S Permit #: 6,�'7
9
gate: �0 4//2-
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
wnd in your Habitat code sheet.
abitat 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
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 ❑