60700D - Smith

�•CAMA / -- DREDGE & FILL / No. 60
GENERAL PERMIT V Previous permit #
KNew Modification -Complete Reissue Partial Reissue Date previous permit issued
Drized by the State of North Carolina, Department of Environment and Natural Resources ''] `` UU
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �" •
((� -p Rulgs attached.
nt Narne j[Yj�C}1yN {i%, Project Location: County I2Y1)1%,2V) ► Liles
s i' Street Address/ State Road/ Lot #(s
-at RMT
State ZIP 2- -T�s 6 } j }
41( ) Fax # () `� _ Subdivision NSA
zed Agent W� Act y} fu _ x,� _. City ZIP 'LO-11
CW , EW YPTA �j ES PTS Phone # (G ) Z32 - ZS3D River Basin Lrat
❑ OEA ,� HHF _ IH UBA 1 N/A Adj. Wtr. Body--- N w(NN/1,j` (nat%
❑ P ❑ FC: i'C W W
' Closest Maj. Wtr. Body
ve / no i PNA ves //no Crit_Hah_ vec /' nn
)f Project/ Activity
`� — (Scale: '
ock len h X /�__ _ Al
ength
umber
ad/ Riprap length
tg distance offshore
iax distance offshore
:hannel
abic yards
Lmp
'use/ Boatli �—
i- —
3ulldozing
a/1 Wi►l7_ ALF.,< X
ie Length
not sure yes no
gs: not sure N.
yes no
rium: n/a es no ,
yes o
Attached: yes nod---�
'ing permit may be required by:/
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0
ryylsyo CIL U rL4-L- _ ❑ See note on back regarding River Basin i

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
w A diva I
Mailing Address:
7210 > ko/n)
//I�
I certify that I have authorized (agent) /illr ' Aof ^•�r-164o act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at)
This certification is valid thru (date)

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property: 3 t1J,,JqA P41`�NN�"'�
( of or Street #, Street or oad, City & County)
Agent's Name #: Ji fl4le6�QMailing Address: )D yc
Agent's phone #:U
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, 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
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmanagement.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 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' setback requirement.
If I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
�49TI LLI 41 dL'l.P
Print or Type Name
(Adjacent Pro/perry Owner Information)
A !,/—
Signature
j? I C C64 bN 0�y
Print or Type Name
Y-7s kW1yd

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #,
Agent's Name #: r
Agent's phone #: CTIZ)
I-iK
WP4kd(K
or Road, City & County)
Mailing Address: OL J/
14J; ✓ z-
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are oposing. A description or drawing, 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
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmana_gement.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 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' setback requirement.
� 1 do not wish to waive the 15' setback requirement.
(Property Owner laf rmation)
Signature
Print or Type Nam
(Adjacent Property Owner Information)
SigA(�I-JCL�k
nature U
Print or Type Name
l0023 ��,�L C ► rrJ4Z-

Permit #: � 6 TO D h
)escribe below the HABITAT disturbances for'the application.. All values should match the name, and units of measurement
ound in your Habitat code sheet.
DISTURB TYPE
labitat Name Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impracc
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
2� V
Dredge ❑ Fill ❑ Both ❑ Other
2
'7 2 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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
K (0 > C,4__A:) �5