59239D - Surratt

CAMA / DREDGE & FILL
:y
GENERAL PERMIT Previous permit#
;New -Modification ❑Complete Reissue El 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
BRules attached.
it Name t�Ao ae RI`,'Tf� Project Location: County ws (w ) C, L
State ZIP 123.1
O Fax # O
zed Agent A10Y� I riJ N",,�-V*k
Street Address/ State Road/ Lot #(s)
1 11 0 �-. L)" prr�j
Subdivision
6ty (! )e, Is" -*JD ZIP—?a.O
i ❑ Cw DEW "''('TA `DES PTS Phone # ( ) River Basin C--11 r
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ,��
Adj. Wtr. Body � G C h
❑ PWS: ❑ FC:
yes /6P PNA / no Crit.Hab. yes / no Closest Maj. Wtr. Body
es
4 Project/ Activity \\j�"iE j�l 4\J%
(Scale: ��—
xk) length � 2 "-'1
n(s) Is'), (a —ttXD
ength -
imber
ad/ Riprap length_
rg distance offshore_
iax distance offshore
:hannel
ibic yards
mp
use/ Boatlift
3ulldozing
I r —...a
ne Length _ � �
not sure yes
gs: not sure yes
mum: n/a yes
yes o "
Attached: yes o
ling permit may be required by:
11Sa / . . - - . r n--- w , t _
it
❑ See note on back regarding River Basin i

licant: olf 5 �{i'%r
Permit #: S�--%Z 3q
7111/1 Z,
gibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
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 andh
temp impact
amount)
—
Dredge ❑ Fill ❑ Both ❑ Other•F/
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 ❑

American Fi5n Company
0 Box 11046
Southport. worth Carolina 2846
Finad 4FC036004ao► corr
d
a
ri
T
N'i0or- E 0-10 r
1�10► 457-548b
3101 -157 6551 F
i
i
i
i
i oJ�

..45 ; ;55,
Jame of Individual Applying For Permitf
kddYess of Property, 114fl Etia'% �Ia%i i\
rLct or Street �$, Street or Road)
'.City and. County)
hereby certify that I own property adjacent to the above- referencea propc:- . The individual
ipplying for this permit has described to me as shown on the aaacneci draw,no the development#"
ire proposing. A description or drawing, with dimensions, snoTalc with this let4er,
have no objections to tmis proposal
1t' you have objections to what is being proposod, please wrire the Di�,Ijl.,n of CofistaL
Management, 127 Cardinal Drivo Exten9ion, Wilming on, NC 2.8405 or c:01 41 79b-72tS
wirbin 10 days of recaiptofthis notice. No response is considered the some as na ot%ectionif
you huve been notified by Certified Mail,
WAIVER SECTION
I uaderstand that n pier, dock., m.00 ring pilings, brenkwater, poor house or boa: lift mustbeset
bck a minimum distance of I?' from my area of riparian access - unless wai.2d b" me. 0(you
wish to woive the setboclt, you must initial tho approprime blank be►n\�
do wish to waive the I setback
i d0 n9 'A ish to Wnive tnC i setba.k-eo'-!!
'A U1,21WAi W—WOVIA0A
AAA

ime of Individual Applying For Permit: 4Sur r a' _
I&ess of Property
of or Street 0, Street or Road)
!.City and County)
hereby certify that I own property adjacent to the above. referercea prope, y. The in 'a
)plying for this permit has described to me as shown on the aaached drawing the deveiopft
'e proposing. A description or drawing, with dimensions, should be provided,with this 1&--
have no objections to tit+.3 propesfl;
f you have objections to what is being proposod, please Nvrire the Dig ui"'n of Cobst'8L-
laaagement, 127 Cardinal Drivo Extension, Wilrnin,on, INC 1.8405 or cnil 91`)-796-716
+irbia ld days of recoipt of this notice. No response is considered the some as no oblectionif
ou hzive been noriiied by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, brenicNvater, bout douse or boa: lift mustbe set
Eck s minimum distance of 14' from my area of riparian access - unless Nvai-, m ed b-, e• (if You
visb to waive the setbock, you must initial the nppropriatc blank
: do Wish to waive the 1 setback reatirer-a�
�,.,,� i do not A 13n to waivt the 13' setback .a,.:,,"c��� :

r1n A
same of Individual Applying For Permit: �V © _
address of Property J 5• vll. (o�h --
r
(Lct or Street #, Street or Road)
!.City and County}
hereby certify that I own property adjacent to the above-referer.cca proper-v. The individual
applying for this permit has described to me as shown on the aaacheu drawing the developmcntthev
ire ptorosing. A description or drawing, with dimensions, should be p,ovide�! with this It er
have no objections to tnis proposal
Et' you have objections to what is being proposed, please write nic Dig isiun of CofistdL
Management, 127 Cardinal Drivo Extension, Wilmine on, NC 28405 or cnii 41-'-79b-7215
within 10 days of receipt of this notice. No response is considered the some as no objectionif
you huv-e been noriised by Certified Mail.
WAIVER SECTION
1 uaderstand that a pier, dock, m,00ringpilings, brenkwate r, bona house or boat lift mustbe-set
bcl: a minimum distance of Imo' from my area of riparian access - unless Nvai• ed b� me. Uf you
wish to woive the setbucic, you must initial the appropriacc b1tink beige ;
ao wish to waive the 1 setback reouire,�-�
i don , a isn to "vnivc tnc 15, 5Ctbn.k ,Ca,-; ...• :
j in C

AMERICAN MARINE CONSTRUCTION INC
CHARLES H. OR KAREN Z. PERRY
P.O. BOX 11046 910-457-5488 SOUTHPORT, NC 28461 DATE 7711 - 1 � - Q 2
PAY Rr.�, C'
TO THE
ORDER OF � • r
First Citizens
Bank 7/1.5'y 2.3q -1- 4 f;1 5-9�
FOR C.f-vAzt*- &4�&�

a Vcr rY\.t,-1r "a
ZU:&r rc..*
Nlicnael F. Easley, Governor
i order to obtain any CA
S 23c(
NLUtNK
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
James H. Gregson, Director
Authorized Agent Consent Agreement
William G Ross it
C ( is hereby authorized to act cn my t
(Pnnted Name I Agent)
� permit(s) r quired for the property listed below. The authorization is limiter
pecific activities described in the attached sketch.
OCATION OF PROJECT:
'ROPERTY OWNER MAILING ADDRESS:
o a!s
�Pe.1\-rbn C. • C • 2-1 2
PHONE NO.
WTHORIZED AGENT MAILING ADDRESS:
PHONE NO. -�, V, q5 I X
3icnature of Property Owner: