38968D - Thornton

ICAMA / '7_ DREDGE & FILL
1EN.ERAL PERMIT
Previous permit # N
New 'Modification ❑Complete Reissue Partial Reissue
Date previous permit issued
•ized by the State of North Carolina, Department of Environment and
Natural Resources + i�
1
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC lJ
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❑ �`'les attached.
t Name
Project Location: County
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Street Address/ State Road/ Lot #(s)
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Phone # ( )
'ver Basin CFO
OEA ❑ HHF ❑ IH ' ❑ UBA ❑ N/A
Adj. Wtr. Body C^/V AC C)OCF 161 aYi f
❑ PWS: ❑FC:
yes n PNA yes Crit. Hab. yes / o ,
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mber
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distance offshore
x distance offshore
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Ac yards
ip
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ulldozing
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e Length
not sure yes
s: not sure yes fo
ium: n/a yesyes
\ttached: yes no
ng permit may be required by:
❑ See note on back regarding River Basin n

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111/2012 1E:51 9103271433 COASTALMINISTORAGE PAGE 0
6A -
NCDENR
North Carolina Department of Environment and Naturall Resources
Division of Coastal Management
Micraei F, €asiey Govemor James H. G Director
�son � Rost- �7., Secretary
Date 6 — tv " ,12-
Applicant)\ame o&& rL A o r y 6/�
;flailing Address _g �� ----- --
1 certify that I have authorized (agent) 4 1 o to act on my
behalf, for the purpose Of applying for and obtaining all CAM.A Permits necessary to
Install or construct (activity) .LR
at (10eation) 102 / rce nw , "AR
This certification is valid thru /date)
rr
Signature lip.
AMOK
RECEIVED
J U N 1 1 2012
r%f- 1d Uhl hA1K1r TnK1 K11`

'11/2012 16:51 9103271433 COASTALMINISTORAGE PAGE 02
DIVISION OF COASTAL MANAGEMENT
ADJACENT CENT RIPARIAN PROPERTY OWNER NO IFICAT(ON FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
i hereby certify that I own property adjacent .o %xev rrAA S
I�,? / �'an �, % Qr'� �� (Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.)
on - - , in
- - ...,_ N.C.
(Waterbody) iCity/Town andior County)
Agent's Name #: _ Mailing Address,—
Agent's phone #:
He/She has described to me as shown below the development he/she :s proposing at that location,
and I have no objections to the proposal
---------------------------------------------------------- ..--------------------- --- - ------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
r F C EI"QED
JUN 1 1 2012
DCM WILMINGTON, N
If you have objections to what is being proposed you must notify the Division of Coastal AI&MVernent
0CM) in wilting within to days of receipt of this notice-. Contact information for DCM OMCes is
available at www.nccoastalmangementnet/contact_dcm.htm or by calling I-W8.4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail
(Property Owner Information)
Ngnattire
A1eI4 C. 7xa11"tIz
Print or Type Name
/h`C���
Mailing Address
tRipariann Property Owner
Owner Information)
7 gnature
IIUAMY-1
Print or Type Name
ailing Address
<-/1W"1S il;rry ?,—c 7 Y6 o

/11/2012 16:51 9103271433 COASTALMINISTORAGE PAGE 03
DIVISION OF COASTAL MANAGEMENT
ADJA ENT RIPARIAN PROPERTY OWNED NOTIFI2ATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
i hereby certify that I own property adjacem to,
(Name of Property Owner)
property located at n / bm.
(Address, Lot, Block, Road, etc.)
on , in
(Waterbody)
Agent's Name #'
Agent's phone #:
'City/Town and/or County)
Mailing Address:
N.C.
He/She has described to me as shown below the development he/she ;s proposing at that location,
and i have no objections to the proposal.
-.-------„----------------------------------- -------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
RECEIVE®
JUN 1 12012
DCM WILMINGTON, NC
If you have objections to whatis being proposed, you must notify the Division of Coastal Manpgwywt
(DCM) in writing within 10 days of receipt of this notice. Contact intonnation for DCM offices is
available at www.nccoastaimangementnedcontact_dcm.htm or by calling i-W8-4RCOAST. No
response is considered the same as no ob%ecdon if you have boon notified by Cued Mail
(P perty Owner In ation)
Signature
Print or Type Name
!Rip ri Property Own Intormation)
i
S.gnature
E / i5' G.,4 7T
print or Type Name
/a S- . ��� a l Dr.
Mailing Address
Vatting Address
02etr-y N, c

nplicant: ' %Zv�j�ti
ate:
171ttepi iAoN
Permit #: 0�wA
,scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
DISTURB TYPE
bitat Name 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 FINAL Feet
(Applied for. (Anticipated final
Disturbance disturbance.
total includes Excludes any
any anticipated restoration and/c
restoration or temp impact
temp impacts) amount)
Dredge ❑ Fill ❑ Both ❑ Other
0-0
© 6
Dredge ❑ F' Both ElOther ❑
Zz_e
Z j
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 ElFill ❑ Both ElOther ElDredge
❑ Fill ❑ Both ❑ Other ❑