59162D - West

CAMA / DREDGE & FILL -` A( eA�
1AENERAL PERMIT Previous permit # IY t y
New 'Modification Complete Reissue CPartial Reissue Date previous permit issued
-ized by the State of North Carolina, Department of Environment and Natural Resources J/ a
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
❑ Rules attached.
t Name LA Project Location: County f,, M-
A O .%b' Street Address/ State Road/ Lot #(s)
/r Stat ZIP
' , Fax # .t l ) ? - 4`.; ' Subdivision
ed Agent "T i" .r City S ✓% ZIP
CW EW PTA Fc vTc 6 o:.-- n....:.. 1
COEA" O H CIH
0 PWS:
; / no PNA ves I
)f Project/ Activity
lock) length
•m(s)
pier(s)
length
umber
ad/ Riprap length
vg distance offshore_
iax distance offshore
channel
ubic yards
amp
)u oatlift
v/I
Bulldozing r
ne Length
not sure yes
igs: not sure yes
>rium: n/a yes
yes
Attached: yes
Closest Maj. Wtr. Body
ling permit may be re

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ou} ose ot'this few i_ to provide proper notice ro you as an adjacenr riparian proper own;.r tQ The ind visit or
'siduais liszed below. Tbe CA IA Generai Perizliz application procedtres require that aPPlica1s P3rOvide the
staj tManage-ment conerl,—n-anion that a ivritcen sTazernent has been obtained signed bl y zhe adiacem riparian
mthi that they have -no objection to :he proposed work gr•, what the aajacenT riparian properr'y owmers t al!e oeeti
?`iiT_'e d mail of the 1fU}7osEC} 4Vor . Often These rorn2S are submitted to the adjacent TiPe'-en trope-'- =w*Za?3°t'�
i3C Cr Cr QTner individuals acting as anGttTiiorized aaenT on behalf o" T;'ie agplicaP_T_
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5 fa Mu `slc5 sent to ?/otY bS'2 io1?{}'ir±g iIIcsiVidili Cr iQi73af3v design
ated z` ch8.fii3.T£#?cT z
ti
he ized agent.
�✓ Cam///
o� a
>gerT's Sineitlre lane
lc Z 1rd Viiivai Appl- it for e}isli'r:
Tress 01.0 proDer"C bl rr-- �rtrx�
(f oT or jtreeT f. SITeer or R
J/V"--Vj
any Coun-00
rC
proper` adjecent TC Tne above renced grope: tV. The individusi sooviriz for
v ma 3s ;zhown or; the attached drEwirs the deveiop -IIT ti?4v are proposir ..'. des: ^priori of drascr
=r t
i 3er L'iuiC-is, should be provided wi-C : this lerrer.
S y
i 11L�`a no 'Jb1eCt}orL to this propos'a}.
ct ec-tons to whaT_ is being proposed. please ',F riTe the Division o COSMi rzSti� �iti�ri
3ibi' TQ'.L r�-l�a^!ikiL ledi5 C22--
rTl_LTS?C..�to'.`
r?sponsa is considered the 5ame'as no objection if ivou h& $ tJeSfi ii0i? .ad by iE'd .`%E>€
YV AT'! x.R sr-r- T ON
TSoCk� moor'g pi break -water, boat 1-Guse tar boat :_Zt :11-U5t be 5_ cE
.;i :s•,�. c t tio€fi :nil' r�8 rJ: ian access u-mess wahyed 4OL IS.�?
a i_Iut iuida.3 tnt appropriate blank belor-.,)
I do ri�T 6=ivy_ ro t.+,taive 0b .5 sez' aCl; reGi31r8;r?r!T.
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84- 5-38
Cardiriani Drive klVilmi-19ton, Naith 'A- 2 055 45
0111ut1-7-Qtl.-72-111 � k FAX- v t 0-3Sk;-3964 "k Inteiret:
N A-, ffirmirille Actic-ii EmpizvF, — % PaspV

3/2012 16:22 FAX
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RECEIVED
MAR 2 8 2012
�C M WILMINGTON, NC
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3/2012 16:31 FAX
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RECEIVED
MAR 2 0 2012
r " M WILMINGTON, NC
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icant: . Kin 4 D
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Permit #: 5-1/6 Z-
;vibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
d in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
tat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts
amount)
Dredge ❑ Fill ❑ Both ❑ Other
O o
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front If space permits.
1. Article Addressed to:
1V1(-11WC4 v �� L
91'747
A. Signature
X ..................
-
B.
D. Is delivery address dH
If YES, enter delivery
Narrip) / I.QlDfte of
�n item 1? ' O Ye!
below: ❑ No
C Q _ 3. Service Type
cS (/ X"1 �%�`� ❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
3 y�n ❑ Insured Mail ❑ C.O.D.
/ 4. Restricted Delivery? (Exba Fee) ❑ Yes
2. Article Number
(W„sfe,f mservice bW 7011 3500 0001 3954 5985
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M_1540 I
Dredge ❑ Fill ❑ Both ❑ Other ❑ I I I I
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑