57428D - Astrakel

:CAMA / DREDGE & FILL ` _ 5;
31ENERAL PERMIT Previous permit #
:New ' ' 'Modification ' lComplete Reissue _ Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources �f
-oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC TT ./OD
es attached
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❑ FC:
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yes / no Crit.Hab. yes / no
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Project Location: County Ar
Street Address/ State Road/ Lot #(s)_
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 45f"e-( /-1 /Js
(Name of Property Owner)
property located at /0 3 3 / 5 t- 5 f -
(Lot, Block, Road, etc.)
on C alp. , in �v T Cif y , N.C.
(Waterbody) (Town and/ r County)
Applicant's phone #: �1l D J�y� "� 6 D� Mailing Address: w aoc Z 3 4
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)
--------------------------------------------------------
(Information for Property Owner Applying
for Permit)
PE) gvx 23y
Mailing Address
NC ?-�19
(Riparian Pro erty Owner Information)
Signature
(2t) D CF-7- V.

r
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOIISE)
I hereby certify that I own property adjacent to .45ffaKd Infclnafikd L l 1, 's
(Name of Property Owner)
property located at to 3 3 rr r5t 5{7(2e-r
(Lot, Block, Road, etc.)
on catia-Q , in �y r( CI fiC , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: %105 1 06190 Mailing Address: PO 6oK 7,3q
W �A ©a*, NG Z8399
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
wish to waive
wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying (Riparian
for Permit)
PO 6 oR z 3q
Mailing Address
Owner Information)
i
Si katur

AUA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date '3
Name of Property Owner Applying for Permit:
Mailin Address:
� 3
I certify that I have authorized (agent) "4>1j4 &O-�f uIpAk-6 act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) �2& 1� 62GJ':�Ie vU 4 G� ,
at (my property located at)
This certification is valid thru (date)
6)2-3)11

)lican{: �/2A'I1-EL Jul' e�v At-Tivt*,-✓ Permit #:
7 / 3 Zo(/
;cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd 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.
dtat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/oi
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts
amount)
W
Dredge ❑ Fill ❑ Both ❑ Other
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r
Dredge ❑ Fill Both El Other El(�0
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�t
Dredge ❑ Fill ❑ Both ❑ Other
UU
(�
■ 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.
Agt❑ Agent❑Addressee
y (Prin d Name) Ci Datg of Delivery
1. Article Addressed to: D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
L rew z-r 71-7
20(, lliyt r ` �'A e, OrZ ---
n � 3. Service Type
ve / Alc 2 g 36Lj fio Certified Mail ❑ Express Mail
egistered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label) 7 010 1060 0000 8468 1053
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
Is Complete items 1, 2, and 3. Also complete X Sig aturo J l�'�' v
-- - item 4 if Restricted Delivery is desired. Agent
■ Print your name and address on the reverse Addressee
so that we can return the card to you. B. ved by ( Printed N e) C. ate of Delivery
■ Attach this card to the back of the mailpiece, , U V�
tp
or on the front if space permits. V
D. Is delivery address different from item 1? ❑ Yes
1. Article Addressed to: If YES, enter delivery address below: V, No

Bank of America
ACH R/T 053000196
ALLIED MARINE CONTRACTORS, LLC 08-03
910-367-2159
92 HAROLD CT.
HAMPSTEAD, NC 28443
PAY TO THE j f I $ hoc
ORDER OF
L� C� t, 7
MEMO 41i 'o-"::-l4
AUTHORIZED SIGNATURE
110004536ol' 1:053000196i: 000684743738,12