59103D - Bond

CAMA / DREDGE & FILL
GENERAL PERMIT Previous permit #
New ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued
orized by the State of North Carolina, Department of Environment and Natural Resources I i
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Rules attached.
int Name j�
�ayjA teAtiLl Project Location: County�T ]VL�SINiLi'�
's r Street Address/ State Road/ Lot #(s)
I State�A ZIP 44 a 1 SI^-
#}- " Fax # O Subdivision Oki
izedggent i&A City
(.k ZIP
�1 22r�
d ❑ CW EW PTA ❑ E5 ❑ PTS P ne # (.' River Basin i
,11/111
1-1OEA ❑ HHF O ❑ ❑ IH UBA N/A Adj. Wtr. Body l nat
❑ PWS: ❑ FC: , /
yes / no PNA yes /f no Crit.Hab. yes / no Closest Maj. Wtr. Body A I" Yy
A Project/ Activity
lock) length r
pier(s)
length
umber
!ad/ Riprap length
vg distance offshore
iax distance offshore
channel
ubic yards
imp
>use/ Boatlift
Bulldozing_
ne Length
-T
not sure yes no
gs: not sure yes no —+
mum: f n/a es no
s no
Attached: yes no
I�- r,r,vr -
.-ling permit may be required by:
(scale:
H
❑ See note on back regarding River Basin
1.9nh A i„A AI I 111.1 A ,r-7.. I C-i-n1.. ,I i A. .1 f„1.

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I
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:RICHARDSON CONSTRUCTION FAX NO. :9108425597 Dec. 09 2011 12:09PM P2
PR
MCDENR
North Carofina Department of Envimment and NaluriReaurces
OvIslon of Coastal M2nagivivil
Qvqry Ea,*§ perdue 4mms H, CAVW Cee Freeman
Nzime of Pmp" Ownw Applying fix Permit: Name of Aoith*rlrotl Agent for this prvilild.
-�j
Owners Meffloog Addrew.
PhonaDumber art "A"
Agent's AfeifingAddr�s•
Phone Number biu.
I certify that I hen authoriied the Spent listed Qbovr� to %k on My bohad, for the purpose of applying
For and obtaining all CAMA Permits, nocAssary to instal{ QF Ihe fo4wng (activity)
(MY property located) at Alah
This certification is vali0thru (dre) —i
property Owner &gnatwa Date

:RICHARDSON CONSTRUCTIDN FAX NO. :9108425597 Dec. 09 2011 12:10PM P4
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tar
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bm Ito obj#o*wq w Jis yroposal. ; Sxldwnu d *x S pkx1raac.—av pimp! boail€t ! boxlow
must be 8a ba& ;,L rjM7c * as$ Unim
wdvad by (If you wish Lo waive 62 wtbwA(� tea aroprb is bl�alt
• HEStYP��i' AZ+iDI'QRDRA.��PQ�x (?� �Ff)S� �3�`���p�T:
(ro by fia�v Fir''°�os�ii8` das�v��rt)
for Pemit)
�effafimg A�3dnesg ...,�
� Cuti�i]
Cl p Pit or %Name
' To Number

:RICHARDSON CONSTRUCTION FAX NO. :9108425597
t Lu"
Dec. 09 2011 12:09PM P3
A CVN?:FAR AN ]PROPERW OWMR S'ATUMT `:..
Y t€mt I ivzt pioty adjacent to ti»t
Ha has describedloi sae, ;as. shnw�t iick�r, tbG t�velaptaot►i lie is �g.�.�at � � I
have m objwdoa to tb pro I. I uuiembwd tbal a � pilings I boatNt/ boa*owe
mast be set be* a wb&Mft distwm afet (151 fi.m MY C= of rogba m�less
waived by mp. • (F yw,k i&h to waive Thesrtback t t � 'biaat�.
bciuw,,)
RECEIVED
DCM WILMINGTON, Ni
4 DECO 9-20)1

:RICHARDSON CONSTRUCTION FAX NO
:9108425597 Dec. 09 2011 12:11PM P5
►prox 5feet off property line
new piling
proposed 8ftx9 Off
additional float
total 8ft x 25ft
existing 8ftx15ft'float
II
Owner: David Bond
2115 Banbury Rd 24 feet
Raleigh NC 27608 f
davidecugmail.cam
919-782-0800 �o foot lot
II
G feet wide

lM :RICHARDSON CONSTRUCTION FAX NO. :9108425597 Dec. 09 2011 12:08PM P1
3235 Seacrest Ave Sw phone: [phone]
Supply, NC 28462 Fax: [phone]
E-mail: [e-mail]
atnc.net
Richardson
Contstruction
Fax Transmittal Form
To AID From ! ��- P94-1'rc 6w,,
Phone:
Fax: �o �t�'rci'�,` Phone: [phone]
Fax: [phone]
E-=1h [e-mail]
T:rgent�D
Date sent:
or eview Time sent:
Please Comment Number of pages including cover page:
Please Reply^
Message:
L e!::� f-n

I :RICHARDSON CONSTRUCTION
FAX NO. :9108425597 Dec. 09 2211 12:13PM P1
3235 Seacrest Ave SW Phone: [phone]
Supply, NC 28462 Fax: [phone]
E-mail: parwa@atrnc-net
Richardson
Construction
FaxTransmittal Form
To go a-,
Phone: �J
Fax:
5;�:WDew
Please Comment
Please Reply
Message:
From wIfIL z9,4ord5r.�►�ti
Phone: [phone]
Fax: 91 Q8d2-5597
E-mail: [e-mail]
Date sent: 4-2-9—
Time sent:
Number of pages including cover page:

C Division of Coastal Mgt. Habitat Impact Computer Sheet
plicant: Permit #:
te:
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
5itat 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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other
so
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 ❑

WILLIE CLARENCE RICHARDSON
DBA RICHARDSON CONSTRUCTION
PH. 910-842-5596
3235 SEACREST AVE SW
SUPPLY, NC 28462-2589
Pay to the
Order of_ D w
arc
4926
-*die b1 (//��L 66-112/531
(/ b Date
$,--2G0 4k,
Dollars
FF.Iu.
D.I.IIF on
ra.
BRANCH BANKING AND TRUST COMPANY
1-800-BANK BBT BBT.
9130
For _., �� o 3 r—) -
1:0 5 3 10 1 12 11:000 5 2 L 5 21,89 2 7110049 26