57443D - Batts

CAMA / DREDGE & FILL
'ENERAL PERMIT Previous permit#
]New Modification ❑Complete Reissue Partial Reissue Date previous permit issued
ri7.ed by the State of North Carolina, Department of Environment and Natural Resources —7 tt
oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ` 1-
❑ Rules attached
t Name T-"&:V' S
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:ed Agent
CW [7EW )PTA ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA Ll N/A
❑ PWS: ❑FC:
es no PNA yes /(D Crit.Hab. yes / no
Project Location: County ft�kt • - • -
Street Address/ State Road/ Lot #(s)
7;,6`% U u7t Fr. L p o
Subdivision V-tN4S („A-1'Jpi'NS6—
City !� C15T� zip z k
Phone #)�-Zjs� River Basin
Adj. Wtr. Body � ' VJ K (nat
Closest Maj. Wtr. Body TbP5# ft. 5- U IJL
f Project/ Activity y., S4 v t + F3 0o�'�' I ��" � � �_ a ,�Ja � �
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ng permit may be required by: �4/`� GQ ❑ See note on back regarding River Basin n
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to G-E R P J_ > B R AT5 's
(Name of Property Owner)
property located at
(Lot, Block, Road,
on 3_ (z Ly , in Ts -A M A 15:c A , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: q/ 0 — 6l.2-05/GMailing Address: C 1.IL Q T 1,00P
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) �
AbD *Bc,F4► C i F i c�ti tV(-'I-
(Information for Property Owner Applying
for Permit)
36� c-,)Q�c
Mailing Address
Property Owner
... ► re:«

11'r, ■ M IS ■ 1 110a ■ man 01■1 111101111101IRV4011ime 1011M
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 6 E C441-D ,R A TT5 's
(Name of Property Owner)
property located at .5 6 y n 1_D E& i a► i Le c
(Lot, Block, Road,
on ? C Ll: , in AA in RsTii A D , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: Mailing Address: 310!B L Q) G IPQ io '
14 iR rn 12ST--k bx U � C_
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 befilled in by individual proposing development)
Obb
�.DC ci— �X►STI�a� P��R
PIE?
(Information for Property Owner Applying
for Permit)
(Riparian Property Owner Information)
'3b'W 0tIk
1 ! •i• • I 1
C

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 9, 3 0 -- 1 /
Name of Property Owner Applying for Permit:
Mailing Address:
3 to Y CA —IL pG i w j �O p e
la ftMQ as4!. 3
I certify that I have authorized (agent)
411i'P, , 7ei n %i e
to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) /0L/�
at (my property located at) A0 L? L'91rlce f f Zoo p
This certification is valid thru (date) 1 Z .3 % — l (
Ns
Property Owner Signature Date

ilicant: r�A
/7 /I/
Permit #:
cribe 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
nee">at t/!
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)
GLl
Dredge ❑ Fill ❑ Both ❑ Othe�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 ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

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
ORDER OF
MEMO
C i5r� R-0
et 6) n
J
11.00459711' 1:05300019GI:
000 68 4 7 4 3 7 3811'