54018D - Bullard

CAMA / DREDGE & FILL
rENERAL PERMIT Previous permit#
New _Modification -Complete Reissue ❑Partial Reissue Date previous permit issued
)riz@d by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ es attached.
it Name ? _,,A 1 AJ LAJ(� Project Location: County Lug
State 1`}-- ZIP-2
#dfio)31S '-11991 Fax#( )
ized Agent{
d CW EW 1PTA ES -IPTS
C OEA ❑ HHF IH ❑ UBA —1 N/A
C PWS: ❑FC:
yes � PNA yes fi� Crit.Hab. yes / no
Project/ Activity t4'y5 a /
jock) length
rm(s)
pier(s)
length
camber
ead/ Riprap length
ivg distance offshore_
nax distance offshore
channel
:ubic yards
anip-
i
e/ Boatlift
Bulldozing
ine Length
not sure yes
igs: not sure yes
onum: n/a yes
>: yes
r Attached: yes
ding permit may be rt
Street Address/ State Road/ Lot #(s)
Subdivision
City %: /VDU N} zIP_9-0
(
Phone # CF
River Basin
Adj. Wtr. BodyC ROE C '✓ na
Closest Maj. Wtr. Body w J
(Scale: / p

� p� CA-K,a-., CAS, 6 CO , N%
I
ini
41)
DCM WILM�NGTQ1,.�.___

12^A611 14n_I= purwxAw/^o u++'vo + 911.31si�17�2
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g-1
v

Ok,12011 14.,25 Purchas i ns Mice > 'OiMrgi?502
.320
ADJr?.0 EN. T RIPARM-N YROPERTY OW-NER 4
'(FORAPIM3100RRE GPI.2-NGS/B'OATLIFM
I hereby cerfttthatl own property adjacent to /AN4�
(came of
property located at. vs
(Lot, Bloc , Road, etc.)
Oil 3n
(Waterbody) (Town a
LiE iZ
ITH0LIU)
&Z-44'Ab
aperty Omer}
'or County')
He bas described to me, as shown below, the development he is proposing that location, an
no objections to lus proposal I understand that a pierlmooritlg pilings 1 bo I boathouse m
rack a minimum dastanoe of fifteen feet: (15D from my area, of riparian ace ss tmless waived b
(If you wish to waive the Setback, you must initial the approp ate blank below.)
I do
I wish to wive that s�thack requitement ---------
DESCRIMON AND/OR DRAWING OF PROPOSE D
(To be felled in by individual proposing deve pr
gee - a ttr
C;EIVE
Dln��-M WILMINGTO q , NC
If you have objections to what is being proposed, qoa must notify the! Dicv si6n bf C astal Managemcat i
within 10 days of receipt of this notice. Correspondence should be n1a.Hed to 127 Coirdinal Drive Eat V
DCM representatives eau also be contacted at (910) 796-721S_
No arse is considered the same S.no ob'ec�on if ygq have been, iotified by Ce ed
(Information for Property Owner(Applicant (Piparian P perty Owner info
Applying for permit)
�� L
t1�11itin$ Address
f have
t be set
me_
wt
r
51gu m
0rn

ADJACENT RIPARIAN PROPERTY OWNER STATEy1EIN T
(FOR A PIER'11-IOORL-V-G PILLVGSIBOATTLIFTIBOATIIOUSE)
I hereby cer+sfy that I own property adjacent to
(Name of Property Owner)
property located at �e- iys
(Lot, Block, Road, etc.)
on _ZGk/fis/ , in �i4.P.�L/�e/.f —Be4 c, N. i
(Waterbody) (Town and/or County)
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 / boathft / boathouse must be se
back a minimum distance of fifteen feet (15D from my area of riparian access unless waived by me.
(If you wish to waive the setback, you must initial the appropriate blank below.)
o not wish to waive
a wish to waive that setback requirement.
------- --------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
RECEIVED
XM WILMINGTON, NC
JUL 1 8 2�fji1
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in w
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ezt, Wilmington,
DCM representatives can also be contacted at [phone].
No response is considered the same as -no objection if You have been notified by Certified Mail
(Information for Property Owner/Applicant
Applying for permit)
6;09 Cfn�,,¢ Z -
Mailing Address
City/State/Zin
(Riparian Property Owner Information)
a.
Print or Tvne Iv

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue ,lames H. Gregson Dee Freen
Governor Director Secret
AGENT AUTHORIZATION FORM
Date: ZJ01
g2me nf Property Owner Applying for Permit:
Dwner's Mailing Address:
laoq �,✓.w �! v�
-!��Ui✓A- �fi4cfi
i✓c Z,S, �
Phone Number (90) Z3
Name of Authorized Ag nt for this project:
J
Agent's Mailing Address:
W ► 22— Q.PAkov
Phone Number (!a(a)
I certify that 1 have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
.tr.6+Fr .4r- *W exia ri,✓c �.Ee. ef- o 2)
(my property located) at 4,e�af �✓� � ���^/� � uf; A/C zflk-f
This certification is valid thru (date) 7 3 1 41Z
G���Grto( 7 �1�/
Property Owner Signature Date
0"TON, N
JUL 1 6 ' "-J I1

Permit #: , � o /1
L
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
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)
O
Dredge El Fill ❑ Both ❑ Other �
/ 3 L
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 ❑

FREDERICK ALAN TEDDER
642 HALLSBORO RID N [phone]
HALLSBORO, NC 28442
7941
66.19/530 NC
1853
Date
Pay to the l7, F 1 $ ZUDJ
Order of
17Lsr40oe ,•- �v//"� a Dollars a �,
Bankof America -04*00-
ACH R/T 053000196 Bank of America Advantage®
el0y Pr-1161k
For *r 4 /� � �''�' (f it)
1:053000 L961: 000650690936,1'794 L