57325D - Baker

'CAMA/ DREDGE &FILL
3"ENERAL PERMIT
Previous permit #
New Modification - Complete Reissue . Partial Reissue Date previous permit issued
)rized by the StO-e of North Carolina, Department of Environment and Natural Resources
V
Coastal Resources Commission in an area of environmental concern pursuant
to 15A NCAC
it Name
Rules attached.
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-19-2010 11:12 From:DCM MHDCTY
To:919103470748 Page:1
r,lop
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to R t- C-harJ Bo ILL r
(Naitie of Property Ow
pe0r)
✓property located at _J 3 3 _.!� ljl5f L W✓� l-t%+ h� s Soec"AA F&/VY /VL
(Lot, Block, Road, etc.)
on GV\GI r , in n /✓ an 510N c .
(Waterbbody) (Town and/or Con )
Fe
Applicant's phone #: I �d J- 03 r Mailing Address: 9 S neGj
He has describers to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To heJdled in by properly owner proposing development)
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------------ --------- ----------- ---- =_-_--------------
(Information for property Owner Applying
for Permit)
P o L�c��L IU -
Mailing Address
5n s f A 4� 0
City/State/Zip
r
f�c ' 5 Prop. 1.i+1C
--------------------------------
( ,Ow_ur4F-hrf inadon)
Signature
►
Print or Type Name

From:Treasu•e Realty Sales 910 327 2035 05102/2011 09:14
#377 P.00210
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA Ply'R/WOOJUNGPJLDVGS1DOATLIF7YDOATI•IOUSE)
I hereby certify that 1 own property edjncent to R I -C_ 4til e",
(Name of Property %vnerl
pre pert'y Ioca�ed at / 3 3_ _ i''1 t`s SSE Cove, Lone 6.nNe A FF//x�vr✓
(Lot, Block,
1 (Ilk-
Roib etc.)
(Waterbody) f (Town undlor unty)
.appliennt's phone ii .� 10WH 31-mailing Address:
Sn�o.ds ?d C-a�
Ne has described to me, as shown below, the devclopment he is proposing at that location, and, 1
havt no objections to his proposal.
,ram (r.
kIN
l DESCRIPTION ANDIOR DRAWING OF PROPOSE, D DEVELOPMENT,
(To helffled in by properly owner proposing development)
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L%nt
W-,")6
F,
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- ............................................
(fnrarmation (nr l.'roperty Owner Applying
for Permit)
{ailing Address 99
- 5A 6-kcG PU-try 001 6#_
0.11paritan Prop rtyOwncrInrormution)
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.9-2010 11:13 From:DCM MHDCTY
To:919103470748 Pacje:4/�
NCDENR
of Envirc)nmer,,, a
Divisii�.r. of Coastai Management
3eve!v Eaves R�rdllm: James H. Grepon, Oiractor Ge-p F!"frwr,
Date Ll /3 0 as 11
Applicant Name R t "t t/^ , C, �--- L-J; 0 �q
ID
Mailing Address
OL
I certify that I have authorized (agent) - P-C-4-67k/... M14 /I 6TVI to act Oil my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) LA I i C7 5 if
at (location) —
Coil,& Lcl,,(--
n&"ds, Feoyy
This certification is valid thru (date) TL,, A(-, 0
Signature

Division of Coastal N19t. Habitat Impact Computer Sleet
alicant: a �i�(.�-✓ Permit #: o cJ �Z<
Vie: � �r
scribe 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.
)itat 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)
Ov v
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
(o (P kZd :rC�S

R. BAKER 111
INVESTMENTS
PO BOX 389
SNEADS FERRY, NC 28460
Pay to the
Order of
First Citizens 9-V2 c) cal)
Bank R;.�-r L
.:
sz-3'�66-9U,45 ITV /
OC 467
Date
firstciittiiz�ens.com 1
For___t/ 3a I I I y, i I} t' i Cv y e S ' PS
':0S"00300':004577524480u9 00566
s ano"
B.ck.