56674D - Benton

CAMA / DREDGE & FILL
ENERAL PERMIT Previous permit#
'New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
>rized 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 f f-j l L�
Rules attached.
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ling permit may be required by: �P( /1�(�� ( ?�,�ll� �� (l (ice ❑ See note on back regarding River Basin
------.�••---.a..... -IU I girt, /I.AA "tI1 14Ai''T1w �YJ I, r,,_ CnAr -rI 1.-/..II--t-' -

02-19-11;14:36 ;Sweet -Berry -Farms
19102703374
NCD�IR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Pedue. Governor Jarm H. Gregson, Director pee Freeman, Secretary
vate -- 2- 1 S I t 1 --- — --
Name of Property Owner Applying for Permit:
M2iiing Address:
•
I certify that I have authorized (age*t) ._9jL� ___ _ to act on my
behalf, for the purpose of applying for and obtaining all LAMA Permits necessary to
install or construct (activity) P
at (my property located at) l n,n r�yt��it� �vol `rriD l �, r►�c � /��
This certification is valid thru (date) -_ .�
Property Owner Signature Date

4 1107:41 p Microsoft
91 U-bb9=132 3 p.2
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOAIZIFTIROATXOUSE)
I hereby certify that I own property adjacent to ZYt,&" e i�c�n �rrJCl 'S
(N me of Property Owner)
property located at /0 / 4 Cc, r,>1, ky- B 14
(Lot, Block, Road, etc.)
on , in 1 opScc N.C.
(Waterbody) (Town and/or County)
Applicant's phone fit: /° ?� -2075' Mailing Address: / 9 a Z j NL. r1 w E
1y4n AC.e ��/L 28yy7
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 pierimooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (1T) 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)
(5-e-e, )
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
(Riparian Property Owner Information)
/,l n
L
Signature
Print or Type Name
n— . . — A — i

s
JSPS - Track & Confirm
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Label/Receipt Number: 7010 1060 0000 8473 6838 -- -- -
Expected Delivery Date: February 15, 2011 Track & Cordirm
Class: First -Class Mail® Enter Label/Receipt Number.
Service(s): Certified MailT"
Return Receipt
Status: Unclaimed
Your item was returned to the sender on March 17, 2011 because it was
not claimed by the addressee.
Detailed Results:
• Unclaimed, March 17, 2011, 11:11 am, WILMINGTON, NC
• Notice Left, February 15, 2011, 3:53 pm, WILMINGTON, NC 28403
• Acceptance, February 14, 2011, 2:27 pm, HAMPSTEAD, NC 28443
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Division of Coastal &19t, Habitat,lmpact Computer Sheet
Dlicant:Q► Permit #:
te:
31 N/►
Scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
Ditat 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
1 LOO
0
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 ❑

ALLIED MARINE CONTRACTORS, LLC 08-03
910-367-2159
92 HAROLD CT.
HAMPSTEAD, NC 28443
PAY TO THE /j (f I r p
ORDER OF f V /�/ /C..
Bank of America
ACH R/T 053000196
MEMO
/B -
$ /00
118 0 0 4 3 7 5111 1: 0 5 3000 19 6 J: 000 68 4 7 4 3 7 3 8 lie AUTHORIZED SjGNgngE

HAMPSTEAD MPO
HAMPSTEAD, North Carolina
284432174
3613950443 -0098
02/14/2011 [phone] 02:28:19 PM
---- Sales Receipt - ------
Product Sale Unit Final
Description Oty Price Price
WILMINGTON NC 28403 $0.44
Zone-1 First -Class
Letter
0.90 oz.
Expected Delivery: Tue 02/15/11
Return Rcpt (Green Card) $2.30
Certified $2.80
Label #: 70101060000084736838
Issue PVI: $5.54
Total
Paid by:
$5.54
AMEX $5.54
Account #: XXXXXXXXXXXX2007
Approval #: 519158
Transaction # 225
23 903231785 4324705532
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$5.54 1 02/14/2011
O Sent To /�
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or PO Box No. 136 E
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