57484D - Hall

-'CAMA DREDGE & FILL
GENERAL PERMIT Previous permit #
iNev;*- LIModification El Complete Reissue E Partial Reissue Date previous permit issued
wized 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—
Rules
itName
Sta:4,L ZIP L-1,
Fax#(_)
ted Agent
- Cw
-EW JPTA ES LJ PTS
- OEA
'HHF 61H F UBA D N/A
- PWS:
yes / no
1:1 FC:
PNA yes /(nq Crit.Hab. yes no
F Project/ Activity
Project Location: County
Street Address/ State Road/ Lot #(s)
-7 Ci
Subdivision NIft
City U(JUA, ISU, MtL1 v zip Ift
Phone# (A) ILYOM River Basin UVII
Adj. Wtr. Body 4t� At, � 4 (nat(/
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yes
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'Atached: yes no
.ig permit maybe required by: -11RIM-IMPA
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ug 25 11 02:24p 3W275%25
001 4 J/ Gull L l . V77 71 D / ,3""t wi
Not#h Carolina Depadn
sevedy Eaves Perdue
Govarrtor
Name of Property
rAOwnerApptying for perm
Ovdrm's lisafling Address=
Slo a rnnL�u
Phone Number04W- - +c- )I-
i Certify that i have authorizad the agent
ror and obtalning-i-CAMA Pormids nea
:my property tocatMd)
Th s cerliiication is v9lid thrj (date) 1
Pro owner Signature -
6W27%825 p.1
urrL%&- utruf rWjr- 011 C
nt o �ntiifr matt artd Na l ai Resources
e ofi IViatlagemerst •- - � - . .-
James Ft. c�gso,i Qee F�aman
Oirecbr SscretM
,UTROMZATiON FORM
i
Narn$ og of �'AJgen(t for this ..gr4ect
Itlaitirwg
1.4
Pkgne N,wc qr
above to act on my behaIt, ftIhePLwPG3v01 39O&S
to irmW or corWruct the laAwing (ash').
Date
46 (A? I©"' �- C?46

ug 25 11 02:31p 3362755825
VbJ tU/ 1Vi J. il. V7 :m V rUVVL]D
US MAIL
DIVISION
ADJACENT WAS
Namc of Property Clwucr.
Address of 1 zopeny-
3W2755825
urrLI-C ucvt
t or Stmet d, Sutet or Read. CitY & Coutrty)
Ilppl;cant's phoael �Il(611Rig Adtlie oaf Lei(Ja
� � 33(� � �►� -SJ�'�5
( hereby �tti fy dtai toar� property aeijeccs�t tv � abwc tQ6a�rced psoperty. "fine iztdividual applying for this permit
Iva described to me as shown: on the amftdted Brewing the developmery they are pr osing. A clssrxiptivrt o: cisawi�►g,
,with 4 pmmig u. mig his lc.
-6f—A- I have no objectiorm ou this proppsat. Ittavc joctioro to Ibis p=posa2.
1f ycFu bsve objections to what iA being prepieicri,710 must 40fify the Division of Camtrd i6laa gMeat (DCK
in w itt9ng within 10 days of receipt of this rto�dm Carresposrdenm shoisW be ilea to 127 Cwdiuni ©rivetxt.
Wilmington, KC 29405-3345. DCM reymmnw atives ma MW be enulncted stt 0) 796-7215. Ito tupoax u
F-1
r-"Ur- uvr rr
WAIVERSEC'IION
I tirgdeiststtd thatm pica, Back, rttoo[ittg pitirtg brtak�vatt•t. ltoithanse, qr ►ift m a setback a mwimum distance of
1 S' itam lay arre of tiparian arcess up less wRiby me. (If you wisl► to wai-;e setbw you itaast is (ial the
appropriate blank bdow)
1.40 wish to waiW the IS' set h k requirement
I do Rai wish to waive the I S' s back requirement.
(Property -Owner
(.Riparian
Print or Type Nome Pitttc or Type N
Ct3 D �r .✓ S +: ip�o
Muting Address Mai Iing Addn
Lci
City / state I zip ) City I stax t x_
Cell
TeicphnncNurnber — CI /O —ate — ��'� 3 TelepitoncNui
pate
4 n7 /,....IL...t r"a C..) klf.";nn►nn RinAh J"a-A— 0
Owner fnfurmation)
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r

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tVA 1 , _ u D 3362755KS p.2
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U5 MAI
DIV ISIONf
A DJACEKT WAR
R
Name of Prapctty Owen-=
Address orF2L Mty-
+1pPiicint•sghonEat����+
Gcro lt
berrby Minify that I own aroperq, „djacor
has described to Me AS shown on duaftnh
have no obkxU m5 to this p
If yGa hmm obpectivoa eo Wilat is bauag pre
a writing within IQ fts of rectipt of the
WVmis+Rean, NC 2860S_384.S. DCI crm
l mda'aand EMtapj v. ftck, rt o aB pili
I S' from �• a�ett of riparian m�c� uniess
aMmprilp bW* below.1
) w ah to vwaive the 15' set
X19—y"'J"da not wsh to %mere the 15'
COASTAL MANAGEb91 NT
i PROPEI ("MIT 0rA7F.Nm_r
" L L
r Stmet:l, Swet cwRoW,
Mailing Addmu:
M9 :he 8evel0pen
I to
yuo must Got* the Diane
C*n'emmudenae shoeld
res damn atso be eowuW I
A{A�: _
i CR uml
/r_c. _q"-7y o
cl appl*g (QV dlis peYmit
dascriation of k2 g
objoctwrns to thisproposai.
of CouW Maungentnt OX2MQ
Woke. to 124 Candies! Dvwe TM.
910) 7K-7215_ No respupw is
i!-
VArVE>R. SEC WK
,r+e�baathaAn or II ft be set Lmek ¢ vido s+m distance of
sd bytes. (1f you wish A waft a wb;%*x you min: iwtw me
att�tircn�
cW
beck �equizeritecn r
twpari aw P"paarty 01wwr 1R&rma**A )
uaman"Ner
` 5ieestvre
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PTIM or type Name Prins orr TY; a T1
MAlti(jg a►ddSG69 I Wiat A Adn
i
La kW-y- I -
City 1 State / zip City f State ! ,
sit
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Division of Coastal Mgt. Habitat impact Computer Sheet
ilicant:•/ 1 T-7W Permit #: 53-gLl
9 /-Zb)
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)
Dredge ❑ Fill ❑ Both ❑ Other ❑
t
I U
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 ❑

JRW/RDW INC
DBA WEST DOCKS CONSTRUCTION
174 CHURCH ST. NE
CONCORD, NC 28025
DATE
PAY
TO THE ( f
ORDER OF
FIRST BANK
OCEAN ISLE BEACH, NO CAROLINA 20489
FOR ►� r ! "Tx�� �
11'000 2009311' l:053 L045681: 79 L 0 0 L74411■