56677D - Keine

�CAMA / DREDGE & FILL
3"ENERAL PERMIT Previous permit #
-New . ElModification F-1 Complete Reissue El Partial Reissue Date previous permit issued
sized 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 hed.
's
it Name A)Lk Leiv�c Project Location: County LI/
WL I �
UK Utk� I State NL' zip 146Z4
4(q)3-4 Fax #
red Agent
6 Y I
I CW 1— EW L2 PTA
0 OEA Ll HHF D lH
11 PWS: 0 FC:
yes,, no) PNA yes (—no
A Project/ Activity
ock) lengh
I jES L PTS
FJ UBA 1 1 N/A
Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
city, lly'� ZIP —2-�9L-
Phone # (11C ) 54c River Basin
Adj. Wtr. Bo N o, tal S (nat
Closest Maj. Wtr. Body ryla 'isi A /Al Wi
(Scale: I z
m(s)
—M
MMMMIMI
pier(s)
:ength
umber
ad/ Riprap length
:::::::::::-©::■:::a�
.......................■�.�r,,....�
,/g distance offshore
-iax distance offshore
zhannel 22b;( "X-1,
jbic yards
-mp
M
:i:■■■�■■■�r;��nl�
�r�:�ii��iisiiiiif::i
use/ Boatlift
■■■■■■■■■■■:
.ulldozing
FAMI
:::MIMI:::MM■M::iWA
MEN
MOMMEMEMMEMEMEMIM
MMMM1M1MMMM1MWdMrAMM
MEMEMEMOMMI
ne Length
no
gs: not sure yes no
wium: n/a yes
yes
Attached: yes
A
ling permit may be required by: cq' ❑ See note on back regarding River Basin
—1,U I-7V'r, -'1i I le-.cv, A, wd-PJ- I - — - J (. 1. - 11 . -.0. - I - I

MCD04R
North Carolina Depa Went of Environment and Natural Rmxwm
Division of Conn Management
Bemly ESMes PN*K Gave w Jmm K Gmgm, Wreclor On Freeman, SeaeWy
Date
Name of Property Owner Applying for Permit:
_2
Mailing Address:
SDI a Lz ,3�� s
I cer ft that I have authorized S�
(agent) Ma 1'l w� RYndbn " to set on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property Located at)
This certification is valid thru (date)
//
Owner Signature Date

�8I2011 13:45 9198948125 ROSE GRAHAM FUNERAL PAGE
AA re it; c ' P �...a ll L.... n,
(t.rat or 9 rok 4� 3ft it or PANd. CRy a C LN*) i
,era r�-°�'—
-~-_
rw omlLft �uw -
! he c "Iry I own pfvperty adJ0CWd td Me ob we natsnenaed propory,�� NVAwk
ywPP 'tl�ha has dest�R�ad b me as a m m an the atm*m
�►ve objecticaas d� tba� I�posat.. X bare � to lhis
ropoeal.
Kyo i ow dd owift tish ae inefto +
ad iraw�q�t d tld,ti ,+aa�iio��� f8 a"
Dp p w iapca�
wIs
go 1 Aft- ft" of by � ! mmur.
�_ .—.. �:� �+�..� its no 'S. ttfl 1
i unc q ar t tl s1 pier, dock, rnporhlp piArtps, br �'kM►AtX. �ostfxx�s. or Nft m
mini d et ix, 15' *0m ► Wargo of dpaam omm 11111im INS,
Irr rne.
weir o I duck you mmatjllw vw: appr*" b Wank I)1cdow.,1
G(,
{Prp� y
�n
pnw 4 r
�a a
q�s e
raw c
v4sh iD wohn ring 1 J ae6aok 1*qu&w, M.
AiOR wia�y �► tlrfC^"'� 1s rbl �a�k rbq�Jit'arl0fi.
..� ...
imgrit
M Willi-
04 r�
$0 bacit a
i wiah to l
i

Name of Property Owner:
Address of Property:
IA" 57 c5l,, r'-'
(Lot or Street #, Street or Road, City & County)
Applicant phone #: ��9� d 0 �3 Mailing Address: S��z ✓'�`'`J� �G��
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
>v 6 I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastaimangement.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been noted by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a
minimum distance of 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 I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
gnature
Print or Type Name
Mailing Addfess
�tlC .2
City/StatelZip
515?- hFo-,2 33 7
Telephone Number
.- 3��, Z/
Date
(Riparian Property Owner Information)
Signature
'&'Ilves-
Pffnt or Type Name
Y/)0& &/� 7W04
Mailing Address
17;41 i e /1 /✓ ,f- o't 75 0/
City/State/Zip
y/P_817— 7
Telephone Number
Date

�oQoSk-1
2�-
�UA�"LI
Rw
,ENE
11/
0 'A
Ste! I- D5/ln
k-44--A
17

Division of Coastal PAgIt, Habitat Impact Computer Sheet
)licant; Permit (O
Scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd 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
\f� '' 11
/W
Dredge ❑ Fill ❑ Both ❑ Other x
DredgeX Fill ❑ Both ❑ Other ❑S6-D
'K0
Dredge ❑ Fill Both ❑ Other ❑
96-D
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 ❑
I�s x I = l uq ` Ow

B AND B MARINE CONSTRUCTION
1168 COREY DRIVE
WILLIAMSTON, NC 27892
PAY
TO THE
ORDER OF.
06
BRN
DATE I
$ � Ge, 6,6
DOLLARS
® WA CHOVIA
Wachoovl�
FORa Bank, a d sioon_of Web Fargo Bark N.A.
�I� l(1 b —
1100 110 511' 1:0 5 3000 2 191: 20000 54448 70011'