57368D - Michael

CAMA / DREDGE & FILL
aENERAL PERMIT Previous permit#
New * ❑Modification ❑Complete Reissue ❑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 74 . 11 O v
ules attached.
it Name j i ri 1a 1 C. lr� A 1 Project Location: County f�29 U WSM j C jL
4 j qg12ZL Street Address/ State Road/ Lot #(s)
Statef(, ZIPa (o
(_ ) ❑�5—Lk,j,1Fax#(_)
:d Agent
- �� 4'� t [ t.' it t �•:^� �� � K C
❑ cW
❑ OEA
❑ PWS
yes/n,5�'
EW PTA DES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ FC:
PNA ::d�P/ no Crit.Hab. yes / no
Subdivision
CityQA !(-��- ZIP
Phone # ( ) River Basin CAYE
Adj. Wtr. Body Vii V."/
Closest Maj. Wtr. Body A J W W
�f Project/ Activity w C! t N (` NK 11" 1--1 1 t 0 L- K-tk�fl L MNQ& N1?1) G� L11 �TL
(Scale:
iock)leneth
pier(s)
length
camber
-�d/ Riprap length
wg distance offshore_
nax distance offshore O
channel
:ubic yards
amp
)use/ Boatlift
Bulldozing
ine Length
not sure
yes
no
igs: not sure
yes
no
>rium: n/a
yes
no
•
yes
no
'Attached:
yes
no
ling permit may be required by: n A K (S 1, AN ❑ See note on back regarding River Basin
/__SDecial Cnnelitinnc a.•. . t` "114 Ak C-n3- 4m- -2 / Y?C1oti

,n' ysrican Fish Company
t
P.0 Box 11046
Southport, North Carolina 28461 INVOICE NO
rnad APCO3600@aol corn
(910) 457-54a
(910) 457-655
A Tc\,Y°
r
02 i

.SI( dFISHCO 9109576551
1.
Wf )rk C
Name of Individual Applying For Permit,
Address of Property,. i)2-- CWAI0�
(Lot or Street 0, Street or Road)
1V.ins W
{C'ry and County)
PAGE1
cc.
l hereby certify that I own property adjacent to the above- referer,:ed prapc-11, The ►ndividuAt
applying for this per;:itt has described to me as shown on the amichec: deveiopmemthev
are proposing. A description or drawing, with dimensions, shovid rev: Jeci with th;s letter
r-k" , T l have no objections to this propose
jxr-C 13
It' you have oibjectioris cc what is being proposod, please write ti)e D„ i:w.. of CdAS.M
Management, 127 Cardinal Drivo Extension, Wilmin.poil, NC r 4051- or c:ih 910-74-7115
wlrbi❑ 10 day5 of rctoipt of this notice. No responso is considers + the ss me -,s no ob)CLnan i(
:rou have been notified by Cerd lod Mail,
WAIVER SECTION
i uaderstand that a pier, bock, m.00ringpilings, bran lnvater, beat ,oasc or on, t liftrnustbeset
bCk a minimum distance of 15' from cry area of riparian access • u1) wul\ e.d by me. V rda
wish to waive zhe setback, you must Initial the appropriate blark
do wlsn to Nvaive the i setback
a is:n to waive the : se;bacf:
Nov,
Tit _
?tint Name

Name of Individual
Address of Properly;
i O' 4i'.Yebb'si
lying For Parfait R 1 MOI
1
or Streec #, Srreet or Road)
(City and County)
I hereby certify that I own property adjacent to the above•refercnced properry The ind►v+c
applying for this permit has desarihed to me us shown on the coached drawing the devfst*prm J
are proposing. A description or g, with dimensions, should be provides: with this ledet
k cK T have no objections to thu propose;
k+crt A
ti' you have objections to What to being proposed, plea9e write the Di+ iyirrr1 of Cox
MaGolemant, L27 Cardinal Drivo Extension, Wilmington, NC 28405 or c-311 910•796-1
witbin ID days of receipt of this notlal. No rospottse la considered the some as no ob)ectia
you have boon notifiod by'Certif4od Mail,
WAxVMR SECTIOIN'
I uaderstund that a pier, dock, mooring pilings, breakwater, poet hQusc or boat lift?" tstbt
bcka minimum distance of is, from my area of riparian access- unless w,,0%r4 by me, If
rvisb to Nvalve the satbock, you Must initial the appropriate blank beiow,.
�f+ q� ? do Wish to waive the 15' sccback reo�iren'en:
1 do mat wish to waivo the ii' setback requircm.cr.c.
Print Nrme
.I'7. .
-Arli";A

North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Mirhael F Easley, Governor James H. Gregson, Director William G Ross r
Authorized Agent Consent Agreement
pR-� PC-f- C"4 is hereby authorized to act c,, my L:
(Pnnt d Name of Agent)
order to obtain any CAMA permit(s) required for the property listed below. The authorization is (unite.:
aecific activities described in the attached sketch.
OCATION OF PROJECT:
�j C) („
T5(Cnd
IROPERTY OWNER MAILING ADDRESS:
/i
` r
PHONE NO V " 7-1 v v � 0 1
AUTHORIZED AGENT MAILING ADDRESS:
-�(a00 o1'D T-'4.
�S"W -k �\' C • `xci tw l
`tq3- %04S C.
PHONE NO. "tk0-4S-1-S4tS'8" w
Signature of Property Own(
Signature of Authorized Ag

Division of Coastal Mgt. Habitat Impact Computer Sheet
Iicant: ,t�j ( C ttfl PEA, 1)�,J�
Permit #: S7k(g
cribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremeni
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 fina
disturbance.
Excludes any
restoration andh
temp impact
amount)
11
`►'K�
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 ❑

16-714312531
50p 1 �7
OOgg 3