56568D - Taggart

CAMA / DREDGE & FILL
ENERAL PERMIT Previous permit #
New Modification Complete Reissue -Partial Reissue Date previous permit issued
rized ` Y thev)tate of North Carolina, Department of Environment and Natural Resources
oac;tai Resources Commission in an area of environmental concern pursuant to 15A NCAC
ules attached.
t Name ( Cti` Project Location: County j���ncL( r
2 AbrL LAKk Street Address/ State Road/ Lot #(s)
State N C ZIP LE i,i� - ' _. 1 _� • h i lA ySt 1] kV A
r
Fax# O Subdivision N Y
zed Agent !t'`F t /" r'-k (�, City _ 1 _ ziP�
CW -1 EW /PTA ❑ ES PTS " River Basin
j P❑ OEA ❑ HHF ❑ IH ❑ UBA ; J N/A
Adj. Wtr. Body G l Y1(k nat
❑ PWS: ❑ FC:
yes / no PNA yesclo�)
Crit.Hab. yes / no Closest Maj. Wtr. Body
Project/ Activity
kcr(s)_
length
umber _
x
x
:ad/ Riprap length
vg distance offshore
iax distance offshore
channel
ubic yards
unp
ruse/ Boat 3 X 13�
Bulldozing
ne Length
not sure
yes
Snogs:
not sure
yes
Oum: n/a
yes
no
yes i no
Attached:
yes
no
P
(Scale: I y/
ling permit may be required by:
❑ See note on back regarding River Basin i
L f 1 n ,. e-:" I— . _ A 1 < f! — I .

vial
' M

� 1 ` v Oir(LT "A3 2 ?(a
_..7- L
7`xY'
DG
�c
,.a

���
NCD04R
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
hael F. Easley, Govemor James H. Gregson, Director
Authorized Agent Consent Agreement
William G. Ross Jr.,
.� Ba)C: L r= ( is hereby authorized to act on my be
(Printer! Mww of Agpn )
rder to obtain any CAMA permit(s) required for the property listed below. The authorization is limited
cific activities described in the attached sketch.
CATION OF PROJECT:
OPERTY OWNER -MAILING ADDRESS: -
PHONE NO.
THORIZED AGENT MA LING ADDRESS:
PHONE NO.
,nnh vra rtf Pmnwrty f')Wnt-r ;t C'

POEM
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
chael F. Easley, Governor James H. Gregson, Director
Authorized Agent Consent Agreement
William G. Ross Jr.,
1 )1- + t��/Ct L ► is hereby authorized to act on my be
(printed Name of Agent)
arder to obtain any CAMA permit(s) required for the property listed below. The authcrization is limited
;cific activities cescribed in the attached sketch.
CATION OF PROJECT:
06 C Ito-
r
:OPERTY OWNER MAILING ADDRESS:
Z /J C 41,-h,.
PHONE NO. 7 / ? d fd -!r �Z- I
)THORIZED AGENT MAILING ADDRESS:
PHONE NO. 91 0 !�U Z 3 /
I.. __ — ,.-..- --- 0im,. - --- -'*'

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL M.kNAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATENIENT
dame of Property Owner:
address of Property:
applicant's phone #: q 19 S so - ?j (� a
(Lot or Street #, Street or
Mailing Address: _.i,i rr�rJ , }�Xf/
42?.Sn-a
hereby certify that I own property adjacent to the above referenced property. The individual applying for this perr
ias described to me as shown on the attached drawing the development they are proposing. A description of drawil
vith dimensions, must be provided with this letter.
I have no objections to this proposal. V I have objections to this pr posal
f you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM
n writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive E:
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
onsidered the same as no objection if you have been notified by Certified Mail
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distance
5' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the
ppropriate blank below.)
I do wish to waive the 15' set back requirement.
I do not wish to waive the 15' set back requirement.
Property Owner Information)
Q04A
signature
'rint or Type NAme
. a\ 0 _p1 t 1 b f
Mailing Address
(Riparian Property Owner Informa 'on)
ignatu `
CAP
Print or Type Name
Mailing Address
—T15 mod] (�-- I—\C- 'Z
d'w_. All n7rn-1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/VIOORIVG PILL- GSBOATLIFTIBOATHOUSE) nn--
l�
I hereby certify that I own property adjacent to RMM tA l — 1 '
(Name bf Property Own r)
property located at o-\ ?) U .
r (Lot, Block, Road, etc.
on �Z1� (� �•a,,ti..��1 , in N.0
(Waterbody) (Town and/or County)
y
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 pier/mooring pilings / boatlift / boathouse must be set
back a minimum distance of fifteen feet (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 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)
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in wi
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Est. Wilmington, I
DCM representatives can also be contacted at [phone].
No response is considered the same as no objection if you have been notified by Certified Mail
(Information for Property Owner/Applicant
Applying for permit)
la\0 G04mNE_V #II/
Mailing Address
i\QQ , �� q-7 5-0 a
(Riparian Property Owner Information)
Signatu
Print nr Tum- Nae

Division of Coastal Arl9t. Habitat Impact Computer Sheet
)licant: m Permit #.- e:.
>cribe 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/oi
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
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 ❑

DELTA DOCK & BOAT LIFT
PO BOX 3532
TOSAIL BEACH, NC 28445
/
DATE ' _
PAY <�
TO THE
ORDER OF
8247
66-30/531
365
Zoo
DOLLARS
D-U
First Citizens
Bank
e fins.com_ r
FOR / /1 �G f± '�� J6 qp ✓�Et/��✓ _ _--- nr
iu rl r1 D 711 rl o■ ..-_...._____..._—__.--