56640D - Williams

' CAMA / DREDGE & FILL
GENERAL PERMIT Previous permit#
-111evT. ❑Modification ❑Complete Reissue El 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 I SA NCACr/Q�
IrMules; attached.
it Name��
. c�r1
f1�l44*1 $
State__ ZIP ti
Fax #
:ed Agent
— '' f? �.�
f' ►+ 1
EW
PTA ES PTS
❑ OEA
❑ HHF
❑ IH ❑ URA ❑ N/A
❑ PWS:
❑FC:
yes /(o
PNA
yes /(9 Crit.Hab. yes / no
of P rojecct/ Activity C
ldiFf�/t t
Project Location: County�i
Street Address/ State Road/ Lot #(s)
9!V /"l A!l* 4� I )Y/ ✓t
Subdivision
City %/VI^/,j� �'/�/Ae % /,�1; ZIP
Phone # O River Basin
Adj. Wtr. Bod(nat
Closest Maj. Wtr. Body
,a 4&
(Scale: l �.
■11■r!/1'■1■■■■rar■■�i■i■i■�■I■���I�ir■a■
length
iumber
ad/ Riprap length
/st�NC!Y�/�■■
%
■■��1■11111■■■■■■■■■■■■■
■■MEN■
MEN
►�I�■MPEN
�:
HMEN■■■■■■■■■cwa
NMI
■I■1■■■■■■■■■■■■NNE■
-vg distance offshore_NI='r1111A
nax distance offshore1"P
1111N11■n1Iil'�TG��INIlls■■11M:IImil
\101111■I11■1CHI■■■1■■■■■■■■■■■■■
1011151111,■/I�■I■■W1.
U
'it■■■■
I�111■III■I
NOON!
NOON
NOON■■
channel
1
if■III■111■■■1�■■■
■■■■■■
i/II■I.�I:I�MOI,rt'"'==:_;
; __'.■■■E■IE■■■■■■■■■■■■
:ubic yards_i
UnpNOUNNE■EA1%
w
RUN■iNi■■■■■IEEE■ioE■i�EEE
■■■■I■.z_;;.,mm.1■■■■■■■■■■■■■
iluse/:..
■■■OMEWIS
■'MN■■■E■1■■■■E■■■■■NEENNE
■11■■■:iw—ifin
■■Na■O■I■■■■■■■■■■■■■■■■
■1■■■
INES=■■!
■■■■■■i■■E■■N
OMEN
■■■■
NBulldozing
M
II
MW
'
■u■Nu■■YIOm►mNN■ommi
mew
imn■■►E1w■■�:�:
■■Ly■■1'r!!■■Lr\■�a■■L!a■■I■i�■■■Il■■■■■�i■■l�■I
Lengthnot sure yes no
not sure yes no
no
yes no
Attached: yes no1■■E■E■■■EN
■11-��■■H�■■►_■■■
■■1■Ir■uN�7�N■■
11■rOOi■■■■■ii■■■t��j■■■�■■■■wiw■■■■s:
1■O■N■O■■ONO■■■■■1■■■■t3:�iZZ'!G7©!��''/.II
1■■■■■NONE
MENO■■CME■O■■NEEI
ION■■E■■■■■■■
MENEN■■■■E■■■E■EI
1
■■■ENE■■
11fE■1IYi��1■�■AIII■■
NOON■
OI
.7.!
mom
■NOON■
i�il1■Sr�'■iiiiWt■WMLaE■■■■E■■■1
ILI
■N■■■■■ENE■■■ENN■E■O
ling permit may be required by: 7AW k7 611 �i�yN li/�C� ��i� See note on back regarding River Basin

0r
ete
erse
piece,
A. Signature
X �{ , c — ❑ Agent
l� mod— ❑ Addressee
B. Received by (Printed Name) C. Date of Delivery
D. is delivery addre> dHT"nt from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑Certified Mail ❑ Express Mail
13 Registered 0 Return Receipt for Merchandise

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
;everly Eaves Perdue ,lames H. Gregson
)overnor Director
AGENT AUTHORIZATION FORM
ate: � - (.- /y
ime of Property_ Owner Applying for Permit:
j okry AIL OUI A W111 t &rev
Wing Address:
[Z coro--
QUww 'WC' Z u33 �
ione Number:( q1d) M - .Q 3 35
Dee Free
Secr
ertify that I have authorized (agent) rN _ to act on my
half, for the purpose of applying for and obtaining all CAMA Permits necessary to install or
nstruct (activity)
(my property located at) 4 1L �2, .
its certification is valid thru te) Sr
n , , I I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to ��( G>E,/ � p'Z fj 'C�f�s 4 6�11
(Name of Property Owner)
property located at vt i4 L vT I5 S�z <'a n) �
(Lot, Block, Road, et .)'
on %Q� S (P T , in UJ d9cc,kc 5 U14.E 'g-c4r , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #:
Mailing Address:
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)
--------------------------------------------------------
(Information for Property Owner Applying
for Permit)
Mailing Address
(Riparian Property Owner Information)
�l
Signature

i' " 1)kA-- . I --
CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
ame of Property Owner: ec ovu b -+ - ' cv DA
ddress of Property:
(Lot or Street #, Street or
7h730,/1
& County)
pplicant's phone #: %60 — a�-7 T — �07 Mailing Address: 2-0 6 S C l/' C aP-,q f�
.D czPJAJ A)C, Z ��4t
iereby certify that I own property adjacent to the above referenced property. The individual applying for this pens
is described to me as shown on the attached drawing the development they are proposing. A description of drawin
ith dimensions
,
must be provided with this letter.
no objections to this proposal. I have objections to this proposal.
you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ei
lilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
)nsidered the same as no obiection if you have been notified by Certified Mail.
WAIVER SECTION
inderstand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distance c
5' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the
)propriate blank below.)
do wish to waive the 15' set back requirement.
I do not wish to waive the 15' set back requirement.
?roperty Owner Information) (Riparian Property Owner nformation)
ignature Q� Signature
Q W • C��
rint or Type Name Print or Type Name
Mailing Address Mailing Address

CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
dame of Property Owner: :rQ( ; k'..1 c; � Lik1 (r{T gJ ,I 11 3E Arta
address of Property:
♦ '.
?C
vpplicant's phone 4: 910 -'"ici S - (; 4R
�097-2, R- 6-nT' Nt, . AGO---j AL
"w"C-rt Vipvc-s .
(Lot or Street #, Street or Road, City & County)
Mailing Address:
Li P
hereby certify that I own property adjacent to the above referenced property. The individual applying for this per.
Las described to me as shown on the attached drawing the development they are proposing. A description of drawi
vith dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
f you have objections to what is being proposed, you must notify the Division of Coastal Management (D0
a writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive F
Nilmington, 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
appropriate blank below.)
I do wish to waive the 15' set back requirement.
I do not wish to waive the 15' set back requirement.
Pro rty Owne nformation)
re
,�, 13 A,c To,� nTi lip 4 ki rHe AG E-4 -
Print or Type Nafne
(Riparian Property Owner Information)
Signature
—rb",,1 0; LLe'Ac'4'1
Print or Type Name
Sri pa
Wailing dA dress
Mailing Address

d-4 nkA� L-
CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
ame of Property Owner: C67"-,� -f
ddress of Property: _2
iJc L • c'Q --J D 2
U c l l-v -toL—A'G
(Lot or Street #, Street or Road, City &County)
pplicant's phone #: ��� �% 7— ?y Mailing Address:
Zereby certify that I own property adjacent to the above referenced property. The individual applying for this perry
is described to me as shown on the attached drawing the development they are proposing. A description of drawin
ith dimensions, must be provided with this letter.
" I have no objections to this proposal. I have objections to this proposal.
'you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM
i writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ei
lilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
)nsidered 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
)propriate blank below.)
&110
VU I do wish to waive the 15' set back requirement.
I do not wish to waive the 15' set back requirement.
Property Owner Information) (Riparian Pro erty Owner I ormation)
4 ze6-2 Z�b,
y
ignature � / � I ignature
Gc�-, w/
Print or Type Name Print or Type Name
dor Opp
Mailing Address Mailing Address

Division of Coastal N19t, Habitat Impact Com titer Sheet
ficant: �po �'i (�IGt S Permit
-vibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
id in your Habitat code sheet.
tat 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
`) 1i�
v V v
Dredge ❑ Fill ❑ Both ❑ Other
/
f
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 ❑

BOATZRIGHT INC.
817 BERWYN RD. 910-795-0228
WILMINGTON, NC 28409
iF n ��
J. nos
First Citizens
Bank
Q7 . Afirsns.
t tne1 - . ,
1165
66301531
DATE 1 356
$ a Oa '
���' DOLLARS 8 �__