54520D - Core

CAMA / DREDGE & FILL 5
GENERAL PERMIT Previous permit #
❑.New Modification _ Complete Reissue ❑Partial Reissue Date previous permit issued
iorized ioy the State of North Carolina, Department of Environment and Natural Resources _ }
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / Z CO
ules attached.
int Name h i_ N �l-"-7u r� A1rb CV Crel-- Project Location: County }
;s LO)EC At CK KJ - Ems!
%Qn T 12C / A17- State N6 ZIPZCH s �]
Fax # ()
-ized Agent
CW EW PTA ES PTS
OEA HHF IH UBA 1N/A
PWS: FC:
yes i' no PNA yes / no Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
,5#711 L
Subdivision
City f G'CtC y h01 A)7— zip s'
Phone # ( ) River Basin L ►1 t
Adj. Wtr. Body N C T-- nat-
Closest Maj. Wtr. Body ( t' C L-
of Project/ Activity tt C Ic(ST11`�>`' i f lJl f}'fr1Ct21Y�
(Scale: -
Jock) length
rm(s) ( (L'
pier(s)
length
camber
aad/ Riprap length
ivg distance offshore
nax distance offshore
channel
:ubic yards
amp
Ouse/ Boatlift
Bulldozing
line Length _
not sure
ags: not sure
orium: n/a
r Attached:
yes
yes
yes
yes
yes
ding permit may be required by: Kt-19w, El See note on back regarding River Basin
.1 c---:-I �__�:�:_-- I" w % ,^A d%, �1 I A \ i P � l � lib 1� 1 r1' L ., -'t eT'L —'

NC Division of Coastal N19t, Habitat Impact Computer Sheet
Applicant: I�LJ�/�N ��L� Permit #:.S��SZ�
Date: 0//10/1 J
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurem(
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp imp/acts)
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 f
disturbance.
Excludes any
restoration ar
temp impact
amount)
C V v
Dredge ❑ Fill ❑ Both [IOther fe1
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 ❑

SNOW MARINE CONSTRUCTION
& DREDGING, INC.
108 SUMMER SALT LANE
CAROLINA BEACH, NC 28428
PAY
TO THE
ORDER OF
rW/,/Tl
1495
66-112/531
DATE $r ;�o W' O
tiI(i
$ zoU•
U
THIS CHECK IS DELIVERED IN CONNECTION WITH THE FOLLOWING ACCOUNT S
Ar
.. A
11100001495o' i:053101120:0005LOL37463911' __

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORIIVG PIL)NGSfBOATLIFTBOATHOUSE)
iereby certify that I own property adjacent to*A-1 &ft# J��p
s
(Name of Property Owner)
ty located
(Lot, Block, Road, etc,)
C6z 1 Div , in �- I �C/ l U N.C.
{'UVaterbody) (Town aatd or County)
ant's phone Mailing Address: 2
described to me, as shown below, the development he is proposing at that location, and, I
objections to his proposal. I understand that a pier/mooring pilings / boatlifl / boathouse
set back a minimum distance of fifteen feet (151) from my area of riparian access unless
by me. (If you wish to waive the setback, you must initial the appropriate blank
_ I do not wish to waive
_ I do wish to waive that setback requirement.
-
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT-______._-_
I':
(To be filled in by individual proposing development)
)Oe,C N17H 0=w ftCP 5 &f I#M5 W4�

ewA
NCDENR
North Carolina Department of Environment and Natural
Division of Coastal Management
;rly Eaves Perdue, Governor James H. Gregson, Director
e of Property Owner Applying for Permit:
E
Address:
Resources
Dee Freeman, Secr
that I have authorized (agent) S 6 r'k 6In0w - 5 /Vk C to act on
for the purpose of applying for and obtaining all CAMA Permits necessary to
or construct (activity) J 4~cct r'5 `r ( ��� — Q 14- V 1L`L i !S
property located at)"__
II&MY

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT
TATHO E ENT
(FOR A PIER/MOORING PILINGSB OA
hereby certify that I own property adjacent t
's
N4691
(Name of Property Owner)
,rty located
:.. . �r.;r�r�
N.C.
(Waterbody) (Town an r County) Ax
"�-�/pMailing Address: 6) An6a4K
licant's phone #: 1 g !RWY-&(-AR�
A M£
as described to me, as shown below, the development he is proposing at that location, and, I
no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
led by me. (If you wish to waive the setback, you must initial the appropriate blank
w.)
r
I do not wish to waive
I do wish to waive that setback requirement.
---------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To befilled illed in by individual proposing development)
If Afl �ky
boltK_ � 5��� ��7�t� s�t� NAM"
--------- „___ _a. n.,...o,.-Ar.i,bina-- z arlan Property Owner In �rm�tionl ---