55892D - Hardee

y
CAMA / ErDREDGE & FILL
IENERAL PERMIT Previous permit#
New ❑Modification El Complete Reissue ElPartial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources/�I /1 o U
oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC QRules attached.
NameProject Location: County
LQ V, �� /Za/ S Street Address/ State Road/ Lot #(s)
State ZIP y !S
( /U) 99TV -.3U2 2 Fax # ( ) Subdivision
ad Agent , Seo /{ i4y/? City ZIP
❑ CW G;Vf/ ❑PTA ❑ES ❑ PTS Phone # ( ) River Basin
ElOEA ElHHF ❑ IH ElUBA ElN/A Adj. Wtr. Body S,44 l te)/ P /i ✓e-,j nar
PWS: ❑FC:
Closest Maj. Wtr. Body
yes /4�_! PNA yes /_i(o % Crit.Hab. yes / no /
'Project/ Activity Re,01,ACe 6-
X ' s4,,�^3
(Scale: / "-,,
ck) length
,ier(s) —
:ngth
mber
d/ prap lengthFg
distance offshore _
ax distance offshore---------------
p
F
hannel
-
i
t
ibic yardsrnp
use/ Boatlift

el F. Easley, Govemor
NUDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
James H. Gregson, Director
Authorized Agent Consent Agreement
.f'
William G. Ross Jr
is hereby authorized to act on my I
(Printed Name of Atretft)
ar to obtain any CAMA permit(s) required for the property fisted below. The authorization is limite
is activities described in the attached sketch.
kTION OF PROJECT:
ca �tv4� S�
' }eCroT7� �/✓
PERTY OWNER MAILING ADDRESS:
ej. s (-, - -J
l �p!✓1 /(�.�. 2SYi U PHONE NO. 4?/0—75 ``3d Z 27�-
'HORIZED AGENT MAILING ADDRESS:
o AQX t9 7
t v
PHONE NO.
nature of Prooerty Owner:

CERTIFIED MAIL - RETUKN, RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATUMENT
me of Property Owner:
.dress of Property:
E.
)plicant's phone #:-//0—%J`Y 3d 2"i
Pp
w7 led. cS' Sli �1�3,s� C,
or Street #, Street or Road, City &
294
Mailing Address: /%2y U 1 f(AW.R P4. n�
n3- ala 7V1 1)VIC, zgw -76
kereby certify that I own property adjacent to the above referenced property. ine muiviuum 4ppywg —1 u-
s described to me as shown on the attached drawing the development they are proposing. A description of di
ith demensio�ns must be provided with this letter.
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 0
i writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Dri
Vilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No respon.4
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 disc
5' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial
Lppropriate blank below.)
I do wish to waive the 15' set back requirement.
I do not wish to waive the 15' set back requirement.
(Prope Owner Information)
Signature
Jetovy �W,/' /��k4iv -e-p
Print or Type Name
(/ l� ,�N RJ sJ
(Riparian
Property Owner of atior
�2 - o
Signature
Print or Type Name

CERTIFIED MAIL RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
me of Property Owner:
dress of Property:
) /Ow"
14,
sU ..51jg116_,4A-
(Lot or Street #,
C. za Ir7
or Road, City & County)
)pIicant's phone #: q10-%ST/ ._4,6Z Z Mailing Address: S
tereby certify that I own property adjacent to the above referenced property. The individual applying for this
Ls described tome as shown on the attached drawing the development they are proposing. description of di
ith 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 C
i writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Dri
Vilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No respon:
onsidered the same as no obiection if von have been notified bv Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum dis
'L5' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial
appropriate 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)
Signature
Print or Type Name
17;b (lit
(Ri rian perty Owner Informatioi
Signature
Print or Type Name
A AA-

cant: /�E,✓ )/,��� e' 'P Permit #:
;vibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
d 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/c
temp impact
amo-u�unnt)
L
Dredge ❑ Fill Both ❑ Other ❑
�1
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 ❑

KENDALL L. HARDEE4NCDL 1413714 15. , � r'M A'A Y^ 4� JACKIE L. HARDEE NCDL 834010 66-7713/2531
PHONE [phone] /
1720 VILLAGE POINT RD. SW
SHALLOTTE, NC 28470 Date
Pay to the /
Order of /
GP� A'-Sg
Rie�w*d ( �
163 John Riegel Road
Federal C,e& UUniam Riieegelwo���/JdJ��JN�C228456
1: 2 5 3 17 7 13 31: 11 20000 6 100 511' 40 L 5
Harland Clark.