54586D - Incatasciato

-CAMA / DREDGE & FILL 5,
GENERAL PERMIT Previous permit#
Alew OModifiication ❑Complete Reissue El Partial Reissue Date previous permit issued
)rized by the State of North Carolina, Department of Environment and Natural Resources /��J
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
jj) ulesatttaa h/ed.
it Name I�GrSS� I� .&A' IF Cj? Project Location: County / (/P� t'/ /�i; �4(JY,
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Fax # ( )
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i ❑ CW FLEff W NI' TA J, ES
❑ PTS
❑ OEA ❑ HHF ❑ IH = UBA
❑ N/A
❑ PWS: ❑ FC:
yes / no PNA es;/ no Crit.Hab. yes / no
t --
4 Project/ Activity �
xk) length
rim^�=ss�raw
■�.►.s+�31■E►I.TL
imber
id/ Riprap length
■ ■■■■�\'
rg distance offshore
■�■■■�■�
■�■■■■�1'�■■►\'�I
■ ■■�►ram■■�t�ll
jbic yards
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. L IMMIMEMENWE2421TIMMEM11
Widozing
ie Length
not sure yes
gs: not sure yes o
rium: n/a yes
yes
Attached: yes no
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP c Ge
Phone # ( ) L5144fte River Basin Znat'
Adj. Wtr. Body Lf1C�l�
Closest Maj. Wtr. Body
(Scale.
ling permit may be required by: %J fi L 41-111Aw . ❑ See note on back regarding River Basin r

1
Letter of agent
F14Ss UGC, -T--PCA1 A Z id(Ta
have retained Mark Clements DBA, Clements
Marine Construction Inc, to make application for any and all permits needed to start
construction on the work requested for our property or properties.
By allowing Mr. Clements to make such applications l do understand that this will in no
way relieve me of any obligations to perform all work according to the building codes of
North Carolina, C:AMA, DWQ or any other state and or count} ordinances.
I OSSEt.L -:L�VGATASu-Afia
Print n
signature
Contact informatiat
daze 6W/a�� ��

- — —y --L-Ly Lua, i vwu ptuporty to
as r scent ,12SSerj ( l f-,cot
(_�
(Name of Property Owner)
Property located at
(Lot, Block, Road, etc.)
on L2 C r'eeK OP� {-AnoveC
' m— ,N.C.
(Waterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
re� tines
1 0 0 '►�
�I
-----------------------------------------------
S ature
Print or Type Name
Telephone Number
t Date:

4"x +0
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at-1-6 I -P u+z h -C-4-ceik
((`` (Lot, Block, Road, etch),,, ,, w
on TUC(`E�. - in--11-� N.C.
(Waterbody) (Town and/or County)
Ile has described to ine as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
t i r�
C �SY►��00e-
�., ce
0 0� ►PrreP
oO
Sign tur ---
Print or Type Name

LC Division of Coastal Mgt. Habitat Impact Computer Sheet
pplicant: 2145se1( T",cn- ra� 1,4 to Permit #: 5�5i'6
ate: /Zq (11)
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
>und in your Habitat code sheet.
abitat 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 Tina
disturbance.
Excludes any
restoration andh
temp impact
amount)
DDredge
❑ 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 ❑

dimm +, I amass MINE
sm I loom x: ia>nrw ,gram GOOffill
CLEMENTS MARINE CONSTRUCTION INC ® 1999
112 CIRCLE DRIVE 910-270-9110
F-IAMPSTEAD, NC 28443
�f First Citizens
Bank
firstcitizens.com
For 6f?c> j_ �( 1.4
1:0 S 3 100 3001:00 3 S 3 208 l4 SIB III
I
Y66-30/531
365
0 1999
$ , 2- 6, --
0
COASTAL VIEWS*