54556D - Kattman

iCAMA / ' 'DREDGE & FILL ,
3ENERAL PERMIT Previous permit#
T�Iew -Modification ❑Complete Reissue CPartial Reissue Date previous permit issued
-ized by the State of North Carolina, Department of Environment and Natural Resources �j
;oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC /� Pey
ules attached.
t Name K /�''.9-'4 /;v Project Location: County
112 4®•r k d , Street Address/ State Road/ Lot #(s) 121 ,!�—D y 7'�
P ^O_s 64 A o State,.,Y L ZIP 2-2 Y—G 3
Fax # () Subdivision
ed Agent 949 %iCity ,%Y c+�p �OAc A. ZIP 2 5/
❑ CW SEW ZPTA F;F - ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
Phone # ( ) River Basin L ce
Adj. Wtr. Body 4012/ na r
40
yes ig1 PNA yes / Crit.Hab. yes / no Closest Maj. Wtr. Body j
' Project/ Activity // -e �,�i /��ci CA 0/1 d
(Scale: _
ck)length
ngth
nber
prap length �-
distance offshore
x distance offshor
cannel
iic yards_
ip
se/ Boatlift
illdozing
Length
�z
not sure
yes no @
not sure
yes
um: n/a
yes 94
no :l
,ttached:
ig permit may be required by: P., s<i,�q( 4
Lt I I�
❑ See note on back regarding River Basin ru

AWA
1114mina DepwUnwd of Em&mmant wW Natural POWJM
Da SJM of Coastal VAMW"Wlt
haal F. may. GOWW
wlibm G. its Jr..
Authorized Agent Consent Aor"ment
is hereby stAhorixed to ad on my beh2
tp,;ne.d fto(Ao@nb crated below- 1`ne authorization is limited to
rder to obtain sny CAMA permit(s) required for the prop"
caflc adities described in the g"chw skttch.
ATKM OF PROJECT:
S pry
Gam..
OpERTY OWM9k SWUNG ADOPPS3:
/ cn --�
�rU
noRUM AGENT IAAI-NG ADDRESS:
PWONE MO.
PHOME NO.

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d
to
f / [
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i
hers d -�i r Pra re-r y o

T3-16-2LjO5 15:16 From:
1 V . 751 V 1 .TT
Name of Individual Appiying For Permit:
7-
C
Address of Property: 3 I ,-Yb &-A J 1 o re Pr( V e
(Lot orStreet 9, Street or Road)
6V-ttj--)6
(C.ty and County)
a7
i hereby ccrtify that I otv:: properly adjacent to the above -referenced property. ITz individLal
applying for this pernit ha: described to me as sho%sm on the attached drawing the development theN
are proposing. A description or crawing, wide dimensions, should be pro%-ided with this letter
VN 1 have no objections to this proposa .
Tf you have objections to what is being proposed, please write the Division of Coastal
Manngement, 127 Cardinal Drive Extension, Wilmiogrou, NC 28405 cr call 910-395•3900
within 10 days of receipt of this notice, No response is considered the some as no objection it'
you have been notified by Certified Moll.
WMVER SECTION
1 understand that a pier, bock, mooring pilings, break-Avater, boat ;souse or boat lift must be set
bek a mialmum distance of 13` from my area of ripurion access - unless svoitied by me. {1j you
wish to waive the setback, you must initial the appropriate blank be(ow.)
I do wish to waive the 1 S' setback requirement.
1 do : wish to naive the 1 S' setback requirement.
_ . N[DENR

icant: K Q v / ,-, 79mf1
2 f/�
Permit #: �. y/ j f �ji — D
tribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
id in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
Itat Name
DISTURB TYPE
Choose One
Disturbance total
includes any
disturbance.
Excludes any
Disturbance
total includes
disturbance.
Excludes any
anticipated
restoration
any anticipated
restoration and/c
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts)
amount)
Dredge ❑ Fill %, Both ❑ Other ❑
(j
G
Dredge ❑ Fill5. Both ❑ Other,,
Dredge ❑ Fill ❑ Both ❑ Other ❑
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse'
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
P011M &C, ck z� r '
I �c�rc iv
H 6ldzn I -a d� nr L.
� � l l�
by (P7 a Print Clearly) B. Date of Delivery
& Agent
t ❑ Addressee
D. Is delivi4ry address olliGnt from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
Service Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number (Copy from
7009 1410 0001 8701 5217
PS Form 3811, July 1999 Domestic Return Receipt 102595-0044tt952
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

JOSEPH V. MILLIGAN 66-7143/2531 5329
LARA R. MILLIGAN
NCDL 4319111 4299734 DATE
P.O. BOX 131, HWY.130 PH. 754-9345 pi _{
ASH, NC 2 20 a
e � Q
hEORDER
w�w
B FLARS.IItTTY
Kim bShallotte, 284 9
MEMO
N! `
1:2S31714301. 06200 ll' S329 dap 15 C ,�