55870D - Lee

°CAMA / - DREDGE & FILL't
.ENERAL PERMIT Previous permit#
�Kevv - Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
/ ules attached.
it Name /(1/'O /7y G- « Project Location: County
O O / `/j9/Z L) , ti Rd Street Address/ State Road/ Lot #(s) -?. 2 / f'
U/' DState ZIP Z F3 _
/o) 7ya- i3�3 Fax # ( ) -
:ed Agent R , k ye t../ e ' �
❑ CW C9EW EIPTA C3E5 ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
M,
Subdivision
City ZIP
Phone # O River Basin
Adj. Wtr. Body /Q/ !n/G►/ n
Closest Maj. Wtr. Body A% W!✓
yes / ;fio., PNA yes �_ Crit.Hab. yes / no /
A Project/ Activity U�/%1,9,r •P �X � S �' • s � s ��� i'-" �7 ✓ alli C-' /rGo7y�� I 71
(Scale:
lock) length
m(s)
i
pier(s) -- --
i
length
umber
,;�Z)tiprap length��
vg distance offshore
iax distance offshore _ i I
channel
ubic yards
imp
wse/ Boatlift
Bulldozing I _J I A
ne Length (G'—�, '
not sure yesCO
,
gs: not sure yes
>rium: n/a yes
ye no
Attached: yes G_._ - .... ___,__ _.____.
ling permit maybe required by: ea'.' ❑ See note on back regarding River Basin
/ Special Conditions & L L"U.✓D i S ot %%l. //d/1 4 t /./Eii A r- A/ i l iL 'P"

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date v to bo
Name of Property Owner Applying for Permit:
l omA i Lre
Mailing Address:
!()' / �Ifiedl AI
I certify that I have authorized (agent) to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) Jock ,
at (my property located at)
3 2(7 R? r'x l E i w,
This certification is valid thru (date) IZ 31 I6
2 q44 2 .
9/23/0

I Nf9led; +vim
` etiiing Address
L.4 ��-6U _4)(
Citylstate/Zip
0/07/?O1t) 11 11 FA1; 9't;il J:_'-)' HI:
t 07 2010 SiOGPM RlnkyiCindyNewett 9108427471
p.2
ADJACENT RIPAJRIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to TO M M LC6 's
(Marne I Proptrty Owaer)
property located at — 7 1 i E
Al
(Lot. Bt k, Road, et .)
on �� , in I lAi�1`.7ca.1 t C r` CJ t-I t'JT � , N.C.
(Waterbody) (Town and/or County)"'
Applicant's phone ft:10 '714611U Mailing Address. 1661 1-10 rt!: t t-1
Lure r.rz+CA1>
He, has described to me, as shown below, the development ho iv proposing at that location, and, ;
have no objections to hie proposal.
-------------------------------------------------- -------- ----------------------------- ........... -----------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT/
(To be JTJIed In by property owner proposing deswlopment)
X 1�5� "sic a K ASt! Cdlt4
---.---- --------------------------------- ----------:-------
(Information fnr Property Owner Applying (Ripurion PrQnc Q tntormatioon-
for Permit) lip
_ Signature
Print or Type Name
Telephone Number 0

tic has described tc mc, as ghvwr: by ow, the development he is proposing at that location• and, i
have no objcction; to his proposal.
DKSCWF'r10:N ANDMIR .D):A%IN(; Olt PF OPOSED DF.VFI-OPWXT-
(To be fi/!ed Ia by pp operrr owner proposing dervelopmenl)
REpJAC0 IEX,4AV
r'S-i,.�r,' �u�Ki,fgc� nsrsrjd�a
(Information for Property Owner Applying (Riparlan PrQ arty )rruer.Information)
for Permit)
11X1� Nr �ltj iZ
---......._
Mailing Address •-Signature
L u►� bcu
CitylStatr/Zip _- -- _.._..._-
_
rint or Type Name
Telephone N�urnber - —
Telephone Number
u o/a
Date Date

1111111=73M is
fax. Oct '5 2010 09.12am
P
ADJACENTRIPARI,k1i pRopf,,R'I,% OWNNFR STATEMENT
I hem6y certify that I own properl , adjacent to 0MI". (_Cf,
Pmpetly located at -W)j (k . ........ . ... ..
(I ot, Road.
or NC.
(Waterbody) (rown nud/o'r­­ C" 0 U-11 t-Y)
Applicant's phone 4; _TD 2YAU0 Mailing Address:_ ICO k I—JACJ, jj Vq,�_
Lk m

icant: Ile" /-9 /n L e
1 C12 411jo
Permit #: S S � 70
cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
id 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 fina
disturbance.
Excludes any
restoration and/(
temp impact
amount)
L
Dredge ❑ Fill Both ❑ Other
5
C
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 ❑
7::j
Dredge ❑ Fill ❑ Both ❑ Other ❑

-RR�`lewett Constnwtion
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BRAN 'H BANKING AND IR
BB7 UST
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'a00-BANK B
2897
W112/531
Date
Dollars
For
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':0 5 3 10 1 1 2 140
005198385958n■ ---__-