54548D - Lagomersino

-'CAMA / DREDGE & FILL
GENERAL PERMIT Previous permit #
_'New Modification, ❑Complete Reissue Partial Reissue Date previous permit issued
>rized by the State of North Carolina, Department of Environment and Natural Resources -'] jJ
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC — n i �Ld d
/ LA Rules attached.
nt Name 61t%/'fbj Z�440 Project Location: County
q3� W Street Address/ State Road/ Lot #(s)
State4T ZIP ZRV 7-0
i% Fax # ( ) Subdivision_
zed Agent � jpdte W1� City_ ZIPS
I Cw EW P4A _ ES PTS Phone # (_ _) �G� •,ri River Basin
❑ OEA ❑ HHF O IH UBA N/A Adj. Wtr. Body
❑ PWS: ❑FC:
Wtr Body
es no PNA yes / no Crit.Hab. yes / no Closest Maj. —� 00
,Tf
f Project/ Activity
/-e4141r
)ck) length
n(s)
)ier(s)
_ngth
ember
id/ Riprap length
g distance offshore _
ax distance offshore
hannel
ibic yards
mp ��
use/ a6 tlift i
7
lulldozing
ie Length >/ztv
not sure yes
;s: not sure yes
-ium: n/a yes rC
yes
Attached: yes np%
ng permit may be requirec
(Scale:
r
7 i i

JUN-20-200e 10:09 From: To:9104581966
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Mich3el F Easley, Governor Jamos H, Gregson, pirector William G. RC
Authorized Agent Consent Agreement
PPY !�= �& is hereby authorized to act on r
(Flintod Namo Of Apn!)
in order to obtain any CAMA permit(s) required for the property listed below. The authorization is lin
specific activities described in the attached sketch.
LOCATION OF PROJECT:
PROPERTY OWNER MAILING ADDRESS:
.50 me 0 dove
PHONE No o
AUTHORIZED AGENTVAILING ADDRESS:
Y
%
•
• r
i
I
�
PHONE NO. , /O ' '-/ 7 3G
Signature Of Property Owner; _�—�
Signature of Authorized Aaent: � �_ ��1. A-1-01 .10 / -- -

i aic�
CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to qez/ i L/�4 it St s
property located at 4q3 l e 4I,+ L,4 wt (Name of IYoperty Owner)
(Lot, Block, Road, etc.)
on S—GGJ , in /!/raj lles,/o.,e i Ca..,, & N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 9 /d N y 3/ Mailing Address: R3 I /i4 14,,,,t
fd)9 "r!!� 1,,, A/c J0
e/ e has described to me as shown below the development he/she is pr+sing at that location,
and I have no objections to the proposal.
---------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Individual proposing development must fill in description below or attach a site drawing)
�r
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writ
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext. Wilmington, N(
DCM representatives can also be contacted at [phone].
No response is considered the same as no.obiection if You have been notified by Certified Mail
C? /O .S`4� 2 „/ 406 Atlanta Ave
(Property Owner Information) Carolina Bch, NC 28428 (Riparian Property Owner Information)
Signature
-ch9zos 1-15�- 6^- c�, p",,>§�7 /,
Print or Type Name
L GL r�
Signature
C'
Print or Type Name
9?11 12111zi
Mailing Address
Mailing Address

Keceivea: May 20 2010 11:46am
[AY/20/2010/THU 11:46 AM FAX No. P•003,
Pleasure Island Ins. Fax:91U HRS3 May 19 Z010 11:Stam N(
CERTTHED MAIL — RETUR- RECEIPT REQUESTED
DZvISIOr OF COASTAL 1Vf-�NAGE1riENiT
ADJACtNT PJPARLkN, PROPERTY OWNER STA.TEiv9,NT
I hereby certAfy that T owTi property adjacent to ?�L 4"p,&
property located at (came of Property Owner)
on 1. e. k", (Lot, Block) Road, etc.)
(watezbody) (Towm and/or County)
A�pp)acarit's phone #: Mailzng Address:
lie/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.-------------------
-------------
DESCRVTXON AND/.OR DRA,' ]N(; OF PROPOSED DEVELOPMENT:----
(tndivzdual,Proposing deyeloprnelzt must fill in description below or attach a site drawinZ
6-e:!r1"> PEnL"aK�r L-�f:/-
1
r✓
p i %C,-54 93o,r4 ` ?t
/- ! r✓'F' p :- Lam' x , : -ii✓ , m c
If you Have objections to What is beilag proposed, you must notify the Division of Coastal I Maoaaetnent
wlthia 10 days of rtceipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Pxt• W�;agton.
DCM representatives can also be contacted at [phone].
No res once is considered the same as no ob'ectrnn if YYMbave been notified b Ce a ,i1
`06
406 Atlanta Ave
(property Owner Information) Ca 01 as Bc4. NC 28428
k
0 , -�-- — —
C/i5 1 05 L
Pridt or Type Name
aQ rope O"vRerinforwatioa
Signature
Marl— ,;-
Print or Type Name
> / SAL
Mailing ,address
-f3V '?x ,,r,64J A
Mailing Address

IC Division of Coastal N19t, Habitat Impact Computer Sheet
3plicant: C�� l (7 S' l Permit #:
ate: 15,/Z0//0
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
fund 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 fina
disturbance.
Excludes any
restoration and/(
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other [
ZG
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 ❑

DA Ip C WINNER
VIRGINIA 7 WINN�R206
(910) 45s-45n (910)
406 ATLANTA AGF, iNS 2$428
CAROLINA 8� n
2013
,20 l o
pate
dc'
Pay to the
Order of E ( O
Customer Since
Bankuf America 19 9 y ''�,`
Rancho E�,Wtas
givdr i j L:' �
1340 F.nc'nit.as JI^{�,,,)
�sp.63O 322
For
w L L8 24�.�Q445?°'
1: L 2.20
0
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