54463D - McCain

_-CAMA / DREDGE & FILL 5!
"ENERAL 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
-oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
L9-Kules attached.
it Name s C s P9 'Cpz ✓ Project Location: County
2 P ,1 7 c0 'V '-, e N A&Og Street Address/ State Road/ Lot #(s) Sal -Le
�71/� �✓� State/YC ZIP /O
ced Agent Cllf' ItLDS%AQ o C
L CW Law [LLP-TA EES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
yes / r!fo� PNA yes no , Crit.Hab. yes / no
Subdivision
City /l/e/ /c/P A ZIP z 9y�
Phone # ( ) River Basin Lei
Adj. Wtr. Body C/I r A ( dr-11' X1 A4"v (nat
Closest Maj. Wtr. Body '0 /Ww
F Project/ Activity pool d /Y.t 4-,/ Jt - ; t e % �I t' I'x ' S
Pck) length
iier(s)
�ngth
mber
d/ Riprap length
g distance offshore
ix distance offshore
cannel
bic yards
np
ise/ Boatlift
ulldozing
IV
r.
(Scale: / - ,
ng permit maybe required by: 0�Pa G 4
❑ See note on back regarding River Basin n

AILVT-VY
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson
Governor Director
AGENT AUTHORIZATION FORM
)ate:
Jame of Property Owner Applying for Permit:
Nailing Address:
,,2 6 /7 0o R4Lk,
VL,Ls. NI a, 12�1 c
'hone Number: ( 7: 8-
Dee FreE
Secr
certify that I have authorized (agent) , .y/C',S �r�� to act on my
)ehalf, for the purpose of applying for and obtaining all
;onstruct (activity) ,T ,/W& �Gvt /� T �7)e—1
it (my property located at)
Phis certification is valid thru (date) �S
Permits necessary to install or

From:CAROLINA IMAGING CENTER 864 226 6133 03/23/2010 07:13 #001 P.002
d
d
U

From:CAROLINA IMAGING CENTER 864 226 6133 03/23/2010 07:13 #001 P.001
him, `-
CERTIFIED MAIL - RETURN RECEIPT R1E',QUE5T
DIVISION OF COASTAL MAINAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Name of Property Owner:
Address of Property:
or Street #, Street or Road, City & Comity)
Applicant's phone
Mailing Address: I
MaN—P05. A 2�` ,10-s
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permi
has described to me as shown on the attached drawing the development they are proposing. A description of drawing
with dimension;_ must C vided with this letter.
(� I have no objections to this proposal. I hRVE objections to this proposal.
If you have objections to what Is being proposed, you must notify the Division of Coastal Management (DCM)
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Exi
Wilmington, NC 28405-394.5. DCM representatives can also be contacted Rt [phone]. No response is
considered the same as na objecrs►n if you have been notified by Certified Mail,
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distance o:
15' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the
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 Qwner formation)
Signature
R M i r/I �r�! 1 1 l,C1Ui1
Print or Type Name
l:��� Connur� jar
Mailing Address
(Riparian roperty Owner Information)
Si a re
Print or Type Name
S/P1 IV 1� q~T 4.3-t, A-�
Mailing Address
ai
�1 r, , o fc c n, 4

cant:
3/zs�iG
Permit #: V S l % 0
ribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
d in your Habitat code sheet.
tat 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
amount)
Dredge ❑ Fill ❑ Both ❑ Other
Z
22—
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 ❑

1483
.WATERWAY CREATIONS LLC
66-112/531
405 STONE CHIMNEY RD SW BS. 910-619 0655
SUPPLY, NC 28462-2662 —W,4dut"I.
ord
Pgord the
er o
$ woo- d�
— Ilollars
� � • 1lOD• �'o��l� d" � i"� ` gyp
For
:053LOLL2L1:000529429375411'OL48