54486D - Moss

=i CAMA / DREDGE & FILL
aE N E RAL PERMIT Previous permit #
ew —'Modification ❑ Coniplete Reissue ❑ Partial Reissue Date previous permit issued
)rized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
lomles attached.
it Name P) %�i4S S Project Location: County 32 N s tv /( Ile
J?Q 4 L e"� /��1//-A^` ) / Street Address/ State Road/ Lot #(s) 2 Q /��yIr
-r� 94T Y - !!ea 0N� StatEY � � zlP� .G .C7 .�1,
-� i
#O?n/)-2'iYYV FFa^x#( )
ized Agent � Cc/ J/9Rr» ��-
d CW _'EW ❑PTA ©ES ❑PTS
OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
P W S: ❑ FC:
yes no PNA yes no Crit.Hab. yes / no
of Project/ Activity
;dock) length 0 ,( y �l C ff
r pier(s)
i length
number
lead/ Riprap length
avg distance offshore
max distance offshore
,channel
Subdivision
City (c^P,r S Le 6egc� zip zp
Phone # ( ) River Basin L11,r
Adj. Wtr. Body ng"4 L 4r (nai
Closest Maj. Wtr. Body 9/
cubic yards ■■■■■■■■■■■■■■■■■�■
ramp INNEEMMEMENrIIIIII1111
louse/ Boatlift ■■■■■■■■■ ■■Iu
i Bulldozing■�■■■■■�■■■■■■■■1line Length
■
not sure yes . ■■■■■■■■■■ ■■■■■■■■
■■MIN ■■aE wW■■0■■■s: yes no
IN
I/ e
(Scale:
ding permit may be required by: OkO4 w !'s `p , �,¢� ❑ See note on back regarding River Basin
of Project/ Activity
;dock) length 0 ,( y �l C ff
r pier(s)
i length
number
lead/ Riprap length
avg distance offshore
max distance offshore
,channel
Subdivision
City (c^P,r S Le 6egc� zip zp
Phone # ( ) River Basin L11,r
Adj. Wtr. Body ng"4 L 4r (nai
Closest Maj. Wtr. Body 9/
cubic yards ■■■■■■■■■■■■■■■■■�■
ramp INNEEMMEMENrIIIIII1111
louse/ Boatlift ■■■■■■■■■ ■■Iu
i Bulldozing■�■■■■■�■■■■■■■■1line Length
■
not sure yes . ■■■■■■■■■■ ■■■■■■■■
■■MIN ■■aE wW■■0■■■s: yes no
IN
I/ e
(Scale:
ding permit may be required by: OkO4 w !'s `p , �,¢� ❑ See note on back regarding River Basin

9j;
�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
!I F Easley, Governor Charles S. Jones, Director
Authorized Agent Consent Agreement
William G Ross Jr., Secre
cw4eo,- is hereby authorized to act on my behalf
(qtted Name of Agent)
r to obtain any CAMA ermit(s) required for the property listed below. The authorization is limited to th�
: activities described in the attached sketch.
'ION OF PROJECT:
:RTY OWNER MAILING ADDRESS:
�> e,/7
'������it-�/1�C�%O PHONE NO.
,RIZED AGENT MAILING ADDRESS:
PHONE NO. �/O ' W3� 7��
-e of Property Owner:
... ..0 A..LL-..:--J A_._-

DIVISION OF COASTAL MANAGEMENT
A DJ A CENT RIPARIAN PROPERTY Owti^ER NOTIFICATION,"WA IVER FORN—t
!Tame of Individual Applyina For Permit:
address of Property:
(Lot or Street 4, Street or Road)
1 c_J2� J--S
(City and County)
[ hereby certify that I own property adjacent to the above-referenced__property. The indivic
applying for this per *. it has described to me as s hovvri on the aitached drawing the development t
are proposing. A description or drawing, with dimensions, should be provided with this letter
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coax
Vlauagement,. 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3
within 10 days of receipt of this notice. No response is considered the same as no objectio
iou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
et bck a minimum distance of 1-5' from my area of riparian access - unless waived by me.
'ou wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
1:11) —54'A)
i a n Ntgne
Date
---YU -/ 17/ Y1W bo V,:?, A,

DIVISION OF COASTAL kIANAGF._L fENiT
ADJACENT R.IPA.R.IAN PROPERTY OW`INTR NOTIFICATION.WAIVER FOR-.1
�7ame of Individual Applying For Permit:
�G�j1/tGJYt �I
address of Property:
(Lot or Street #-, Street or Road)
ck
1,—IJ wLu %-vu«Ly)
hereby certify that I own properhj adjacent to the above-referenced-prope.-ty. The individ
,pplvin a for this permit has described to me as sho-7 .1 on uhe attached dra�vin g the development tl
:re proposing. A description or drawing, with dimensions, should he provided with this letter.
JJ7 uc, I have no objections to this proposal.
f you have objections to what is being proposed, please write the Division of Coas
'Iauagement,. 127 Cardinal Drive Extension, Wilmington, NC 2840� or call 910-395-39
,ithin 10 days of receipt of this notice. No response is considered the same as no objection
ou have been notified by Certified Mail.
WAI v ER SECTION
understand that a pier, dock, mooring piiins, breakwater, boat house or boat lift must t bck a minimum distance of IS' from my area of riparian access - unless waived by me.
)u wish to waive the setback, you must initial the appropriate blank below.,
rnN
I do wish to waive the 1 5' setback requirement.
I do not wish to waive the 15' setback requirement.
is- Id
Date

Division of Coastal Mgt. Habitat Impact Computer Sheet
licant: M �GS S
5/,;? 711.0
Permit #:
cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd 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)
ptacct's)
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)
(N/
Dredge ❑ Fill ❑ Both ❑ Otherg
200
2 ,40
C Ci✓
Dredge ❑ Fill ❑ Both ❑ Other-0-
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 ❑

STEVEN T. FARMER 3729
TRA COM SERVICES 66-112/531
PH.910-754-2725 BRANCH62401
897 MIDDLEDAM RD SW
SHALLOTTE, NC 28470-%57 02 '�D Date
Pay to
theordero
BRU
BRANCH BANKING AND TRUST COMPANY
1-B00-BANK SOT BBT.eom