54452D - Martin

54.
CAMA / ❑ DREDGE & FILL
iENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
ized by tPle State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC E9ftres attached.
f7
Name lff, ��O r2 t
% 7 &all h,7 ri , Da 16
�, ,�/ State ZIP , r3 % Z
Fax # ()
ed Agent t5 /Z �P � 2 d4
❑ CW DEW C411MA ❑ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
Project Location: Countyrfl
Street Address/ State Road/ Lot #(s)
Subdivision
City Ad d2.— 6-AA qc % ZIP 2 `/
Phone # () River Basin L-ti .i
Adj. Wtr. Body OA�+.4 L d 4'�WI 4-" `- (nat �t
Closest Maj. Wtr. Body 4 y 4-✓ h/
yes, no PNA yes f/ Quo c-rrc.mam yes i no 7,
F Project/ Activity A Cl /✓ O,,,i
(Scale:
ick) length tr— , '.3 A - y �
n(s) x
>ier(s)
mgth
amber
id/ Riprap length
Fg distance offshore
ax distance offshore
:hannel
ibic yards
mp
use/ Boatlift
Bulldozing
�tcPss �Rm� /b �c3
ne Length �' I
not sure yes (Ono'
kgs: not sure yes bo
xium: n/a yes !�4
yesi
Attached.).L Avgs
Jing permit may be required by: / 10 L��•✓ fl�."gC- Yl
❑ See note on back regarding River Basin

Fee 23 10 0575Fn 61'eg Holden 842SO06 p. 1
iCIS-(.13•-2t' 7 19cW.. From". To:6429M6
r +mow. a a�7. .,.►. ��
The psrpase *(this font ;s m provide p vW mr;ce to you us a:% add a'V' owssr to dw individual nr
Adtvi a)v Numl bWow. 'tilt LAMA 6eaanl pensit epylieatiau precedwa raWito dart ttpplkwm 9mvidt OR Divi3ioi
Cvobsnl Mapagartcttt contiWf+tas#on *m a wrilttoo stiWntttt has tiea 4tfOMw4d x*rte0 di aaj=em ^PwY at
indict&g that they have no objet if to the pMpttsed vans U dtet the adjat0m 6pwiart pn**Ky okra have bees noti
by cmjrttad mail of the proposed *0& O%m tACS0 (am ate mlii%id d a the sd*m* npm� pmFeM a*w-+x by a in
cormacw or oew indi viduak ud" m aA Writ dzcd agam an ttshoif of d* spit
This (brat was W"t to yore by the follswfag btttividad or COMWy dlefte a ed by tits appmaml as as
authoriZaQ spent:
A 1 Ascot's Stgrtat m pits
Ncme of Individual /ippiying For Rormit: i / &./, �'
zz� 'g
Addmm of Property:
(t.cx or arrest A. stroet Of
t
(City ana COunty) _
hrreby ►erdfy dw 1 own pro}uty ad atant to the atwve-it temrtced pniperty. The individual sppl� in& for r ' i
►taa described to #" as tit wn on the stated drawing the 4evelopmem they we pmpast+ & A deseripttan or c
with &met%si ns. ethould be pr+ovitkd with this 1cm.
_ I have co abjectom to this proposui.
if you have obj"fiens to wMI is being propped. plcoc wrrta the DWIS d of COiurttl ifonasm
Cardiaal Drive Exteatuor•, vv'drrti*910". NC UAGS or cu119t9.79i-7115 withiw tO day$ of Mc6pt of thi
Ne reipoarra is snsdidsred the tWtwre IS 06 oQJO-ctlorr if y+an hart bMA *went W by t erNlied Nlait.
WAIVER SF.C71ON
t undkrsl"d tbut a pier. dock. meorcltg Pilings, brvakwoter• bout soars or boar tilt mu5r be x
mimmaris titttanet of is, from toy area of ripariam aceess - pa,111% waiv�„ SA tLMS. (It you '*dh ie .
attltwck, you famm initist the apprttprirtte Mast[ below.)
..' IEX . .�. 1 cl,) wish to waive the 13" scamA requimmenc
_ I og m Mush to wkive dt&: I S' staback mquirornant.
4
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IMA

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�22 10 06144p _ -Greg Holden 8429806 P
07 M62 From
y
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in aidwr ft alb �► t�JIMA �r.rw *a h°'aibw sWo t m to
*d %rtl PrOPOft filed bOier16 TW
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22 10 10:53a Greg Holden 8429805 p.
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Division of Coastal Mgt. Habitat impact Computer Shut
iicant: /? O� ee f �!/� Lai, �/ !) �� y 2 "
2�2,/lo
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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Q
Dredge ❑ Fill ❑ Both ❑ Other J4
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 ow #te front if space permits.
1 -
to:
V�2-leer li ne ari he C-�r�s`hr. -
�lo m
—p, o.3�c, Ie►�
KC
V p 4s'
A. jSiture/
X ❑ Agent
❑ Addressee
B. Aeceived b Printed.Namef ` .- � r C. gate of Delivery
L . r✓ C" � L"-L? I l f,
D. Is delivery address different from item 1? ❑ Yes
If YE , enter -delivery address below: No
00 0101
3�rvice\.1""y`je
Certiffe`d f'ftil ❑ Express Mail.. ��r)
Registered` ❑ Retum_Receipt for Merchandise
❑ Insured Mail ❑ G.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. ArticleNumber
from
7008 1140 ' 0002 9563 0925
(transfer from service label)
t
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
Dredge ❑ Fill ❑ Both U Other U
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other 0

---------Cashier's - Cashier's Check =--------- ---_—__
vyACCt]LV1AW 66-1215/531 lit`
BANK
February 25, 2010
lialc- _
Pay to the NCDENPR
order of -- — I -- -- -- -- - —+
C_.
Notice To Customers
-
I he purchase of an IndenI Y Bond or an Insurance Bona array 1k mqurred before an olfic iul
heck of this hank Will be rCplac eJ or refunded i» tltc cv�nt t n luxt, nutplaced or a ko
ReC-1P SLI��4a�,
lnitter ��� HOLDEN � ..
B05-1005R (10/04)
lie00 L 13 24611' 1:0 5 3 L L 2 IS 21:980 L994990iim