54508D - Motsinger

]CAMA / _-7DREDGE & FILL 54
3,{'E�N ERAL PERMIT Previous permit #
7NeW ' ]Modification ]Complete Reissue ]Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources -7
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ! 1J,
©Tfules attached.
t Name
5a w ''Aw Stated ZIP 2sq z-:5
. (e[ o )q -N3LJ Fax # ( )
ed Agentt
CW C i EW -ETA ❑ ES CAI L°TS
OEA HHF IH ❑ UBA ❑ N/A
PWS: ❑ FC:
yes / no PNA yes /,no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
city ZIP
Phone # ( ) J / jYO C River Basin (( C
Adj. Wtr. Body /L/C -
Closest Maj. Wtr. Body
Project/ Activity�``%'T�
(Scale:
ck) length__
1(s)
ier(s)
ngth
,nber
'plength_
distance offshore (Of
x distance offshore�T
cannel
)ic yards
ip
se/ Boatlift
Aldozing
Length
not sure yes
not sure yes
um: n/a yes
yes
attached: yes
ig permit may be required by: _
.. ..., .... [lam .
POWW Oz- ❑ See note on back regarding River Basin ru
^ , r Vl.- ,% r-- i r . — —si / / / )) n / Tel _a- l —:— A -

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue .lames H. Gregson
Governor Director
Dee Freemai
Secretar
AGENT AUTHORIZATION FORM
Date: J`y-j I
Name of Property Owner Applying for Permit: me of Authorized Agent for this project:
1� rri. E �e,
Owner's Mailing Address:
n q 2,,)&e b��� -0Z
600,�
Agent's Mailing Address:
0,n, 4, t
Phone Number f9/0 i 161- 6 4 2 4 _ Phone Number. 10
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
(my property located) at
This certification is valid thru (date
Property
ignature

be sv1W
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to q C.,- rs
(Name of Property Owner)
property located at lC t Jnexx-4 -Ipei yeyc
/ (Lot, Block, Road, etc.)
on kk�4Lf E i9 $� ��� , in , N.C.
(Waterbody) (Town and/or Co nty)
Applicant's phone #: Mailing Address: % 95-S 4 /, t6abe hem pe
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
regfoo I )Jne )/"N I- U-) (V k z f ea� o 4 j4.
30 �4
� py
--------------------------------------------------- N oQd,--- 1-----ems ��-------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
2E.
Mailing Address
Signature
Print nr Tvne Name

,,.J - boww
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
�8 U 1Y1 04ef6t4cier
I hereby certify that I own property adjacent to is
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
P<� o��
on in ?VKD� LJJu , N.C.
(Waterbody) (Town and/or Countyf
Applicant's phone th
Mailing Address: �9 S5 1 r a&leh .c,,
l3L)les A-k--
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
------------------------------------E---- --------------------- —
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
Ig5s - 2Lige IWI
Mailing Address
Signature
/�y_ u , _tip �� y 12 C�c��,J
Citv/Stat /Zin Print or Tvne Name

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: r�010 011M1NID'-(L
Date: (Q1 tl y ( p
Permit #: 514;,OK
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measureme
found in your Habitat code sheet.
Habitat 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 f
disturbance.
Excludes any
restoration ar
temp impact
amount
(,
Dredge ❑ Fill Both ❑ Other ❑
3 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 ❑
Dredge ❑ Fill ❑ Both 0 Other ❑

§oldcen Circle
BETTY N LANIER
RICKY J LANIER
105 COLQUITT DRIVE
WILMINGTON, NC 28412
66-8453/2531 1244
01101967483
DAT is � 3 v
LOCAL GOVERNMENT
MEMO L C E
MEMO "tll.F� ro )Nc
8453?1:011019674831""214----