55852D - Moore

63"CAMA / ❑ DREDGE & FILL F'
GXNERAL PERMIT Previous permit #
ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
prized 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�J
% 1A , ❑ Rules attached.
nt Name ,Jn+'sI'! CVtOar� Project Location: County Ald�_L
s 32 f B4pskmz bow - Street Address/ State Road/ Lot #(s)
OF
/�hlkk%/State NC ZIP�Y1 /
01 CM) �'i 6 , g&/ Fax # ( ) Subdivision !G" ��✓� �s �S
zed Agent J C(., n t571 w City 54"tl ZIP sill
d NEW Yew E TA ❑ ES ❑ PTS Phone # ( )-�-ti*�1/f River Basin
1 Y [[��� , J -t�lS (l�
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Ad'. Wtr. Bod D/'iS ��«� nat ,
❑ PWS: ❑FC: �+ y
yes / PNA es / no Crit.Hab. yes / no Closest Maj. Wtr. Body�ls
)f Project/
ock) length �7 X _
pier(s)
�ength
umber +
ad/ Riprap length_
vg distance offshore_
iax distance offshore
-hannel
ubic yards
imp
ruse/ Boatlift
Bulldozing
ne Length /M - C
not sure yes
cgs: not sure yes
)rium: n/a yes -
yes Attached: yes .___✓�-___
ling permit may be required by: N
(Scale: /
r. ❑ See note on back regarding River Basin

IN J-K;WA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson
3overnor Director
AGENT AUTHORIZATION FORM
Date:
3me of Property Owner Applying for Permit
wner's Mailing Address:
L , AJU Ril
1_ _ L ► K Ws
Dee Freen
Secret
Name of Authorized Agent for this project:
Agent's Mailing Address:
lui� i-w&
1) L UMNO&E cIZ
Phone Number (o -a w 1_
certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
)r and obtaining all CAMA Permits necessary to install or construct the following (activity):
my property located) at
his certification is valid thru (date) J09 vT lVoV, A..6*149.
Prope y Owner Signature D to

DIVISION OF COASTAL ?vLai�I.�OE��;�T
ADi,aCENTT RIPARIAN PROPERTY O�Z"'rER \TOTIFICATION�� AI��R Fnu;
Name of Individual Applying For Permit:
Address of Prope : rZ
l �--
(Lot or Street m, Street or Road)
(City and County)
I hereby certify' that I own property adjacent to the above-reie;enced--property. The in(
applying for this permit has described tome as shown on the attached drawing the developm,
are proposing. A description or drawing, with dimensions, should be provided with this 1,
--- I have no objections to this proposal. ✓
If you have objections to what is being proposed, please write the Division of (
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-39
within 10 days of receipt of this notice. No response is considered the same as no obje
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift n
set bck a minimum distance of 15' from in area of riparian access -unless waived by
you wish to waive the setback, you must initial the appropriate blank below.) V
I do wish to waive the 15' setback requirement
Gy� I do not wish to waive the 15' setback requirement. ✓
S i gn�ame Date

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NC Division of Coastal Nlgt. Habitat Impact Computer Sheet
Applicant: J�NYI All"
Date: ql-3 J a)
Permit #: �grg SZ
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated fins
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/
restoration or
and/or temp
restoration or
temp impact
ternimpacts)
impact amount)
temp impacts)
amount)
L ni
Dredge ❑ Fill ❑ Both ❑ Other
/ Z.5S
w
Dredge ❑ Fill ❑ Both ❑ Other j�r
12
■ 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 on the front if space permits.
1. Article Addressed to
32 q _ 5W4r_ DPmj�--
oT,I„uujm )'�C _AL L
A.
B.
❑ Agent
(Printed Name) I C. Datepf Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: x""No
3. Service Type
ed Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7009 2250 0001 9573 4817
(Transfer from service labeq
5 Form 3611, February 2004 Domestic Return Receipt
Dredge ❑ Fill ❑ Both LJ Other III I
102595-o&M-i mo
Dredge[] Fill[] Both C1 Other [-I QVI V1%,U7r.1
CERTIFIED MAIL, RECEIPT
Dredge C] Fill [] Both [I Other El (Domestic Mail Only; No Insurance Coverage Provide
For delivery information visit our website at www.usps.com,.

JOHN H KING 7672
130 E BRANDYWINE CIR
WILMINGTON, NC 28411 66-1121131
�^.. O
,7777
BRANCH BANKING AND TRUST COMPANY
1.800-BANK BBT BBT.eom G,pC`C��►_
r rJ N-VC�1�%
l:053 10 1 1 2 11:000S 2908 L 7 25 211.0767 2
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