54470D - Norwood

LICAMA / F}DREDGE & FILL
GENERAL PERMIT Previous permit #
®New -]Modification , ❑Complete Reissue CPartial Reissue Date previous permit issued
iorized by the State of North Carolina, Department of Environment and Natural Resources f_.
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC X# I l (J G
is;Roles attached.
int Name .31 Z L %yU 2 woad Project Location: County Ega'v,s zwc
;s p • 0 • '6" �-U / 9 Street Address/ State Road/ Lot #(s) /Y6 &IC-r7
7o,�R u State 19 C ZIP
# (ZOY) 2 � 5J - � Va Fax # ( )
-ized Agent 6, %i le
.d ❑ CW SEW FiPTA L.ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
is
❑ PWS: ❑ FC:
yes —Ao PNA yes /cl� Crit.Hab. yes / no
of Project/ Activity %YE " & Z k' `�o9 d
lock)length i✓ X , S ..'y
length
lumber
:ad Riprap length YS '
ivg distance offshore
nax distance offshore
channel
:ubic yards
amp
Ouse/ Boatlift
Bulldozing
ine Length I
not sure yes Lo
ags: not sure yes �5 7
orium: n/a yes 46;
s: no
r Attached: yes
Subdivision
City ache" -tI-SL e A'CAch ZIP ." � yd
Phone # ( ) River Basin LY,.,,
Adj. Wtr. Body ©Lar sc"., i -c E K nat
Closest Maj. Wtr. Body /9/ w w
(scale:/ --
ding permit may be required by: t/CGA,✓ nLP tgogc 4 ❑ See note on back regarding River Basin

Di'VISI4N OF COASTAL MANAGEN1E3aT ..
ADJACENT RIPARIAN PROPERTY 0 NOTIFICATIONIWAIVER FORM
Name of Individual Applying For Permit:
Address of Property:_
(Lot or Street #; Street.or,. Road)
Tste Po"
(City and County)
I hereby certify. -that I own property.adjacent. to the' above -referenced property. The indivi,
applying for this permit has described tome as shown on the attached drawing the.divelopment
are proposing. A description or drawing... with dimensions, should be provided with this lette
/ have no objections to this ro osat.
I ) P P
If you have objections to what is being proposed, please write the Division of.Co;
Management? 127 Cardinal Drive Extension, i7�iltinin;to4,. NC 25403 or cull 910-796-'
within 10 days'of receipt of this notice..No response is considered the same as no objecti
you have been notified by Certified Mail. _
WAIVER SECTION
t understand that a pier, doek, Ynnoring pilings; breakn��ater, boat house or boat lift must 1
bck a minimum distance of 15` from myare a of riparian access - unless waived by me. n
Nvis.h_ to..ivaive the setbacl:,'you must initial the: appropriate blank below.)
I do wish to waive the.1 5' setback requirement.
I do not wish to waive the 15'. setback requirement.
Name Date
V

• DIVISION OF COASTAL ItiLANAGENIENT
ADJACENT RIPARIAN PROPERTY 0VNER NOTIFICATION/WkIVER FORD
?`lame of Individual Applying For Permit: 13 O 1 ATE
Address of Property: 1 `tom 1AIE5 r'
(Lot or Street 9, Street or Road)
occA N TnE &A'C'g L Z$�KO 1
(City and County)
I hereby certify that I own property adjacent to the above -referenced property. The indi
applying for this permit has described tome as shown on the attached drawing the deveiopmei
Are proposing. A description or drawing, with dimensions, should be provided with this let
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of C,
Management, 127 'Cardinal Drive Extension, Wilmington, NC 23403 or call 910-796
within 10 days of receipt of this notice. No response is considered the same as no objec
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
bc1: a minimum distance of 15' from my area of riparian access - unless waived by me. {
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to vvaive the l 5' setback requirement.
I do not wish to waive the 1 5' setback requirement.
Sian Nan v
�� t w► M�� evS CI 4 yJ
Date
AVUCWj

NCD NR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
iichael F. Easley, Governor James H. Gregson, Director
Authorized Agent Consent Agreement
William G. Ross Jr., Seca
ATEis hereby authorized to act on my behall
(Printed Name of Agent)
property listed below. The authorization is limited to tt
order to obtain any CAMA permit(s) required for the
ecific activities described in the attached sketch.
)CATION OF PROJECT:
) 517,
N 5 UE _F2e5 -A i�(- Zb" )
ROPERTY OWNER MAILING ADDRESS:
.yo 11 1�1?wba�
p•� . fox S'�d 19
(MOIJ tDE i�• L• 28 1 1 1 SD 19 PHONE NO.
DQ'
WTHORIZED AGENT MAILING ADDRESS:
PHONE NO. 4910 � ~ D t Z
Signature of Property Owne'.

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147

icant:
Permit#: S %t /%O
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 fina
disturbance.
Excludes any
restoration and/(
temp impact
amount
G-
Dredge ❑ Fill 19 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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

JESSIE &MYERS CONSTRUCTION
P.O. BOm5024
OCEAN ISLE BEACH, w0004a*
(910)575'3063
PAY
TO THE
ORDER OF DEHNR
Bw
NORTH CAROLINA
66-zzu-sa1
-
81C
4/8/2010
�
+' **400. 00
Four Hundred and
DEHNR
' WILMINGTON REGIONAL OFFICE
~ DIVISION OF COASTAL MANAGEMENT
127 CARDINAL DRIVE EXTENSION
MEMOWILMINGTON, NC 28405-3845
146 W. Third
Go-) 541410
146Lob 1112
AUT7SIGNATURE