54554D - Pittman

,CAMA / DREDGE & FILL
3ENERAL PERMIT Previous permit#
i New '-]Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
prized by the State of North Carolina, Department of Environment and Natural Resources /� Do
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
D `� J ules attached.
it Name5C: /Z_ OM r T / Project Location: County9x1/,WSs✓ C//`
9 it 2 CeStreet Address/ State Road/ Lot #(s) ,S 2 V
gal Y_ State/4C' ZIP 2, V6
� ( ) YZ- 5 G7eFax # ( ) SubdivisionS6 A /2,2
ced Agent
❑ Cw
❑ OEA
❑ PWS:
yes no
SEW ❑PTA ES ❑PTS
❑ HHF ❑ IH UBA ❑ N/A
❑ FC:
PNA yettn� Crit.Hab. yes / no
City
ZIP
Phone # ( ) - River Basin Z-U.&„
Adj. Wtr. Body&,�A /L (nat I
Closest Maj. Wtr. Body 1�9/w �✓
f Project/ Activity
T
)ck) length L. '-c"(scale r ,
mgth
amber
d/ Riprap length
g distance offshore
ax distance offshore
hannel
bic yards
np
ulldozing
T:��s�•Tf"Le��
e Length
not sure yes 59
s: not sure yes
ium: n/a yes
yes 41r
Vtachec 2— 4z _ no
ng permit may be required by: %L hi+ J iv cle �Qc�.. �� ❑ See note on back regarding River Basin rt
41211_ P h . I- I /

plicant: Y�/Z O m 2 /`� Ti /j 1 �� Permit #:
te: �/2 YAO
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremer
and in your Habitat code sheet.
bitat 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 fir
disturbance.
Excludes any
restoration am
temp impact
amount)
(�
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

1 . 1. .. • . • .W M t ► • 0 12 • . . ,.
Name Of Individual Applying For Permit:, 6—ROM-6- (71, RA222A.4i
Address Of Property: 1(SA cj • C-- , sn4 /e;tilza C4'Vag_[_
R
(Lot or Street #, Street of Road, City & County)
re t -bt- 9/61 -b yL-:s'o-sc)'
I hereby certify that I own property adjacent to the above -referenced property. The individual
applying for this permit has described tohie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
I have no objections to this proposal.
.. .� •. ..
:1.1 . 1 •. • .:.. u • �.• ►• ••. •. • •
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
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.

—_ _- _
r-Q�!%= �ylcgoK
A `;�,K� y�� r2-1 0
MMS gauge
Name Of Individual Applying For Permit: Jg : R�r»
Address Of Property: �� - , ea 4-iP4 q
S" L't,
(Lot or Street X,
or Road, City & County)
I hereby certify that I own property adjacent to the above -referenced property. The individual
applying for this permit has described to iiie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
(f L' I have no objections to this proposal.
►••� • 1. D . �� �� •� ►•r� • �. :'1 • 1 ,.
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
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.

O------ 4
7V8 Y 7 �v ' .l ev,
7 vabJ a ?/,i (y 66Y '7 .611
ObUlfq d a4/0'/07

JEROME G. OR SHERRY S. PITTMAN
1889 E. SEA AIRE CANAL S.W
SUPPLY, NC 28462-2381
C
8002
66-19/530 NC
_ 1856
„
i Vu«
$ Zoo
uy Dollars
S
tot rder o
BankofAmerica
ACH R/T 053000196 MP
Memo
i:0 5 3000 L 9 61.
000 L8 3 50 6 5 00 2