54427D - Rose

CAMA / F-1 DREDGE & FILL 54t
IENERAL PERMIT Previous permit#
Vew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources
>astal Resources Commission in an area of environmental concern pursuant to 15A NCAC % G
gi Wes attached.
Name i�7n�g . 'P 100 sf 'e Project Location: Countyt w i t/e
O ZN5 L'Q , Street Address/ State Road/ Lot #(s) Q L
e State a C ZIP 7 3 03
'?/,0) J 2Z Fax # ( )
d Agent ` �e % L 4- 3 S
❑ CW LW_ E}PTA DES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS: ❑ FC:
Subdivision
City. /1 /O LO'o,✓ 46109c,/7 zip-2- F
Phone # ( ) �River Basin L.Nr7
Adj. Wtr. Bodt d C ky a, (nat
es / itio PNA yes Qno. Crit.Hab. yes / no Closest Mai. Wtr. Body �� d ✓ ``�
Project/ Activity k f o L A C r "o S ll -` %-44T
(Scale:
c) length Cx, I/ ,-„
I I
-
gth
fiber
I
,kipraplength_9
distance offshore
distance offshore
nnel
c yards
e/ Boatlift
Ildozing
Length (09
not sure yes
not sure yes
im: n/a yes (fi
no
ttached: yes 10
g permit may be required by: �l/L dot'/ 13y,9c ❑ See note on back regarding River Basin rul

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12 09:54 Joel Klass 9*646.3360 >a 465 5M
MCbMR-
"Wh Carol: -,a Depaftent of Environment and ida*urai Rewurces
Division of Coastal Management
James H. Gregson. Director
Authorized Agent Consent Agreement
P 313
Wdlism ' Ross r SecxF!a,
is hereby authorized to act on my behalf
pnrw Name Of AgOWj
girder to obtain any CAMA permit(s) required `or the property listed below. The authorization is limited to The
:cific activitles described in the attached sketch
CATION OF PROJECT:
e,
DPERTY OWNER MAILING ADDRESS:
l97SV-;(-1- V-CV?r1—
Mp&
'HORIZED AGENT MAILING ADDRESS:
PHONE NO. (d GI1 "7
FµONE NO C y 4L C�
azure of Property Owner: `

DIVISION OF COASTAL -MANAGEMENT
ADJACENT KIPARIAN PRUPI✓K7'Y U\\ NER NOTIFICATION�NVAIVER FOP�1
Name of Individual Applying For Permit: e-© e—
Address of Property:
(Lot or Street n, Sheet or Road)
(City and County)
vA/Stci�'v
I hereby certify that I own property adjacent to the above -referenced property. The indivi(
applying for this permit has described to me as shown on the attached drawing the development 1
are proposing. A description or drawing, with dimensions, should be provided with this lette
&— I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coa
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3
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
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must b
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (11
wish to waive the setback, you must initial the appropriate blank below.)
9KI do wish to waive the 1 5' setback requirement.
I do not wish to waive the 1 5' setback requirement.
t I ll
0: XT..__
AAA

Division of Coastal Mgt. Habitat impact Computer Sheet
L/!
dicant: 6 >e ✓L� F do's 'r
a: 3/y-�// 11�
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
Ind in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
)itat Name
DISTURB TYPE
Disturbance total
includes any
disturbance.
Excludes any
Disturbance
total includes
disturbance.
Excludes any
Choose One
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount
temp impacts)
amount
6'
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 ❑
COMPLETEI SENDER: • • • • .
Dredge ❑ Fill ❑ E 0 Complete items 1, 2, and 3. Also complete A Sig re
item 4 if Restricted Delivery is desired. X
■ Print your name and address on the reverse
Dredge ❑ Fill ❑ I so that we can return the card to you. B. Received #9 (Printed Name) C..D
■ Attach this card to the back of the mailpiece, �/
or on the front if space permits.
Dredge ❑ Fill ❑ I
D. Is delivery address different from Rem 1?
1. Article Addressed to:
If YES, enter deli ery address below:
Dredge [IFill El, I 'b 4 k 4 17
3. Service Type

Serial Number
Year, Month, Day
Post Office ✓so',.
1 7 4 9 2 6 4 5 9 O 2 PU.S. Dollars and Cents
Amount HC1Nirf'EG DOLLARS
Pay to
Address C`") p �544D-7 / h 6 rk
----- --- from ` 1`J/
— _ Address
Memo - -- _ /
Unaey Slates Postal Sa I Rip�LS Reserve0 J
1. 0 0 0 O 0 6 0 Q 2 1: SEE REVERSE WARNING •
l 7 4 9 2 6 4 5 g p 2 I .E 71ABLE ONLY IN THE U.S. AND POSSESSIONS