54590D - Simmons

JCAMA / 1 DREDGE & FILL
EN ERAL PERMIT Previous permit #
New ❑Modification Complete Reissue ❑Partial Reissue Date previous permit issued
rized 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 /,7
L;Rules attached.
t Naml —5'1 na MoProject Location: County �2y�S/✓��J
SOX Street Address/ State Road/ Lot #(s) 7,o
711-e State /V C ZIP .2 F% 5 ,i
( /O )�2 Fax # ( ) Subdivision zed Agent City Shg LC��I ZIP,2l/p $/�
d ❑ CW ErfVN m Fwi-PTA DES ❑ PTS Phone # ( ) River Basin
OEA CI HHF ❑ IH ❑ USA ❑ N/A /
Pws: ❑ FC: Adj. Wtr. Body S�A � L o 7 �P ,/�� {/ P.c na
Body —
yes /ono,. PNA yes �% Crit.Hab. yes / no Closest Maj. Wtr. Body
A Project/ Activity c,/ ��,L,[�1j,cit ty -"P0 2 '-PaG all AW 'eq
(S s
ock) length
pier(s)
length
umber
/
ad/ Riprap length / %Y 7
vg distance offshore-4--
iax distance offshore -t-
=hannel
ubic yards_
imp
Ouse/ Boadift
Bulldozing
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4%. fr , t C � 0.9
g O
T`" \ CoL I ---------- 1K
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c° \
ne Length U�
SIDEWALK
not sure yes c no;-
+�.,� EDGE OF PAVEMEN
not sure yes - no '
�rium: n/a eyes .no,
`-�✓ no
Attached: Y- Z:� l
ling permit may be requiredd' by: le 4 xs-
) /a^, r iP ❑ See note on back regarding River Basin r

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
IEVERLY EAVES PERDUE
GOVERNOR
July 16, 2010
NCDERN
Attention: J4
on Dail
Division of Coa MtMinagement
127 Cardinal Drive Extension
Wilmington, NC 28405
�itJ�CJ e
EUGENE A. CONTI, JR.
SECRETARY
Subject: Joann Simmons (Proposed wall along Shallotte River near Business US 17 Bridge) in
Brunswick County.
Dear Sir:
This office generally does not object to the proposed wall as indicated per attached drawing (s).
However, the subject proposal shall NOT be encroached the NCDOT riparian right.
The subject owner is responsible to obtain necessary information from her consult (engineer) in
order to verify its limitation in regard riparian right issue.
In addition to the conditions above, any construction of such wall shall not interfere (disrupt)
with daily movement of the traveling traffic along Business US 17 and shall not cause any
damages to the surrounding of the bridge structure.
Please let me know if you any questions,
Sincerel
on an
Assistant District Engineer

"a' /
DISTRICTS
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
JUL 0 8 201
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT RECEIVED
I hereby certify that I oven property adjacent to �� � 5 j �MN\� S 4s
��(� (Name of Property Owner)
property located at
�' i� (Lot, Block, Road, a c.)
on �Cee, �( ye r , in S ha, � 0 > N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: MailingAddress:
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
------------------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Individual proposing
►ment must fill in description below or attach a site drawing)
61�s # la 7 p(,0 01 e'
fro
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in wrl
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive last. Wilmington, N
DCM representatives can also be contacted at [phone].
No response is considered the same as no obiection if you have been notified by Certified Mail
(Property Owner Information)
Stt6ature l
Print or Type Name
P. 0 . & x 7
Mailing Address
1 r - _Z'. -
(Riparian Property Owner Information)
L.
Signature
Print or Type Name
Mailing Address R C C ;:' xJ

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Label/Receipt Number: 7009 0080 0001 9499 2996
Status: Delivered
Your item was delivered at 12:15 pm on August 10, 2009 in
SHALLOTTE, NC 28470. A proof of delivery record may be available
through your local Post Office for a fee.
Additional information for this item is stored in files offline.
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,AGA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson
Governor Director
AGENT AUTHORIZATION FORM
late: ke
lame of Property Owner Applying for Permit:
,-fir _, n N --V\3n, I W wly
failing Address:
,,,
AL a <LSySy
'hone Number: (,-I14).7.., t!.�
r�
Dee Free
Sem
certify that I have authorized (agent) to act on my
,ehalf, for the purpose of applying for and obta)Qing all CAMA Permits necessary to install or
.onstruct (activity)
it (my property located at)
Fhis certification is valid thru (date)
q/

e')a tz �Vlqtz adh.�..k impact computew
Q _ycant:' JO l/ /►/ /✓ �, �� o ,✓ ( Permit #: S
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 final
disturbance.
Excludes any
restoration and/c
temp impact
amount)
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Dredge ❑ Fill $ Both ❑ Other ❑
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Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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Dredge ❑ Fill ❑ Both ❑ Other ❑
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Dredge ❑ Fill ❑ Both ❑ Other ❑

WATERWAY CREAMONS LLC
405 STONE CHIMNEY RD SW BS. 910-619-0655
SUPPLY, NC 28462-2662
P�Yto the
order o _
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BRINCH BAHIaNO qND TRUST COMPAW P
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For
1:053 LO L 12 Li:0005 294 29375411'0 L59 2
1592
6&112/531
Date
00,
Dollars 8 �•; �•

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(Transfer from service label, 71109 0 0 8 0 0 0 01, 9 4 9 9 2 9 9 6
PS Form 3811, February2004
Domestic Return Receipt
i)2595-02-M-1540
Postal
CERTIFIED MAIL,,,
RECEIPT
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Provided)
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