54099D - Seal

CAIViA / u DREDGE & FILL
'ENERAL PERMIT Previous permit#
New "Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources
oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 'r I"i • j�Ob
j attached.
Name 1� �'�}� ��U)l� �(� Project Location: County �11s`(1W �,(�.
E i
y, Street Address/ State Road/ Lot #(s)
State ZIP <aa�t -t 13 1'
O Fax # O Subdivision N
.d Agent kt►�YC `� E✓Y1V
❑ CW 'X EW XrPTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
yes no PNA yes no Crit.Hab. yes / no
Project/ Activity
-T—
:k) length X
(s)
er(s)
igth
nber
I/ Riprap length
distance offshore
< distance offshore
annel
is yards
ip
;e/ BoatliftBoatlift Q
Length
✓J
not sure
yes
no
not sure
yes
no
um: n/a
yes
no -
yes
no
attached:
yes
no
City 1 +t; Zip
nir oon# ( �li) o� - �n 1-3River Basin Ca,�x
Adj. Wtr. Body t w&k(- Inat
Closest Maj. Wtr. Body U' i Sul. 1 o L4JLA
a z
(Scale: I _
ig permit may be required by: V{(� {�5��� C fjl)�� ❑ See note on back regarding River Basin ru
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22'007:22a Seal of Approval Builders 919-542-2119 p
ADJACENT PROPERTY
STATEMENT OF
NO OBJECTION
i hereby cerrty that ! own property adjacent to Ak t-\1
(Name of Property owner'
property located a, C>r� �'� S v w . r
(Address)
on ` r, 'Syin Surf City, N.C.
(Wataftdyl
He has described to me as shown 'In the attached application and project drawing(s),
the development he is proposing at the above referenced location, and, I have no
obiections to his Proposal.
j�sigrll re
Print Type Name
a �z
`Phone Number
Date
Retum form to:
jim a oabbis Saar
382 Biis Creek Drtve
Rlfsbm. NC 2Mi2

ru
O Retum Receipt Fee
$I I, I111
O (Endoreemerd Required)
0 Restticted Delivery Fee
$II,11(1
(EndorsementReqW�
l�
$ $ro 3. 24
O Total Postage & Fees
O
tal
Service
FIED
MAIL-
RECEIPT
F
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Only;
No Insurance
Coverage
Provided)
information
visit
our
website
at www.usps.com
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Postage •
CertifledFee $2.80 03 - �'1EAijj
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7 RECEIPT
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$1 i, flit 9�lAere y
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Total Postage & Fees $
$3.24 (16
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I a�3S
N
PS Form :00. August t,.
See Reverse for Instructions
ACADEMY ST STATION USPS
Cary, North Carolina
275199998
3631970501 -0097
03/16/2010 [phone] 10:09:10 AM
;ales Receipt
Product Sale Unit Final
Description Oty Price Price
NORTH CREEK NY 12853 $0.44
Zone-4 First -Class
Letter
0.70 oz.
Certified $2.80
Label ifs: 70090080000244585987
........
Issue PVI: $3.24
PINK HILL NC 28572
Zone-1 First -Class
Letter
0.70 oz.
Certified
Label A(:
Issue PVI:
$0.44
$2.60
70090080000244585994
$3.24

JSPS - Track & Confirm
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Label/Receipt Number: 7009 0080 0002 4458 5987
Class: First -Class Mail® Track &Confirm
Service(s): Certified Mail"m Enter Label/Receipt Number.
Status: Delivered
Your item was delivered at 11:26 AM on March 20, 2010 in NORTH
CREEK, NY 12853.
Detailed Results:
• Delivered, March 20, 2010, 11:26 am, NORTH CREEK, NY 12853
• Notice Left, March 19, 2010, 9:34 am, NORTH CREEK, NY 12853
• Acceptance, March 16, 2010, 10:07 am, CARY, NC 27519
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A

USPS - Track & Confirm
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��� Home I Sty
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Label/Receipt Number: 7009 0080 0002 4458 5994
Class: First -Class Mail® Track & Confirm
Service(s): Certified Mail" Enter Label/Receipt Number.
Status: Delivered
Your item was delivered at 2:51 PM on March 18, 2010 in PINK HILL, NC Go,
28572. --
Detailed Results:
• Delivered, March 18, 2010, 2:51 pm, PINK HILL, NC 28572
• Notice Left, March 17, 2010, 10:41 am, PINK HILL, NC 28572
• Arrival at Unit, March 17, 2010, 8:55 am, PINK HILL, NC 28572
• Acceptance, March 16, 2010, 10:08 am, CARY, INC 27519
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e

ry 11 10 08:55p Seal of = pproval Eau biers 919-542-2119 p 1
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May 10 10 03 24p Seal :)i Approve 3uikzers 919-542-2119 PA
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary
Date J � ( 1 ( b
Name of Property Owner Applying for Permit:
Mailing Address:
i � �)O" 'tJ QC- `2--I. S I 1�>
I certify that I have authorized (agent) _Z — to act on my
behalf, for the purpose of applying for and obtaining all CA)/IAermits necessary to
install or construct (activity
at (my property located at)
This certification is valid thru (date)
5 i 16
Date

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dC Division of Coastal Mgt. Habitat Impact Computer Sheet
applicant: <
�m , �ebbt'e Seal Permit #: 5-4O99 r-
)ate:
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measureme
ound in your Habitat code sheet.
habitat 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 fi
disturbance.
Excludes any
restoration an
temp impact
amount
�w
Dredge ❑ Fill ❑ Both ❑ Other
O
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 ❑

LIGHTHOUSE MARINE CONSTRUCTION INC.
P.O. BOX 2532
SURF CITY, NC 28445-0028
PAY
TO THE
ORDER OF
BankofAmerica��
01-10
DATE
r7l,
FOR
t ) - w
1160 376611' 4053000 L964 2370054 L588711'
$
37
L L A R S