54540D - Thornton

CAMA / L. DREDGE & FILL `,} 4. 54
3ENERAL PERMIT Previous permit#
�,New i7111odification El Complete Reissue El Partial Reissue Date previous permit issued
irized by the State of North Carolina, Department of Environment and Natural Resources II ,)
Zoastal Resources Commission in an area of environmental concern pursuant to I SA NCAC H . I �( � 0
{"{" Rules attached.
it Name Nh K ` I il©V11 K- Project Location: County C�Aslulw
- Street Address/ State Road/ Loot9#(s)
T _StatxT.1 ZIP aj 'f Vit�'
e ^tP 6 Fax #
O Subdivcision
:ed Agent 101A NPh.n;p
Sv V� ZIP
�
❑ CW �' EW PTA ❑ ES ❑ PTS # (1�() 5� 3✓ River Basin F
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
El PWS: ❑FC:
Adj. Wtr. Body d wt(5 nat i
yes / no ` PNA yes no Crit.Hab. yes / no Closest Maj. Wtr. Body
F Project/ Activity 1 M4A U ULGl � � � QA 1 C w& 4T) oos+ , )o (tc d-
ck)length
ier(s)
ngth
mber
d/ Riprap length
distance offshore
x distance offshore
cannel
)ic yards
ip
se/ Boatlift
illdozing
a Length
not sure yes
not sure yes
6no
um: n/a
no
y�
attached: yes
roL,
/no
(Scale: I "
ig permit may be required by:
- ... .... �i✓.t1� '111 � fib n_.� n{� [ � .,-..i
❑ See note on back regarding River Basin ru

io WA
RCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date l �L l6
Name of Property Owner Applying for Permit:
/29 d1Y
7 f
Mailing Address: T�
�jg:� �
(Ty
I certify that I have authorized (agent)� v r) to act on my
behalf, for the purpose of applying for and obtaining, all CCAAMA Permits necessary to
install or construct (activity) 6047—
L /al
at (my property located at)
This certification is valid thru (date)
4�'F e"-7? X�(
9--2- 9
^ 12 _l C
Property Owner SignAfure Date

CERTIFIED ?MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL INL NAGEMENT
ADJACEAT RIPARIAN OPERTx OWNER STATEMENT
Name of Property Owner:
Address of Property: .7/,2J
(Lot or Street #, Street or R&d, City &&)County)
Applicant's hone /
Ss Mailing Address:: �-O& ��
��v�
? S7 �L "
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this per
has described to me as shown on the attached drawing the development they are proposing. A des ' n of drawi
with dimensions,, must be provided with this letter.
I have no objections to this pcopusal. I have objections to this proposal.
If you have objections to what is being proposed, you mist tify the Division of Coastal Management (Do
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive k
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no ob'ection if you have been notified b • Certified'_Vlail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distance
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' set back requirement.
_ I do not wish to waive the 15' set back requirement.
Print or,1' pe Name
-3A0,4.2",fn__k
Mailing Address
Cl / State / Zip
(Riparian Property Owner ,Information)
Signature
Print or "Type Name
Mailing Address
City / ate / Zip

03 09 01:36p
3
CER D i�— RETURr RECEIPT RI✓ LrESTED
MISXON OF COASTAL MA-NAGEME`T
ADJACENT RI1P-4RI11—N PROPERTY OWNER STATEMEjN-'
Name of Property Owner: no o yY r r^ _
Address of Property:
7 (Lot or Street, Street or Road,
Applicant's phone #-
I hereby certify +t,.• r
Mailing Address:
Couary)
shown
M the to the above referenced property. The individual a 1
has described to me as shown od the attached drawing the development they are proposing- des ywj for this with i ensions n,ti9 he permit
-- P i with this setter. o Fd a o
i),ave as objections to thi;, proposal,
.� I bare objections to this proposal.
in you have objections y what is be* proposed, you must notify the Division of Cozstal Management (D
in Wilmington,
n, NC 10 days of receipt of this notice. Corrtspon0tifY se Divbould io marled to IZ7 CM}
'ilnxiagton, NC 28a05-3845. DCM representatives can also be contacted at (910) 796-72x5. 2�io response is
Cardinal Drive Ext.
�uu�ider a out as a rr'u.r if vo�t >, v
be u CiGcB bV c:.•rior,..a -*—,
I utdmtaad
my that a p ter, dock, nnooring pilings, breakwater, bcatb �e, or liftmast be set back a minim
IS' from my area of riparian access unless waived by me. ff you wish to waive the setback ' arStance of
appropriate blank below.) , you must initial the
I do wish the 15' set back requirement.
Q enL
I do not wish to waive the 15' set back requirement-
0 W a erIn%rm—a on)
-Fruit or T-Ype Name
Mailing Address
' f a 7S 7 7
City /State /zip
Telephone Number ( `p�
D1
aze ( - a� - /
(Riparian Property Owner In.formatioa)
Signature x ]
Print or Tye Namer!
p
Mailing ddre;s
.ky'/)sK/ZQCp 115
Telephone Number
127 Cardinal 0nve Ext., Wilmington, North Carolina 28405.3845
Phone: [phone] PAY. 0tn_,iac 9neA , .

Division of Coastal Mgt. Habitat Impact Computer Shoe'
licant: �}/�Q�6ynY� Permit #:
5V
cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
id in your Habitat code sheet.
,itat 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/or
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
I Iq
l I�
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 ❑

Afthomy 3 Z-hormtoo s6-30/MI
Z'raccy 9 ZhorotoH oae 4658
Plt [phone]
3160 ✓i Misom Road /
Claytom, ,VC 27520 Z �` DATE.
PAY TO THE
ORDER OF 2C 6
DOLLARS
First Citizens
Bank
rsts.c o m&
5Li9d - D
FOR 01:0531001:00867290442u='✓
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58
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