52586D - Alford

;AMA / DREDGE & FILL
FENERAL PERMIT Previous permit #
Jew -Modification Complete Reissue FPartial Reissue Date previous permit issued
ed by the State of North Carolina, Department of Environment and Natural Resources d
astal Resources Commission in an area of environmental concern pursuant to 15A NCAC �/Y ��� F!.4�iles attached.
Nam d Project Location: County & ✓ /V S w -, c le
4-?J 7 G a s6� 460. Street Address/ State Road/ Lot #(s) !/G Swf 1,
e 4�(f
,,,,r State e-_
ZIP 2-7 L/
hYj < 232Z.Fax # ( )
d Agent
/) &4 � h l � M
❑ CW
❑ EW ❑ PTA E;ES
❑ PTS
❑ OEA
❑ HHF ❑ IH ❑ UBA
❑ N/A
PWS:
❑FC:
es / no
PNA yes&no- Crit.Hab. yes / no
Project/ Activity Ot�
k) length
s)L�C
Br(s)
igth
nber
I/ Riprap length
distance offshore
K distance offshore
annel
iic yards
ip
se/ Boatlift
Aldozing
i"1e,R � 22-0;w
e Length
not sure yes no
Subdivision
City .4/0 do, -6OAC 4 ZIP 2 ` �6 s
Phone # ( _)
River Basin L 4/�v
• r 09% W w (na m
Adj. Wtr. Body �Nl� L �
Closest Maj. Wtr. Body Ay w
A
(Scale: l
s: not sure yes no
n/a yes no I _
yes no
�( 2- I
Attached. e no -
ing permit may be required by: y^ dew P,(;tc ❑ See note on back regarding River Basin
Special Conditions "gi [ Ca NJ, /o.-t U J/� Z 4rl a A y l� Q/ / /9 ©j/

ALT
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 as ID9
Name of Property Owner Applying for Permit:
-)an c4 �—' I (Lk- k�+o (- C)
Mailing Address: ^I .
(n3 I q LiSb6�
0 lat-&bn, NL 3-8433
I certify that I have authorized (agent) 44L &� K Sh m,,) r-\ to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) -F I Q&k
at (my property located at) 1 t U
This certification is valid thru (date)
_IQS fv
Property Owner Signature
Date

by —A vt l/'
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS-B�OA�TLIFTB OATHO USE) ,, )
I hereby certify that I own property adjacent to n 4 ie ► ak- A ) l�s
(Name of Property Owner)
property located at
(Lot, BlozW, Road, etc.)
on ana1 , in t-[dene_ach)�bCUNnio'*.C.
(Waterbody) (Town and/or County)
/III�� Sban ��
Applicant's phone #: D o�14�,�Qc2 Mailing Address: I`1 Li
a r E--:0 =0Nc' QL
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (1 T) 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 not wish to waive
'G I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
�lace�e0t of cfoc�
(Information for Property Owner Applying
for Permit)
Mailing Address
(Riparian Property Owner Inf rmation)
eary (yvt Ur'f 20. Signature

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to l `�c1 �� �� 's
(Name of Property Owner)
property located at G Lkxr 1 , 0G-C"r\ NN
(Lot— , l&, Road, etc.)
on (lcJ , in �[L� �Wt,(1 r�l���.► �, J( t.�f�S l� C i� N.C.
(Waterbod''yff) (Town and/or County)
Applicant's phone #: l G`t�7 93o' o - Mailing Address: C28 I � �- i5b�n P
Cl.pr , Q c ,w'3
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (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 not wish to waive
_ I do wish to waive that setback requirement.
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
--------------------------------------------------------
(Information for Property Owner Applying
for Permit)
----------------------------------------------------------
(Riparian Property Owner Information)
Mailing Address
it I , 1 1 0 r- 'NQt12 �.
n - h
Sig4ature

n)0

H. INMAN
T. INMAN
PH. 910-842-4264
1613 WOODARD RD.
0 022 1820
SUPPLY, NC 28462 DATE
PAY TO THE r
ORDER OFI00 dp
�• :LGLFCU DOLLARS ""'
-LOCAL GOVERNMENT p� •
FEDERAL CgEpT pR1DN SUPPLY, NC
,MEMO G 5 fib
•
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1:2S3184S37i:Oi10134462211'---1820