54412D - Barkley

CAMA / ❑ DREDGE & FILL
PENERAL PERMIT Previous permit#
New -Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
ized by ;he State of North Carolina, Department of Environment and Natural Resources
oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
ules attached.
Name �,,�t V7 �J� Project Location: County AK
C ld E t (l-t State ` C ZIP -1 "t-7� Z.
( L2tj--7( Ne Fax #( )
=d Agent f } L L I W IY plc l KF
❑ CW iitV L; 'T L;&S ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ees / PNA yes k fiq Crit.Hab. yes / no
Project/ Activity t"; iyrb-C i;'
A) length 't . ( J ' x 40 �
(s) 141 x {Z' —
er(s)
igth
nber
I/ Riprap length
distance offshore
x distance offshore
annel u
iic yards
ip
se/ Boatlift
Aldozing
g'
e Length '
?+ `-
not sure
yes
C
s: not sure
yes
ium: n/a
yes'
yes
kttached:
yes
no
Lift
Street Address/ State Road/ Lot #(s)
Subdivision
City _.��_ 1 Sl v-+'� ZIP_ ' t
Phone # ( ) River Basin PA la
Adj. Wtr. Body t/f` dJ C t-TANjN d- Gnat
Closest Maj. Wtr. Body ki w!
(Scale: { r
ng permit may be required by: clfl�-Vv ( sl 01--*0 ❑ See note on back regarding River Basin ru

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 80(-k le"I is
(Name of Propedy Owner)
property located at
/ _ W,?3 -� 8ea6k
(Lot, Block, Road, etc.)
on G� in G
5 �� �.� /G � , N.C.
(Waterbody) (Town and/or County)
Q U ���Id e
Applicant's phone ��3v�- Mailing Address:
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)
Gt?6d
(Information for Property Owner Applying
for Permit)
(Riparian Property Owner Information)
cni) Ail J/,

ALW7WW
���.
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman. Secretary
Date ) I j 7
)oq
Name of
Property Owner Applying for Permit:
Id &Ck' leJ
Mailing Address:
IUm 1
104 d,11
I certify that I have authorized (agent) A)j,, 64,a6kt' — to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) V
at (my property located at)
5%
16)C
This certification is valid thru (date) 11/0
1-7

Brunswick County, NC
Map Scale
1 inch = 100 feet
Disclaimer. Map and parcel data
are believed to be accurate, but
accuracy is not guaranteed. This
is not a legal document and
should not be substituted for a
title search, appraisal, survey, or
for zoning verification.
233ND011 233

RANDALL B, MOSLEY PH. 910-232-2530 04-01
125 N.W. 20TH ST.
OAK ISLAND, NC 28465
6ankof
America
ACH R/T 053000/98 �Vi+t�l[gY
L 1 � S 1 E. "ex
I'O 5 3000
0006847454
00684�454 7 711@ 25 .
2561(
Date /
ss-1sis3o
702
$ Gov

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
L�'n�u ����
A. Signature
X ❑ Agent
❑ Addressee
B. Received by (Printt-e-dd Name) C. Date of Delivery
18"A/yi V%., I /�—/ 9, q
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service 1, 7008 1830 0001 0339 9989
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
S3%U
A. i atu e
X ❑Agent
❑ Addressee
B. ceived by ( Printed Name) C. Date of peli ery
/// ) /!/-
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number — -- — -
(Transfer from serviceh, 7008 1830 0001 0339 9996
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540