54011D - Jones

CAMA / DREDGE & FILL
3ENERAL PERMIT Previous permit#
New Modification ❑Complete Reissue Partial Reissue Date previous permit issued
riled by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC / L
_�`
[Rules attached.
it Name L...1 J W G"-?_, J.. .,,' c , Project Location: County E" JD ,_ =yk�.s
141 se---..) ( )i L t_. i..a. Street Address/State Road/Lot#(s)
I Ot,i 4 C State° L ZIP 2 '3(.c'' LI. j,�.T+L_-C )
( ) Fax# ( ) Subdivision
:ed Agent p;c T 0(35 e '(\'i... City��.N(Z-4- Cf i ) ZIP LuyL
`7 CW LI EW ❑PTA ❑ES D PTS Phone# ( ) River Basin-_-AW
OEA 11 HHF i IH UBA III N/A Adj.Wtr. Bodj��4,> :+(.- ` ,yt -43/1
P. PWS: f I FC:
As-�`` '
yes / no PNA yes / no Crit.Hab. yes / no
Closest Maj.Wtr. Body �
f Project/Activity �-�-.5)44-/__ LI l( q g a-c. :_-- ,--^%= 1 , j ,.-} x t ` ► t- 4.(e
/ (Scale: 1 .4
o c k)length 1-1 A 4--i`1 ! S
n(s) )0/( 11-- „„___:1 ./ —
aer(s)
mgth I
amber }.) ;
id/Riprap length •--- -«— I I
g distance offshore - f _
ax distance offshore i
hannel
ibic yards
np i —
—
Jse/Boatlift I •
Bulldozing * ' ' / 4 i �'( ( i
' ® „., , 4>
r
ie Length -cam L i
not sure yes no ' j _ i i
yesI al
s: not sure no , I
num: n/a yes no
yes no
f I
Attached: yes no - 1 — -
ing permit may be required by: �•"2C C,,r1"1-) . I See note on back regarding River Basin r

Ai,,,A,
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 F/23/o y
Name of Property Owner pplying for Permit:
/_i/Vlvpotl S • c7NES
Mailing Address:
7/bkNSE ii M: t \ -ft'3L.
* O \ - vuc , S 3,4635
I certify that I have authorized (agent) J6 )1..i e-&-C.C.t1� to act on g � my
behalf,for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct(activity) et E4Z
pp11
'
at(my property located at) a'�-b d ,t1 c P-'MS*r ka ZS 4 C0't,/ .,5-
This certif cation is valid thru (date) G/30/0
Noms4 s-- - ._,,. ',A___e/6 .
Property Owner Signature Date

d
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
/4
' doc,S .1;5441._
I hereby certify that I own property adjacent to 's
(Name of Property Owner)
property located at 404 4i 1 i it/S{ 4 CYC Qc�-1 N)C
(Lot,Block,Road,etc.)
on , in Y..- %^c Q 4 v ,N.C.
(Waterbody) (Town and/or County)
Applicant's phone#: '1 I i� 6 ' 274/4 Mailing Address:7 VO)-l t`1 M'/i
�!%- i1�C'_ 2?36 s
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)
1 ‘30‘ck
�'
4.- I q 1—M .4-- (°f-`--7u I cam"
511' >
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
74o K ry .e Rd
Mailing Address Signature

1�CJi vG/
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATMOUSE)
I hereby certify that I own property adjacent to 1 N Woo ° Ivtf 's
(Name of Property Owner)
'get!) ELFk ( J Sk � N 1property located at �� S ��, � � ,
(Lot,Block,Road,etc.)
on , in S�'r ,N.C.
(Waterbody) (Town and/or County)
Applicant's phone#:91765g-2-746 Mailing Address:71' '7 /I/7-4 eci
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)
V6A I ft- ,i/ - 4
1 /9' y 3 /9'-�.
I 54.,
•
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
710 �. f A I-46
Mailing Address Signature

4-11g00 Tro - Zo ps494..)
I w A4 E" w fsri
I +A
a w14t aEf
rn L. kJ
I if I st
I j
I I
rks� 41N�_ - - - -
V NC it 14 77
( ‘t ‘1
? ? ô
P \l< Pro 'peeht c

7778
66-21/530
BRANCH 77599
LINWLOD SCINES ZONES,SR. t�( I
•
Ph 919 6 T.746 pate
Ph 9(i se -Mil6Rd $ �0,DO
Maw pl ve NC 28365
o49�� /� 6�eF.Y
❑ F.N�Ie e
Pay to the Dollars ' °'
Order of
�■ N.A. p
�� ��
ACTIONTIA
Wachovia m 12540\1
wachov' .`om , _
for,_
1; L044?052? 53020 ? 7 ?8
1;0 5 3000 2 L 9