52573D - Purcell

'CAMA / 6REDGE & FILL 5,
;ENERA►L PERMIT Previous permit#
tNew 1—Modification LiComplete Reissue JPartial Reissue Date previous permit issued
•ized by the State of North Carolina,Department of Environment and Natural Resources ' �7
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 2,.4) /i I/00 v /e . 0243
Roles attached.
t Name WI/jig,' ?k 2 C e // Project Location: County 6( 4 r S wic/d(
67, Q, l ' to 7 Street Address/State Road/Lot#(s) 2 y /J i e a
74 4I N )1 mg, State L ZIP 2PS?
(2./O)-27?/S F6 Fax#( ) Subdivision
edAgent L94Ay ,t ( ,,✓or City L/CPf)N -l'iSLPtaPAc4 ZIP 2 Yb
❑cw SEW L PTA 3-ES- E PTS Phone# ( ) River Basin Le,,,y,ei
❑OEA ❑HHF ❑IH UBA C N/A Adj.Wtr. Body rf7"I14 I 014cI /Ail.) (na<
❑ PWS: ❑FC:
ij
yes / PNA yes / Crit.Hab. yes / no Closest Maj.Wtr. Body /9"/ IN
'Project/Activity P,1'/C.P 1� is 47). -9 41 1,., 2 N `/eJ eg e P e/I Ay
(Scale:f ;4
ck)length
ier(s) (
ngth
I
dfir ra length D 1 i C.
distance offshore -� —._.,._ .
ix distance offshore -et-- , Ir- 1 i
'
cannel
11
f ---1' L --- t-Al ,
bic yards 1{><r 4
J
ise/Boatlift
ulldozing { G f i 4 i ,
C14 i sf,j `Ini....
e Length V i I 111.--
not sure yes Cio
s: not sure yes pa U !' i,/ P
cum: n/a yes no j I - tv
yes no i.
i
kttached: yes no / /
rig permit may be required by: OC Q/9� e J QppG�1 �j n See note on back regarding River Basin r
Special Conditions 9// �'v•.L"Ii I .-c 0 7C .71/ /�G O T / 6203 AJ G✓f ff A S 19

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tic;S4C;r'1 i e".�a�'�J
50'
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,'n `� t\skv;l It 5+ [-; Peril
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to t&i%'I I 4 170kit 's
N (Name of Property Owner)
property located at 2 YI-Sk C oil 1( ,0
(Lot,Block,Road,etc.)
on e G r. ,in o ceao (e ,N.C.
(Waterbody) (Town and/or County)
Applicant's phone#:qI b—21/`( Mailing Address: 0 ' )e I S6
LAUrilvtrS iv( 2 3c3
He has described to me,as shown below,the development he is proposing at that location,and,I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
y e((4 I k tiekd a►-t& re act-lcktL
Doc iz.
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
Mailing Address Signature
Lau►rtw.-‹ nib 2 3S _ _ ��i a r,P /14 - U o L L
City/State/Zip Print or Type Name /
916 "-277 —/“<0 ?o w qrs-c o33
Tel5plitirt,NumW Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to vV.1 I - I/K ''f I 's
I N (Name of Property Owner)
property located at 2`t ►45k C✓t ifr
(Lot,Block,Road,etc.)
on C A r. ,in 0 Cear. as l e ,N.C.
(Waterbody) (Town and/or County)
Applicant's phone#:gib—217'f 'V'Mailing Address: /0' 130e JS` �
LatA a'A PZ3 M)( 2 3C 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
IZf IetaAlk Aekd a-td
Ds3()Z .
(Information for Property Owner Applying 'parian Property Owner Information)
for Permit)
P.O,
Mailing Address Signature
1-14,N6- 1.4.:5 iv( 2< 3s d S 1,>A O t a
City/State/Zip Print or Type Name
110 -271 '/“0 9 I v - s-7 s- '3 L4 0 C,
Telepny Number ✓7 Telephone Number

, A7A.
• 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.,Secr
Authorized Agent Consent Agreement
4AACi tC, kikt .oe ter\ . (L0,(c� {�-i3�y.�:> a, l is hereby authorized to act on my behal
(Printed Name of Agent)
in order to obtain any CAMA permits) required for the property listed below. The authorization is limited to t
specific activities described in the attached sketch.
LOCATION OF PROJECT:
2q /96APv,%/P tsj,
PROPERTY OWNER MAILING ADDRESS: - .
f0io JS6 ?
14 ui,/l,s, 0 ,/L 2 >3 Ss 3
PHONE NO. q/. 277 - Xd g
AUTHORIZED AGENT MAILING ADDRESS:
•
tPc 1x; 1,. ti 13
PHONE NO. CI P ` 1 . L 1
Signature of Property Owner. G22' t..vt.iirh. X ✓a41>//7-'1
Signature of Authorized Agent /c. 6)
Date: ,/- d

- ATLANTIC MARINE CONSTRUCTION 1381
P O Box 713
Shallotte,NC 28459 66-112/531
Ph 910-754-4247
DATE /J (�
r,)ER OF
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