52522D - Vojta

CAMA/ DREDGE & FILL
iENERAL PERMIT Previous permit# �: 1
New Modification Complete Reissue -Partial Reissue Date previous permit issued 'J2
izedky the State of North Carolina, Department of Environment and Natural Resources
oastal Resources Commission in an area of environmental concern pursuant to ►5A NCAC 1 H- • I2-
y[' ules attached.
Name SI4 I(Z.LE'{ VUSTA Project Location: County 2 1 QF 2...
I C m Pri I S c Py Street Address/State Road/Lot#(s) 5ikeVVE
t...V f Vu 1' State NL ZIP Z Lt S7
61 ) ((t l- scil Fax#610 (r/5—37g CI ci) Subdivision
d Agent City V O C(rL l j )C IN T ZIP 7 g,L1 S
❑ n9
CW LAW L PTA ❑ES ❑PTS Phone# ( ) River Basin (
❑OEA ❑HHF ❑IH C UBA J N/A Adj.Wtr. Body J C he_ at /rc
❑ PWS: ❑FC:
Closest Maj.Wtr. Body C r '& t"res / no PNA yes / no Crit.Hab. yes / no
Project/Activity 1Ylk_Li t ]L 0-5-1L:�.1 ('\ �kryl 1 T -* 5 3ci V-70 l LXj7AI.1()
60 Prr L I f 'r _ (Scale: 1 a
k)length
s) I— —
er(s) I
igth - 4 4 c T ' i G +
fiber I I
/Riprap length —
i
distance offshore
c distance offshore -- use,
annel 1 1 '
ic yards 4 r I I i
I
., _l_.j „ . _,_ 4_ / Letirtyvjvk6T1t4e tQ'?—awrit4t:
Ildozing ; I 1
Length Z tl I� ■ j
C� 1 - f -
L 4h'
not sure yes
not sure yes
A
im: n/a yes E .1
yes — — i — + MEM 1_ i 1
ttached: <•yes; no i _ I
g permit may be required by: p ' l- 1 i See note on back regarding River Basin rul
ipecial Conditions Au ( (*JO ( l 714 • 12a) L c(f ST1 1"�t,Of

# CAMA/ r=DREDGE & FILL n' ,e
GENERAL PERMIT - Previous permit#
' 'New —.:Modification Complete Reissue Eli Partial Reissue Date previous permit issued
iorized by the State of North Carolina, Department of Environment and Natural Resources t
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC T `‘ Z T;
[ glulles attached.
ttr'% 't ul�\I1 L,}
ant Name .:.,,,Af=,� .� _ :IA_ I f_� _ Project Location: County 1�:� 'J,4
ss_ _ I ^t.' {'a,,t -, ,t‘ '4. ., -' Street Address/State Road/Lot#(s) 3 AA
Q tt E }T State t.,it., ZIP "3 i . \( i f 1ti!-
r r i_ ,�i
#Cli ) .( Pax# (`' 1- ' : J -)I: f ' t Subdivision
ri a'nx City__ ' _ 3.'. ( i 't � 1T ZIP '2 i
❑CW '•E`N , PTA ❑ES ❑ '
PTS Phone # ( ) " River Basin ( r
ed
❑OEA HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body f rtc. ,.?t
❑ PWS: ❑FC: _
yes / re) PNA es{/ no Crit.Hab. yes / no
Closest Maj.Wtr. Body (t .Yt: t-11 C..
of Project/Activity I W t,f" l,(1 "' 1,t•1
(Scale: r{4
(dock)length t r .„< I
orm(s) -- _7
1I
sr pier(s) a i '-- 'L.._ — -
n length I �� ' 1 t I
number l """`.."' m �_k 1T I
F j
head/Riprap length { 1 1 f j
avg distance offshore l �_� _I t I�� _._I _ _ _ _ ._ .�.
} r IC...? ��
-Max distance offshore _ �1 _
n,channel C � 'rat ► 4 `}>xL )1l.141 i z/-st K
.
cubic yards -_ `I i 1 I i i
[ram ---
P
thouse/8 1 { 'y'atlift' i} � � i I _
-,.4 .-
I
( I �
—f-
ch Bulldozing ` I i I.
,
x
' i ,
per ...._.._.�...—,_i.-- 1
i i)-11T1C'tx1t-- 1 try
...__ .1 �'1 YIi.
I x } I WHI...4.- - - � p ie eft
ra6ne Length- _l'il X 4 i�j cwt. :
/: not sure yes ma;y I 1` �I . i
dbags: not sure yes i —
t j I- — .... - -
ratonum: yes .��--
r a yes o I I 1
I
ttgr I I
fiverAttac} d. es no 1 ' ! 1 c \ N1 ' 14 , , ,' ( .1`'X I 6,
wilding permit may be required by: f ~•'. See note on back regarding River Basi

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOA IFTBOATHOUSE)
I hereby certify that I own property adjacent to /I/V Va �' s
(Name of operty ner)
property located at OinOr 1 Y4-Q4 S Co1 \�--�� ("b Y (v Ci 4 I
;� (Lot,Block,Road,etc.)
on N C Cap cr. C..114-3 , in P)Y\ ,N.C.
(Wa rbody) (Town and/or County) '
Applicant's phone#: (9n .-E-xo 7 Mailing Address: 50A O ) Olbbvkt
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 file!in by i dividppl proposing development)ce
PN ''-
(Information for Property Owner Applying (Riparian Property Owner Infor ation)
for Permit)
Via MAriy`.t,,S Cal
Mailing Address Signature
rZ00( Pot NCI aNS1 L . �O( S

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PIL.INGS/HOATLIFT,B0ATfIOi1S i)
h ,
I hereby certify that I own property adjacent to_ �4 "if .� ....,..,._._ts
(Name Property Owner)
party located at /3 ? -/./A/c VS 'tg, c' /e*t,'rf` Lt s --/
/ (l,ot,Block.Road,etc.)
on rVt-� !Mu'.u'. ,in�..m. : de t-I ,N.C.
(W*tsvbo ly) (Town and/or Comity)
Appl csus 'tt phase II: 5)/I /7 %'2 Mailing Address: ,.3 '¢r, #J'arm t^r
tic has dcscribvd to mc,as shown below,the developmatt he is proposing at that location.and, I
have no objections to his proposal, I understand that a pierhmooring pilings I boatliit/boathtxtcc
must be set back a minimum distance of fifteen feet(15) from my area of riparian access unless
waived by me, (lf you wish to waive the setback,you meat initial tke appropriate blank
below.)
I do slot wish to waive
Y I liQ wish to waive that setback requirement. frie ie4.
DESCRIPTION AND/OR DRAWING OF PRO 7DBYIgLOfMIoNT: . -1-
(To be jilted in by f+rdk iral p op'ii g 1c abO kil
o
_______________r_.
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
/_3(2_72;2.e/N'''i'.4 (4), SCIA.,.. „...-----,--
Mailing Address Signature
C min),f T. r.n
City/5m eilip Print or Type Narnc
9.9 _.4/7. 5e'9- 9l0 - 6 '1<z h