52587D - Warren

:AMA/ LI DREDGE & FILL
ENE_RAL PERMIT Previous permit#
Jew Modification ]Complete Reissue LIIPartial Reissue Date previous permit issued
:ed by the State of North Carolina,Department of Environment and Natural Resources /� j/ ��
iastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC f/'• 2 Mt�les attached.
Name 3 9tr7G,S Atel 40el - Project Location: County Be?teoSwr eA
1 S Street Address/State Road/Lot#(s) Sn/n G
[iP,.r '`,PcA State/t/C m
k ZIP 2 r 4loZ
:?° ) Y5 ' ' 2c '/ Fax#( ) Subdivision
d Agent e,L L 46J17/IS City ZIP
❑CW L7 EW EtPTA -DES ❑PTS Phone# ( ) River Basin L-c-tsl G
OEA ❑HHF LT IH ❑UBA ❑N/A Adj.Wtr. Body C/,/ L 0 / -t (nat 4
❑ PWS: ❑FC: /1 G�
Closest Maj.Wtr. Body
'es / no PNA yes /Cla,.r.Crit.Hab. yes / no f
Project/Activity 1c1J ,gG 9 i c7 10 1-x/-SIi_c, Da c �j
(Scale:/ -`
k)length I
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er(s) �.-..._. 4_ 1 t i
igth — ,j� A
: i 1 Eil
nber i ; ;1 E., 1 1 I
I/Riprap length En '
distance offshore
x distance offshore lig 4 1 i
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IIIi
cannel i
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)ic yards I
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ulldozing f
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64cS�,.} oA ( IIi I
'r 1111PIKAke mow —'
e Length , (2;
lay-
_Mil"l"
not sure yes r no v
;s: not sure yes 'no MOM
ii
rium: n/a yes no ; ' r ' . IN* ,: --
1�� i ill• 1 , • i
E yes no �93lL] ' 1 i►
r r
Attached ere^s' :` no / /4 t , t , o f;,. 1
d' s ing permit may be required by: hiatebS £?Owei . n See note on back regarding River Basin r
'Special Conditions rj�'sii,.-S e 7 SK/ Z,�/j u-S a gP,#ao ei ►64- lc' rr„

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ATA
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 1 � �
Name of Property Owner Applying for Permit:
met LIaA tea
Mailing Address:
//2Li,f/97Ze4 c
h4/AA ZeAcd
I certify that I have authorized (agent) Ki/ to act on my
behalf,for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct(activity) 1Gj74 , ;/JL etiv,P//j 1,d
at(my property located at) /2 Zir/97.iPry/ait .5 /16/ ac/4/ ,
This certification is valid thru (date) �—/ 0 ,
Property Ow er S' nature Date

'01/2009/MON 11 :28 PM P. UO3
ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR LAMA MINOR PERMITS .
iche1 hereby certify that!own property adecer�tp.,_ ('`l '`� 's
} '7 ANarrle of Property Owner)
property located at I f N L u 'erZ 7ZN
` Address,Lot, k,Road,etc.)
on C.47014 t ,in 4/11oDeJ l� /461/444424(4L1<
(Waterbody) (Town and/or- ounty)
He has described tome as shown in the attached application and project drawing(s),the development
. he is proposing at that iocatloi land,1 have no objections to his proposal
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED).
skl\N ,'i\-(6\itria
U?Nic,e, TY1C).13
Print or Type Name
Telephone Number

•
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 7Tfl) Mal ► e
II (Name of Property Owner)
property located at /) 7 2,Gip') be/y n o t'T(P e--/-
l_ 1 i jy'
(Lot, Block,,Road, etc.))c4)eA f kCli , In �J�WeAReAA.,1_ ,N.C.
(Waterboogdy) (Town and/or County) /,
Applicant's phone#: f 1 )6) 7U7�VIailing Address: r )9 L Ll M Le�7�,n .5+
JoU 4 Read). A/C a 2 v--6
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
014 V 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 (Riparian Property Owner Information)
for Permit)
119 L cc in b - Si-. dx- 110/4 e,
Mailing Address Signature
1 I i t r, I 1 . I U I _ I .

5
LINDA R. LARKE 398 398531
JOHN P. LARKE 66-112/
PH.910-842-7072
119 LUMBERTON ST. ��
HOLDEN BEACH,NC 28462
ri , OD
oll„r LtDetails on
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Features
,. MSS BRANCH BANKING A�7'^R�P IIIIIIJLGITi
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1.800-BANK BST BBT.com Q /J)
1:053LOLL2Li:0005LL70713 2 600'03985
Harland Clarke Y