51972D - Cotner

HG`AMA/ ❑DREDGE & FILL V`
;ENERAL PERMIT Previous permit#
Iew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina,Department of Environment and Natural Resources �� /2 l/G
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
[}Baas attached.
Name,20,-./,4 /�/,# ,� C..o y/vC2 I Project Location: County eazi 'f Lili cX�
Jo/ ''ujh 0 ./� Pet. Si✓ Street Address/State Road/Lot#(s) /9/7 a,,x
Pr✓V/ /I f State49 ZIP 1 72.1 k`fYn cc/it J ci . )G,/
(52(I)7Y 52 5 Fax#( ) Subdivision 0 0k /iA72 Al lft
ed Agent .__S—C o /7- a wR„,iiil,• C City O(',o, T/p g o2Ch ZIP 2IYd
❑CW ,BEW [ PTA DES ❑PTS Phone# ( ) River Basin Li',.,/
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body //h/J " §i0/r
❑PWS: ❑FC: ,q
yes / PNA yes no Crit.Hab. yes / no Closest Maj.Wtr. Body /l y W�
s.
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i/Riprap length —® j _MOM IMMO=01.111111
distance offshore • iiiil I ME/11® '
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not sure yes R_®INIIIIIIIIM_—®-III I'
yes . ��m�
s: not sure
Cali I
•cum: n/a yes 0i - ®_—•�_��-•
yes %
4ttached: yes INIM1111 MI
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ng permit may be required by: �/C'pf n/IS 10 67..40, /j n See note on back regarding River Basin n
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6331
CAROLINA BLUEWATER CONSTRUCTION
6934-9 BEACH DR.SW PH.910-575-7100
OCEAN ISLE BEACH,NC 28469 _ `1 67-7235-2532
DATE l -v
DOLLARS IJ �-a
asta/Federal (�
IIIIIIIIIIIBank ! is
KW SUNSET BEACH,NC 28468 I
D0633L11' 1: 2532723551: L2580022L0116

]tJ-29-2007 11:55 From: To:904 2605768 P.11'12
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F,Easley,Governor James H.Grogeon,Director William G Ross Jr.,Secretary
Authorized Agent Consent Agreement
l✓ (21giiitilA/rc L/¢/26//10 B/t'/1ii44'r authorized to act on my behalf
(Printo Nomo of Apont)
in order to obtain any CAMA per it(s) required for the property listed below. The authorization is limited to the
specific activities described in the attached sketch.
LOCATION OF PROJECT:
1 c'i7 °AI. ilgykea a
5,A)
c.,,,,,, s/g JPfeA Ale-
.2g 11 by
PROPERTY OWNER MAILING ADDRESS: •
/0/ i5Wiillw A(
pantj; i/ , 4 /782-1 PHONE NO 570 Z19 385
AUTHORIZED AGENT MAILING ADDRESS:
•
(493 y-q li:/Ai
0(.40 TA16 Leath AIL ,wdq
4A-/thfiA /,J'l/1V /h/, 1athwt oAJ PHONE NO. q/0 57S 7/4!'
Signature of Property Owner: !0-' ��1�- �.�
Signature of Authorized Agent:
Date: /,)- `-i/ O 7

•
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
(C/fl
I hereby certiy that I own property adjacent to o,vet � 's
(Name of Property Owner)
property located at ZO O ,k' /Iarbot' On v.
J7rm (Lot, Block, Road, etc.) � /on CV I ,in £2(# i1 i / /& i N.C.
(Waterbody) (Town and/or County)
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.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Ada
(Applicant Information) (Riparian Property Owner In mation)
P4--q l d/'A

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I herebycertify that I own property adjacent to p/v (X, 's
� 169
(Name of Property Owner)
property located at ,L4 6 l q/7 gaie //arbevr firjyi
LI-fracoa,541, (Lot, Block, Road, etc.) /on ,in Dcean if &if C/I ,N.C.
(Waterbody) (Town and/or County)
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.
X - I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Applicant Information) (Ripa n Property Owner Information)