52060D - Davis

CAMA/ i1 DREDGE & FILL 0
ENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
)rized by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 1 , I i V
Mules attached.
it Name le t.ISS DA v 15 Project Location: County 6LM4 juaC{ _
1( 2--Y1 Street Address/State Road/Lot#(s)
i-"OC,OVJ t'ti 1 t State t1/44, ZIP Z 12 t 1 17 c L} C 'y/\r t-f 7 (2,2-.
0(72-C4 9 Ly- "t Z,Fax#( ) Subdivision
zed Agent ; 01,AM&;.. (t1 U(yr - c-[e\k4. S1A- 3 City Off i IS t f- 2 ZIP L5 4(,
j ❑CW E1 tW p PTA ES ❑PTS Phone# ( ) River Basin (Alt
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body A !lt)LA) at
❑PWS: ❑FC: , . 1
yes no PNA / no Crit.Hab. yes / no Closest Maj.Wtr. Body r3 f t&jVv
if Project/Activity Pi' t V 14T -= 1-;L I LK.ttt 7�-.0 (vI \/L_) 1(N)STY..c-rtjJ r r To)
F44 eL1 a L eSi c ) (Scale: t"
ock)length
.n(s) i I i 1
pier(s)
ength
amber
ad/Riprap length b Lf'il
ig distance offshore .
1
lax distance offshore `/
:hannel
ibic yards
— f
mp
use/Boatlift I
1 I ocriw. gamy
Bulldozing *�Y,rT.N(,, rl ti'.1' cousin►�G
�Vj5A dttG i.. �/ I 1 'z-j of
vo, q, , 13' . —I S i 1 Li
Rats 1 AO,__.._
ne Length t '
1 •u 0 ; : N "," : ;
not sure yes 1 f 1
1
gs: not sure yes --«
�rium: n/a yes I 1
yes
no
Attached: yes -t rLi`Lj. � } -1—
ling permit may be required by: 0AK )SJ I See note on back regarding River Basin i

SHORELINE MARINE CONSTRUCTION 5095
1" GREG PREVATTE Bs 11y531 P.O.BOX 10671 BRANCH63003 ri
SOUTHPORT,NC 28461 f/�/v_�-�C -
� // /�//�// 7 l �'SS DATE IM
ORDEKOFE / i ct/1 �� I /00 O FI
YI �T A S/- ��G� ./C' y 4/ ��� DOLLARS LJ gals
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F
Bixxi Business Value Checking
BRANCH BANKING AND TRUST COMPANY
1-800-BANK BBT BBT.cop A
FOR
I AP
1:0 5 3 LO 1 L 2 LI: L 3 40000 L 5008 700509 5 ;,

I / 1 / / / / / / / / / 1 1 J / i ! / / 1 i / / / / , / / ,
(Dc,
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AvreA
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 3-CD
Applicant Name R U S 5 Oct v i
Mailing Address Po IJ c,, ,22, 7
Cakoco wi T 0 y j,,C Q ig i /
I certify that I have authorized (agent) )'1c c-eli.,tC 0)(-1 n F to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct(activity) 1e 4-0 jv-'f,- LJ c1 C)
at(location) /-70 c/ E Yc cl-\ 4- 0c. dG k 131 on cl •
This certification is valid thru (date)
Signature Ile /h4--a
.25Z) Wy 8 9??

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: 55- Dot,/>-
Address of Property: )70 V C y4C1
c 0k 28VC0,5"
(Lot or Street#, Street or Road, City&County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing.A description or drawing,with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management,400 Commerce Avenue,Morehead City,NC,28557 or call(252)808-2808 within
10 days of receipt of this notice.No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags
must be set back a minimum distance of 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 wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Applicant Information) (Riparin Property Owner I ation)
X .23 7 ,�-�
Mailing Address 11 A//,'Gi---C
SSignatureCat O CO/,J(ite / 02 7 S/7 AC% J/l/ /
City/State/Zip ( /.9)
Print or Type Name
�Z� 9ce(i -Sl9�Z -7-0/ -

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Sig . - jr
item 4 if Restricted Delivery is desired.
MIPrint your name and address on the reverse X 0 Agent
so that we can return the card to you. ❑Addressee
■ Attach this card to the back of the mailpiece, B. Rec�l=•. .y(Printed Name
or on the front if space permits. C. Dat='of Delivery
1. Article Addressed to: D. Is delivery address different from item 1? I Yes
If YES,enter delivery address below: v No
7500 /Ve e/`A
(/S� / 3. S_ ervj�cType
C� CA gaoO G ��Q�(/Certified Mail ❑ ss Mail
Registered Return Receipt for Merchandise
0 Insured Mail C.O.D.
4. Restricted Delivery?(Extra Fee)
2. Article Number ❑Yes
(transfer from service label) 7007 3020 0001 5069 6754
PS Form 3811, February 2004 Domestic Return Receipt
102595-02-M-1540