52458D - Hobbs

.CAMA / DREDGE & FILL
EN ERAL PERMIT Previous permit#
C(New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
orized by the State of North Carolina,Department of Environment and Natural Resources h�/
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
nt Name 4- (� . o 1.7
g l to�5 [� l Project Location: County N Q 1� H-es attached.
A�.I1 CYC►".
s o� J�'�{I 4 AS VPc-�- Street Address/State Road/Lot#(s)
11A/ Call AAv1 State Cr ZIP 0(41/540 —i— Irlk4" 1-ttok Kcal(
# ( -) g5 -33 c. Fax#( ) Subdivision` O Y.( EI Cj k'1- ) Sla h(1.
ized Agent (3/lIt" ilini- C01 r(,'ht`'\-- City If\/ ) lYftt4I)(I J ZIP OLI
,d ❑CW EW n ❑ IA ES PTS Phone# ("1 I) d 5-333D River Basin L 4 F
oEA HHF _IH ElUBA ❑N/A r�
): ❑ Pws: ❑FC: Adj.Wtr. Body Ali A A
( VC.(40 at
yes /�no PNA yes / Crit.Hab. yes / Closest Maj.Wtr. Body Il►i a n4\( C CF 4 h< •
no no
of Project/Activity 111,11(( L( bi t' (1•A V I kci C f `'-7S (i 1 re A 5 -(I1,7if(I
.R vvi L tkt C1 (+ -{KLCA-1(j J SSky 4 >1A ie (Scale: I '
dock)length � l
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r pier(s) C
ilength a I / 1 r I / Lr\ i 1 .
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number G tti N
ead/Riprap length L v �-• ► 1` ' ZCAl, I -\`
avg distance offshore T� t
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max distance offshore —� �
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channel I I ,'V\ —
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ouse/Boatlift ((''nn "__fr, 1 —
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ags: not sure yes no — — • —
orium: n/a yes no *,'6 I 14: 1%( 1 b .
s: yes 4i o. ( 14
r Attached: yes 1 no 1 i
ding permit may be required by: Niti I J
O(/l�VCl t-� k,. H fS,ee note on back regarding River Basin
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P•
r0e: 11/03/2008 15:59 11139 P.001/(]01
Avica
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F.Easley,Governor James H.Grogan,Director Wiliam G.Rocs Jr.,Secretary
Date it t 3) .0 C)?
Nance of Property Owner Applying for Permit:
Y dbDOS
Iviar�lag Address:
65 Qv;r,
I certify that I have authorized(agent)U3e,1,1S CC6-etS Cp .k-, to act on nay
behalf,for the purpose of applying for and obtaining ail CAMA Permits necessary to
install or construct(activity) M o u 'r% -5 o - A
at(my property located at) 1 rs. 1 e.A- 14'OOu, l—;gla.Ce - L r k
This certification is valid thin(date) 1 .!3 r j aOi a
127
Property Owner Signature; Date