51303D - Kiger

❑LAMA/ ❑DREDGE & FILL
GENERAL PERMIT Previous permit#
L f Jew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
iorized by the State of North Carolina,Department of Environment and Natural Resources ��77
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC //11. /2 O G
ules attached.
tnt Name.G.2 v 7/4/ ki 6C ,VA', /2, c✓oIte f/e, Project Location: County I?IZ Ntis'h//6
s 7 1.2 r,/"l S y L i7. 5"7 Street Address/State Road/Lot#(s)2/ C 4.t/, (/
u /f; L. /' /C State.''y C zip-2 76 Y 5 A j /
#(iS' ) 242-( 77/ Fax#( ) Subdivision
ized Agent 7:2,12/1 y /-(=a fay City-5-,-/NSC 12G,9cA ZIP 2r '1
•d ❑CW L EW ❑PTA DES ❑PTS Phone# ( ) River Basin L ce r j ,
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body /4i 4.1.1G✓
• ❑ PWS: ❑FC:
Closest Maj.Wtr. Body 62/L✓A/
yes i-1 o PNA ';::_..yes / no Crit.Hab. yes / no
of Project/Activity ,r d d �,/,97 • 2:),,,c 4 't g/7n7r 716 E- '( / S 7 6-Z i 1,/9 f
(Scale:
lock)lengthy i S Ili
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•pier(s) .
1
length 1
1 Lt✓
camber (----1.i 4 I.
:ad/Riprap length
wg distance offshore I ) I
nax distance offshore
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channel I I b
:ubic yards )< I
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amp 1
ouse/Boatlift •
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ine Length 7 Q
4.44x
not sure yes "�"F+ T
ags: not sure yes ("no7 f �� i
orium: n/a yes n - {
!v}�
s: yes ._ ..._.__ i i
r Attached: yes no
ding permit may be required by: 5 q,.i S e { OAC 9 _J See note on back regarding River Basin

THE AMERICAN FISH CO. 79597
CHARLES H. OR KAREN Z. PERRY
P.O. BOX 11046 SOUTHPORT, NC 28461 DATE 1 r�
— 2 L1 66-30/531
453
""4C— �JS DOLLARS 8 ; ^^
First Citizens p�
Bank /,J O3 1�
first itizens.com
71A
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•:0� ' 079597i' : � 9v `
53 �003001.00453L209922ii'

American Fish Company
P.O 130x 1 104t y,3-7-
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Delitke. LYAStn
Arvil
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley,Governor Charles S.Jones,Director William G Ross Jr.,SI
Authorized Agent Consent Agreement
om.reOf ev C _ is hereby authorized to act on my bet
(Prrn d r rrre of Agonf)
in order to obtain any CAMA permit(s) required for the property listed below. The authorization is limited tc
specific activities described in the attached sketch.
LOCATION OF PROJECT:
\S • CoancIA
h v.11ni
PROPERTY OWNER MAILING ADDRESS:s C-
rOfkki � I I aim la. e- 1iSrl
hu.[ , 1 ,\ O S PHONE NO.-s3 - bq - Lflt
AUTHORIZED AGENT MAILING ADDRESS:
tQ(j 4 ©1d k Dt"3 e_
PHONE NO. 9te) r '443 -101-1
Signature of Property Owner: ' ' '��

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.Ajcop ‘\ )r
Air C N'r CQ STAL MAATAGE T
AID PROPERTY 01h NO'r'rFICATION/WAIVER FORM
Name of Individual Applying For Permit: Dort Nt K r rh Ali
Address of Property: 2 t kJ , (Q.r1 of C C .
(Lot or Street#, Street or Road)
S Liik.Se:" (2)rv►n_ ► CAS_
(City and County)
I hereby certify that I own property adjacent to the above referenced property, The indiv
applying for this permit has described to me as shown on the atitched drawing the development
are proposing. A desert ' n or drawing, with dimensions, should be provided with this lam
— I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Co
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 91.0-796-
within 10 days of receipt ofthis notice. No response is considered the same as no object'
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier,dock, mooring pilings,breakwater,bout house or boat lift must b
bek a minimum distance of 15' from my area of riparian access• unless waived by me. (II
wish w ' he 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.
if...24/2)
'hime
Date
fie
Print Name

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�� CERTIFICATION OF EXEMPTION
J_� FROM REQUIRING A CAMA PERMIT
\
\�- as authorized by the State of North Carolina,
0 Department of Environment, Health,and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
icant Name 7)0 4,/ y k/ 6 eft !er 6 r/''"'y ,e'fl'Z.,. Phone Number( J Y . -
ress 7325' 45.0
S/en. .S T,
le ,rs/tl-L -// State i/ C Zip 2
ect Location(County, State Road, Water Body, etc.) 2 /S✓ G✓e./f. C9fs% ! . ,2 ., ,,13 j'""'-"' 74
/Gad j Su..✓set C .9:9cA, asi,s—c,/ic/" (10,--", y
e a/ /
and Dimensions of Project Xec1/?e lig p s 1
proposed project to be located and constructed as described This certification of exemption from requiring a CAMA pe
ve is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expl
ement pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be nec
AA permit requirements does not alleviate the necessity of to continue this certification.
r obtaining any other State, Federal,or Local authorization.
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