52069D - Keczkemethy

I1 AMA/ El DREDGE & FILL LL i.E
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
iorized by.the State of North Carolina, Department of Environment and Natural Resources
a Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC -71-4 • I-2.0.)
..Rules attached.
ant Name k Oil t. k l -t_C-Z.IL_L 11\6 }{`( Project Location: County ii,,I4 LIMSLU I C te—
n 110 1 - f .4..--f='tn;O Or . Street Address/State Road/Lot#(s)
alit, i,` (, J0 State NC ZIP 1 t ‘-ki ' i &- l- .,4--1,,..a) l>Z .
#(110) q 33 —Lki(2Fax#( ) Subdivision
rized Agent `i(L�"1 SCle..., C" S'+ CA-tt - Mt4, City (floc_ I SI-I 0 ZIP 2S f
d ❑CW , EW --FT-PTA ❑ES ❑PTS Phone# ( ) River Basin L X
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
): ❑ PWS: ❑FC: Adj.Wtr. Body Da VI 5 ( ANA--L., nay
yes / no PNA yes / no, Crit.Hab. yes / no Closest Maj.Wtr. Body A ,vU W
of Project/Activity I TJST1\L{.... C Yi'C l_1 r- . F}( (i c,Tl kite (.k.1 ki L, 7 I L_f TV.
(Scale: +'I
dock)length
i
rm(s)
pier(s) i I
lengthI i i 1
number
ead/Riprap length I
I I i
3vg distance offshore i i y
max distance offshore rA�P^v S C'rl N A
channel I i
i
:ubic yards .5 �4 O
amp _ 1 i j rl0 I �......
ous(Boatli 9 k 9 11
�� J jLl �q ,Ti l i..
A ,
Bulldozing 7_ b ` , � 8
24c3.
-- ___ f i ` I
,� 4� i I,L l--
notsure yes of
I , I
ags: not sure yes 0 ..__ — _._ , _....._.
orium: n/a yes (n�>
s: yes I l t V t .i`\�� J 0 112, 1
r Attached: yes 0
ding permit may be required by: 1aik 14 r I See note on back regarding River Basin
./c.....:.1 e.---:..:_.__ AA I I, —1,.-.—i t. t t I . -�71 1 k, — -� 1 __ . .. - r--nn�'1-- _1 �.- --n.-',) A .

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SHORELINE MARINE CONSTRUCTION 5108 `
•, GREG PREVATTE 66-112/531
P.O.BOX 10671 r- BRANCH 03003
M SOUTHPORT,NC 28461 442 �0 MI
V DATE y'
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` 41:10 C syd-de </C'e DOLLARS a;�.0
BB&T I(E C Z c/'n£T 4- . Business Value Checking 11 1I
: BRANCH BANKING AND TRUST COMPA �/1 I'
t-l00-BANK BBT BBT.COm P C 0611
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11:0 5 3 10 1 1 2 LI: 1 340000150087005 108

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: /'fLi((t I2CC7kc-2•c74/
ll
Address of Property: U
(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.
V
ts. 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) (Riparian Pro rty Owner Information)
//O 1 f��
Mailing Address Signature rt4147
(Da—547c//��' o2i/6S
City/State/Zip Print or Type Name

ArrA,
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- $ -C.ce
Applicant Name /C eqi n e,r,e
Mailing Address /iCJ E Or-
Co /Qc
I certify that I have authorized (agent) St c_ -I,4I.e , (i,n t, to act on my
behalf,for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct(activity) 4- a4-
at(location) /ICE rc- J Jcnoi Of. T5'16-,Q1 _ •
This certification is valid thru (date)
Signature —�� 4
7'CTJ viz

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Brunswick County, NC
/ _ 1 _
234JF001
f
234JF002
234JF003
234JF004
234JF005
234JF006
-_,__L
..- "_+. ISLAND
Parcel Number 234JF004 Plat Date
Account Number Land Value
PIN 204615632072 Building Value
Owner BONDS PHILIP J ETUX KAREN F Other Value
Owner Address 1 Deferred Value
Owner Address 2 10659 STONE BUNKER DR Total Taxable Value
City MINT HILL Heated Sq Ft
State NC Year Built
Zip 28227 Bedrooms
Legal Description L-4 B-282 S-18 PLAT 11/98 Full Baths
Parcel Street Number 108 Stories
Parcel Street E. ISLAND Ext. Wall 1