51965D - Smerko

CA MA / ._I DREDGE & FILL
IENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
zed by the State of North Carolina,Department of Environment and Natural Resources �� ' /Z©`
Dastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑Rules attached.
Name :eP f � Ex., Project Location: County /J('4 / ,,.r/7GP
0Qua t ' R i 1'k Street Address/State Road/Lot#(s)
i ih h State ZIP k0 � /
t � I1I� 2
JZ3 Z .2S 3t ax#( ) Subdivision 4 t *j I I A?/
A Agent ►til t!3, y j i(1t' City ��'''`-< ZIP c
i(CW EIW /PTA ❑ES ❑PTS Phone# ( ) Ste '^" ' River Basinas l
/7
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body / l/C tf 5 l/'!</- at/i
❑ PWS: ❑FC: �J�
es I no PNA Ile / no Crit.Hab. yes / no Closest Maj.Wtr. Body ,41J/I7_ Yl, 21,6'z'
Project/Activity ( 4 ' t lil//.,--s, z9 / A ,j"i s ft //0i / 794 (1. . 07
C�yYj' Q'f�/��cf✓ . yJ (Scale:///
k)length 3/Yj x to 4 �1 , , J
s) / 2 X�' , ! 4,
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4, , , , , ' --t � , 1
, _..,
, ,,. 1,
Sth � ~ i i Z'reiA
fiber ;
I
/Riprap length - H--rieNOWIll
• rill!distance offshore
c distance offshore , i
annel 1f0� ////'� , i) k)
Y
is yards !
p ���A 1 115- 1ve
,e/Boatlift - I i I" '‘,
illdozin I i t. i ,( 1 w I /VL W
N
,i4 ' i lin ,
--tK
d/ t
109
Length �'
tt) ql
not sure yes ny7' 1'
U V •not sure yes ,
um: n/a yes X i _ IN
' //: 'y/
yes I C� I .T_— rat 1
stacked: yes
7 F
ig permit may be required by: ' t /7 e //, A,447/FYI . ❑See note on back regarding River Basin r

,
Bank of America 313 6 4.
ACH R/T 053000196 i ,
RINE CONTRACTORS, LLC 08-03 66-19/530 NC
910-367-2159 ) 702
92 HAROLD CT. / /!S/11
MPSTEAD, NC 28443 `
/4 $ d/
/OU DOLLARS
1 —1;
,s
03 L3611' I:053000 L96D: 0006E474373811'

AVA.
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F.Easley,Governor Charles S.Jones,Director Wiiltiam G.Ross Jr.,Secretary
Authorized Agent Consent Agreement
tee) fikifir eonfrazims ziLic is hereby authorized to act on my behalf
(Printed Name of Agent)
in order to obtain any CAMA permit(s)required for the property listed below. The authorization is limited to the
specific activities described in the attached sketch.
LOCATION OF PROJECT:
/A5 044/ i k f'
PROPERTY OWNER MAILING ADDRESS:
VrCiew+er.4 d
a$/r' Exeler
C 3G,Oe PHONE NO. 6/9 8(8 ` 2•5(2
AUTHORIZED AGENT MAILING ADDRESS:
/4//jed If7a 4e, Ln '/4tlrs /J
kilmeleed, /I16' Rb7y3
PHONE NO. 7j as3
Signature of Property Owner
Signature of Authorized Agen / `' / / a Lf,
Date: I ( ( Z OD:
127 Cardinal Drive Ext.,wtlmington.North Carolina 28405-3845
Phone: [phone] I FAX [phone] Internet: www.nccoastalmanagernent.net
An Equal Opportunity t Affirmative Action Employer-50%Recycled 110%Post Consumer Paper

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: 7 ,),))e';'ke
Address of Property: IDS 6.440111 tz�(J G U
z,�ix , i! n r -pv Haadd.
.JJ (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 / 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) (Ri rie ormation)
r
.1), (i)e -Cr CI.
Mailing Address
� /
� 1-A Aiv

T- , ov,_71 17d��b`
Avol„oreo,
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51
frIV6i-AH
(54111/')
7 (-1(017 obT)
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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. / CI Agent
• Print your name and address on the reverse X / �.c.c ❑Addressee
so that we can return the card to you. B. Received by(Printed Name) . D. of Del ery
• Attach this card to the back of the mailpiece,
or on the front if space permits. /L L
1. Article Addressed to: D. Is delivery address different from item 1? ElYes '
If YES,enter delivery address below: 0 No
P4'l4 iO
Gio P.O. r
300 P i V5iiirt Dr. 3. Service Type
❑Certified Mail 0 Express Mail
(A);rPI Al �G El Registered 0 Return Receipt for Merchandise
/ ❑Insured Mail 0 C.O.D.
v/ 4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number 7007 2680 0003 2109 5170
(Transfer from service label) ________
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
i
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items.l,2,and 3.Also complete A
Item 4 if Restricted Delivery Is desired. CI Agent
■ Print your name and address on the reverse El Addressee
so that we can return the card to you. B eceiv y P' d Name) C. Date o Dery
• Attach this card to the back of the mailpiece,
or on the front if space permits. e w /t yd ,� �7
D. Is de' Ty address different from item 1? Y
1. Article Addressed to:. If YES,enter delivery address below: ❑
iiSj ducoll 1065 1)C)
3. Service Type
Wilt*?
0 Certified Mail 0 Express Mail
t*?///,/VA /1)& ElRegistered 0 Return Receipt for Merchandise
0 Insured Mail ElC.O.D.
a 3900) 4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number 7007 2680 0003 2109 5163
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540