49207D - Potter

CAMA/ ❑DREDGE & FILL 9
iENERAL PERMIT Previous permit# 2 2
New L'1Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina,Department of Environment and Natural Resources
oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 71/ 0..0 Cc
Rules attached.
Name //G?A/N I L a Project Location: County 8t2t-1 NSLAJ t(k.-
&I)/ LC A/6ik-Pr OW , Street Address/State Road/Lot#(s)
0I,'T/fP0,C1- State kit ZIP 24Ljb I 12 L //)c' k 17 /37-i3 IAI Dx -
Ip ) L/L/3-302 , Fax#( ) Subdivision
ed Agent /'fl Ate IC .STEW the f—,SF e:Like tn the 1k City _COL'TitP0 ter ZIP 2 S U-{v
❑CW CHEW 1PTA ❑ES ❑PTS Phone# ( ) River_ Basin (./2/:;.
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body y t 11 i' 1 S//s iir.
❑PWS: ❑FC:
Closest Maj.Wtr. Body A I W LI
yes / no PNA yes /6 Crit.Hab. yes / no
F Project/Activity rC Lt_OLi-tit- FLOf377 kJ6- /9c;Cie.. lIreaL[:X,"LE I N c17 F
(Scale: ( ' `1
Eck)length 1 ' 1 i C�'kIkt S N j
i(s)
;ier(s) i ` rtit404404±130111 ,—_ ; ' i
mgth — ?QJ.V1V Of 1 I
imber A v Tttv1a . i i I ,
id/Riprap length E A T I '' 1 t
g distance offshore D"11 - 2 1 1 _—
____ ____
ax distance offshore , 9 '". i
T .� IA
.hannel IN S IL ' PIN
I i- I
ibic yards i1 Pr" 1$ :- _
mp — -;1 ;— { I I
use/Boatlift
t
?It IN I I
Bulldozing / n5w *h j
rLc'A t 3 *2 'KS ' ,�" , l�-t
6& ' ; ' .
ine Length s'
not sure yes • AKnw/L
w
;gs: not sure yes n f i5(1/J _—_ __-__
I
)rium: n/a yes n I �U l0I NI Ct
yes 1
'
Yes r Attached: ' 1
r I i C� ,ykIli �01IS1N, 01Z,
ding permit may be required by: SCL T /e. . I See note on back regarding River Basin
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: _hp,),.z; Po'71-0
Address of Property: /2 2 YAcN> Bass.., ST
(Lot or Street#, Street or Road)
ouyilPce7 /✓G a8-14i B�Pua.5uarc, '
(City and 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 descri tion 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, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215
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,boat house or boat lift must be set
bck a minimum distance of 15'from my area of riparian access-unless waived by me. (If you
wish to ova' a 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.
A -I:22-D1 071Mr.i)47;:,)_ L'APE 1 k
-Sip Name ( Date
iii,,,-5 4,1/a:L._
Print Name Aiir
-"
(9`e) y.0-4'9o9 NCDENR
Telenhnne Nnmher with Area Cnrle _

LAMA / DREDGE St FILL L I O 4
aENERAL PERMIT Previous permit#
1Iew _Modification Complete Reissue Partial Reissue Date previous permit issued
-ized by the State of North Carolina,Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 7
,.Rules attached.
t Name DOPE N►E ? rtCri,_ Project Location: County Ist t, -K-IC..
t22 y&-tt j I{J ae_ . Street Address/State Road/Lot#(s)
,O(flhie e_t state N L ZIP 2 b ( MAYVLG
(919) 3-3o2 Fax#(910) 4-$+`O746 Subdivision __-
:ed Agent City S U C'eT _ ZIP Z41+G
Cw -'SEW Lq TA -ES `J PTS Phone# ( _ ) _ - River Basin Cillk
OEA Li HHF II IH i UBA N/A Adj.Wtr. Body kc I-I T. 11J at
PWS: --FC:
Closest Maj.Wtr. Body- kt‘Al .V
yes /0 PNA yes /n, Crit.Hab. yes / no
I Project/Activity 12Q1LFcCe CFFI J-L Cf2 T 1 N V f -_
(Scale:
ick)length
n(s)
,ier(s) Y W-T 150 si NJ
:ngth
imber
Id/Riprap length - —g distance offshore
ax distance offshore
hannel jtxfsn IJ& ✓
FI—CAT / --a. ExltlnC,
tar
ibis yards _ , / F1-OA'-
use/Boatlift
3ulldozing
T:ttc� FtArer>r�^
FLOAT 4t3'xb' II:
I A4ct,�� e"
,a.Altif• Q�
(S !•i r
-
ne Length -_108g pw I
not sure yes V I 4
gs: not sure yes eolktacte-i—
mum: n/a yes ® 237F....s itk.KISTII PLATFugtO,
Yes 3' TD e3E a 4aCI F0a
® PLAWtnel+T a c FLAT
'Attached: 67 no - I12 yftcOrr C3ks1 l.J Doe:-
ling permit may be required by: UIN I - _ See note on back regarding River Basin
. _ . . _ ..-. A . . r_w I ,lla.I C :1 6= 1 Li 7 (lc,0 I fY r4i Ct - ‘iv

A771
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
lichee)F. Easley, Governor Charles S.Jones, Director William G. Ross Jr.,
Authorized Agent Consent Agreement
rrifl,ex-doe c.v /�Puc o sic here".; thorized to act on my be
(Printed Name of Agent)
)rder to obtain any CAMA permit(s) required for the property listed below. The authorization is limited
cific activities described in the attached sketch.
CATION OF PROJECT:
9u�f/f'o n/c. c2 /G/
JPERTY OWNER MAILING ADDRESS:
DoJtiC ` ✓gi'e
'/ ,Co.04.CE,9/ 46,e.
/Pa77/6 A7C, de44 PHONE NO. gip '-443 30a2!e
IHORIZED AGENT MAILING ADDRESS:
>cu--7.9,2,„e7-,vc_ as7-mil
PHONE NO. 9/17 o? 9-3Dav 9
iature of Property Owner: ,lam
iature of Authorized Agent: (-74Ie

SENDER: COMPL'ETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1',2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. ❑Agent
X
• Print your name and address on the reverse J, ❑Addressee
so that we can return the card to you. B. r-ceived by( rinted Name) C Pa�. Delivery
• Attach this card to the back of the mailpiece, ` D
or on the front if space permits.
D. Is delivery address different from item 1? 0 es
1. Article Addressed to: If YES,enter delivery address below: 0 No
• w 4XIC 6/ire, .0;e
c.24
3. Service Type
P/t4g)9A/' 7 ,q beA4 ,VC. 2 73%.3 Ge Certified Mail 0 Express Mail
❑ Registered 121 Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number 7007 0710 0004 4872 6137
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540