45882D - Brown

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CAMA / I DREDGE & FILL 4
1EN ERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue LPartial 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 15A NCAC ? It , ,Z oo
❑Rules attached.
Name I"0.0 ps-j 3(?_D v./N Project Location: County Pt, a n 6 f_
5"1 b L 0. AP t)r L S-'rJ R)L v 1s) Street Address/State Road/Lot#(s)
pSQ1.Z L Gs A. lk State PJ L. ZIP Z.S Li(-/L 5"1& G V'J. A IJ E a.S. T.,., )Lv I
(9± )b2.... -9S0) Fax#( ) Subdivision
.d Agent CLE n'0--bLE n i S ii 1 to RY tit- CityT PSAT L (2>E. AL`-k ZIP 2.. 4
❑CW LEW TA ❑ES ❑PTS Phone# ( ) River Basin_CAP C
❑OEA ❑HHF E IH ❑USA ❑N/A Adj.Wtr. Body SA -S GM IA ha'V d t- na n
❑ PWS: ❑FC:
ies /nOD PNA yes / io� Crit.Hab. yes / no
Closest Maj.Wtr. Body I P S I .X. S3 1.
Project/Activity =r J5TiAL L 1 Z. X 1 L L a1 i' Lk 1 1 b 4.�F. 1') bow
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(Scale: / 31
k)length
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1 '—1— 1 r
gth - - i 1 LT
fiber
/Ri ra length t-�""�.1,7l I ' 4N I� : 6l
Rip rap gt +
distance offshore 1--
distance offshore
Innel —
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Li ••—r ...1 � ._..
c yards .....
r43 —
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oat i ILA I 1_ {
Ildozing I
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Length -7`� \' 1._..-. i
not sure yes n) 1
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not sure yes `-t1Q) � .. — {- , _ ..._-
im: n/a yes 1 i ` C
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yes ,tf _
:[ached: yes ( n>o 1 I 1 i I

MAN ;,u,a= .: .,sus-v,vAlliiiiVvuw4,-V.,w.6a,t.
Clements J1'arine CaistruetlaH 7936
9 10 2 70-9 1 1O,NCD.0 4356789
577 AV Aghway 210 tU �� ���
*mpsttad,PNL' 28443 Date : 365
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_ayderta e /(; i -/e 1 $ Ge.v —
,Ys v� ''P�� .�-U Dollars 8 0: k'
FIRST CITIZENSug
BANK lFi17mtLax:ZN9Ckvt w CaFparryt._
www.firsteitizens.ebm 'a `" ' W
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For �Il�/),_._ y� n ._
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003001:0035320 L L80311' 07936
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COASTAL VIEWS^

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Notes: Lot St SC 1
I: Areo= 0.35 Acres +f\\- -.
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Legend:
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L'ERttF?CAI E or suliw YoR 1 IVCASre '.y \ ,1 ,µ
4Donny Marco Padgett do certdty �. `, .
thot tinder my directionend supervision. the g S.'
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ottoched pad thot
df i my was awn from en -— 1 �" rt \ �"

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32 ' 53, — 5 90
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For PermitIZAit -g^c1.4.2-r1 37
Address of Property: 5 i C. l' l \et'; of
(Lot or Street#, Street or Road)
77,* r�4u€ C Te/./ck.0
•K - = (City and County)
I hereby c eztify that I own ptupexty adjacent to the-above-refezeuced4 ope ty. The individ
applying forthis permit has described to me as shown on the attached drawing the development tl
•
are proposing.. A desaaip Lion or drawing,with dimenSians, 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 Coa<.
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910--395-3!
within 10 days of receipt of this notice. No response is considered the same as no objectify
you have been notified by Certified Mail.
•
i WAIVER SECTION
I understand that a pier,dock, mooring pilings,breakwater, boat house or boat lift mast
set bck a minima's distance of 15'from my area of riparian access-unless waived by me.
von wish to waive the setback,you must initial the appropriateblank below.)
I do wish to waive the 15'setback requirement_
I sig_i_L4 wish to waive the 15'setback requirement
�• ,&/ 42C �1 e 6/
Sign Name Date

ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: /✓.f4 �r-07z�L�
Z. ` - 93k,
Address of Property: 5/ S it/ ,a/vc rc
(Lot or Street #, Street or Road)
fiA:::/i ,4 -'(% /0C — evt/Z<-
(CitY and County)
I hereby certify that I own property adjacent to the.above-referencedproperty. The indi
applying for this permit has described to me as shown on the attached drawing the developmei
are proposing. A description or drawing,with dimensions, should be provided with this let
C. I.have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of C
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395
within 10 days of receipt of this notice. No response is considered the same as no objec
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift m
set bck a minimum distance of 15' from my area of riparian access-unless waived by n
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
6' L 6 - I; Vo4,
Sign N Date

Clements Marine Construction
NCDENR Letter of authorization of Agent
This letter is to grant permission for Mark Clements, DBA, Clements Marine
Construction to apply for,and obtain permits, and all information needed on my behalf
for projects,building permits,NCDENR permits,or any permits required from the State
or Counties in which work will be performed for me.
V 1 do understand that by allowing Mr. Clements to obtain such permits that this will in
no way release me of any responsibilities to codes, or environmental required permits.
Y date
Print name
y date
Signature
x
Contact numbers