39041D - Afify

FiT C��AMA/ ❑DREDGE & FILL
GENEMAL PERMIT Previous permit#
eNew _Modification III Complete Reissue ❑Partial Reissue Date previous permit issued
orized by the State of North Carolina,Department of Environment and Natural Resources r�
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC f ri . 1 '"1
r r ❑Rules attached.
ant NameMt)l'
Mt) •M(1(1 -}• A ri:4 r, 4 t ,- 1 f Project Location: County 0 n Si o(AVp
s "131 2- N. ri)qn o r Dr• Street Address/State Road/Lot#(s)
Pre,6vf o"k. State NC ZIP If/C77 10//� / 54 5-4
#milt) 26R' 41-b4QFax#( ) - Subdivision
ized Agent ZQ F-4' H 4 rV e y QIU_Z bZ-xlc , City -C."' 11' C 47 ZIP 2A 4
d ❑CW XEW ,1711r1-A ❑ES ❑PTS Phone# ( ) River Basin e-ye'
❑OEA ❑HHF ❑IH ❑UBA ❑WA CQ'R
• ❑ PWS: ❑FC: Adj.Wtr. Body I .-
yes /� PNA yes / no Crit.Nab. yes / no Closest Maj.Wtr. Body A W fJ
Af Project/Activity /J e tn/ l I A 1 fQ r,—/ -C 1 e''- .- �j dot k, 4b r /,' F
l (Scale: /",_•
lock)length R ' ) LZ',Co,e r'Cd T!elk for
I'
-12d3G
'm 4(s) 1 )( S'FID44 k .- - }-..._-�
i _y-. f '
pier(s)
length - {
lumber
f - + I: I
:ad/Riprap length 1 i f + + ... i J -
vgdistance offshore 4- _._------1
lax distance offshore ....... !-- j L.. _ NA.L --
channel '
ubic yards f _ ! J. II ■�0/4 1f. :
iii
imp / I t .....
>use/ oatlift I X i I l • r 1
I /.
Bulldozing
P� , "re4 1
:
. I
ine Length Si S / V T .+....... ..... I
not sure yes o f i'O t, ' 1 S _ ift
1 Vigs: not sure yes no I ' — —
>rium: n/a yes no .. �. t 't. ill i r 1—: t
. 1
yes , .-} ., i _ i f
•Attached: yes no} l
ding permit may be required by: �v,.F i 4 tj ❑See note on back regarding River Basin

(EIS'ERATr PERMIT COMPUTER FORM
2PUCeN1 N. /✓l0licti^lcld 4 An ' +G Pr' f •
ADDITION.=L N S:Te f f N q✓ve
y _
AyC DE SIG: E 1.v l PT DE\.r.L.OP 4 Wiz:_O•D PROJ DESC:P - I z
(wi l only talc 6) (Will onh•mkt l)
/1 c- a
`r )
(Will a iy mi 4)
MkINT:
(Will only rz: 4)
DO: Ow 3 '+0
(x 11 only k 6)
ACTION DPIRA.TION
DR=GE T R QLiRED: 9/ ` /0`f II//1/(54
CAMS MAJOR DEVEL REQUIRED: �'l 19 104 i i f l V6 9

)caliry Permit Number
cean Hazard Estuarine-Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only) '4.,'4
?NERAL INFORMATION
ND OWNER //�� 2)0,0
nett tt 4 tv a16 t n ° 1Q ri P A414
me 7
dress 9 31 A• /440,44®2 b R— q
y -tP�w t o✓�_ State AL C. Zip a 75 9 7 Phone Q/9 3G l 4ieil
JTHORIZED AGENT Erne rie,144, I/
t - I a 4- A-7
[dress /w. p ' n
ty t#- Zip Sc� J Phone O a eSs
YY€JL State C—
DCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what
t is the name of
04—
e adjacent waterbody?) /0 /a / £
►ESCRIPTION OF PROJECT: (List all proposed constructio and land disturbance.)
,IZE OF LOT/PARCEL: “2010 square feet acres
'ROPOSED USE: Residential/X.' (Single-family Multi-family ) Commerical/Industrial
)ther
COTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVI•
IIONMENTAL CONCERN (AEC): W4 square feet (includes all floors and roof-covered decks;
SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT-UPON SURFACES II
THE COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): I 7 55 sq.
(Calculations include the area of the roof/drip line of all buildings, driveways, covered decks, concrete or masonry pat
etc. that are within the applicable AEC.Attach your calculations with the project drawing.)
Choose the AEC area that applies to your property:
(1) within 75 feet of Normal High Water for the Estuarine Shoreline AEC
(2) within 575 feet of Normal High Water for the Estuarine Shoreline AEC, adjacent to Outstanding

he
m
ino
ER PERMITS MAY BE REQUIRED:The activity you are planning may eqrequired.iepermits
rmits7ether than
y t e C k o er the rst
,menvpermit.As a service we have compiled a list of the kinds of permits that might
li
,ur LPO to determine if any of these apply to your project:Zoning,Drinking Water Well,Septic Tank(or other sanitary waste
nt system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,FIA Certification,
►une,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway,Connection,and others.
CEMENT OF OWNERSHIP:
AEC or
undersigned, an applicant for a LAMA minor developmentfor apermit,being either the owner CAMA minor development peromf ptoe rerty rtifY than t the persc
i authorized to act as an agent for purposes of applying
as landowner on this application has a significant interest in the real property described therein.This interest can be
bed as: (check one)
, see Deed Book
in owner or record title.Title is vested in County Registry of Deeds.
in the
an owner by virtue of inheritance.Applicant is an heir to the estate of
ite was in County.
if other interest,such as written contract or lease, explain below or use a separate sheet and attach to this application.
ITIFICATION OF ADJACENT PROPERTY OWNERS:
thermore certify that the following persons are owners of properties adjoining this property. I affirm that I ave given
['UAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
two,1A, e L S�.,L�- d Pa f3dk c /7$ "` Cs;1s A&
)R DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
is planned
or an area which may be
:knowledge that the land owner is aware that the proposed development
explained to mef the particular hazard problems 1
officer has
ision and/or flooding. I acknowledge that the local permit
d with this lot.This explanation was accompanied by recommendations concerning stabilization and floodproofing ti
Ines.
ERMISSION TO ENTER ON LAND:
iirthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer and his ag
ter on the aforementioned lands in connection with evaluating information related to this permit application.
t_c ..I t,t,;c �nnliran on. tl

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3rd ST
✓" LINE BEARING DISTANCE
L1 S 28'51'06" E 0.5' CANAL SITE
MB
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SETTLERS BEACHBLOCK 45
8.00ft 39.00' 8.O0ft z W
SECTION 3 - — 0, 0X
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