38480D - Martino

kAMA/ :I DREDGE & FILL
.EN E_ RAL PERMIT Previous permit#
New Modification -Complete Reissue —Partial Reissue Date previous permit issued
-ized by the State of North Carolina,Department of Environment and Natural Resources ,I v
:oastal Resources Commission in an area of environmental concern pursuant to I5A NCAC 77 , /. 0
'',A� ``__ ules attached.
t Name goLPr plMcc-� (J U Project Location: County
R C M Street Address/State Road/Lot#(s) J 7 ' w(c
t
re 1 k g 1) State 0 !ZIP q, / ,/�
00 ?) -.2� #( ) Subdivision �� ,Cf 6l4n• ^1(-Fe
ed Agent P, ii . S M 0 s ,C City S i 1r( ZIP a t9
� � Y
❑CW NAV y.P'fA ❑ES ❑PTS Phone# ( ) River Basin Wit t tc
❑OEA ❑HHF ❑IH ❑i UBA ❑N/A Adj.Wtr. Body 4,1/ / (nat�f
❑PWS: ❑FC:
ye / no PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body din/° SO NM)
Project/Activity e JktQ jar( 30 /;
r�
(Scale: / _
ck)length I/l J 3/
L(s)
ier(s)
ngth
mber
d/Riprap length
distance offshore
ix distance offshore
`cannel A
bic yards
np
is, Boatlift I )` (3 !
7 rr P r P r
ulldozing ' �/ 27 /
e Length ` I '
not sure yes no yJ
s: not sure yes no eD L e c
cum: n/a yes no ` *1 7
yes no 7
4ttached: yes no
ng permit may be required by: QNS/0 4 4 See note on back regarding River Basin r

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: o 6f r 1 7 h
ADDITIONAL NAMES:
AEC DESIG: DEVELOP AREA: o P ' PROJ DESC: P - 1
(Will only take 6) (Will only take 1)
WORK: CP LI , 30
(Will only take 4)
i3L i3 , 13
MAINT:
(Will only take 4)
IMP: l21" L/
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED:
CAMA MAJOR DEVEL REQUIRED:

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Joseph K Rivenbark 910329052737 p. 2
Oct 07 04 07:28a John Cassidy '. 10-327-6353 p.2
ARSUCIM-Bl
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4 6:_ , ,ro
Name Of Individual Applying For Permit:Addre®e of Property: —
?; G�,�r6✓��.4 ----
��✓�� r� Z
(Lot or Street , Street c ar Road, Cit Y & County)
Certif' that I own property adjacent to the above-
Ireferenced hereby The individual applyi lq for this permit has
ddescribed p� }' on the attached d:-aving the development
hscribed to ma s shorn
they are Prtp°s g_ A description or dray ring, with dimensions,
should be provi with this letter.
Yj - I base no objections to this pzoposal
oed. laisese write the
Gent. 127 Cart ,rirw�r.�
Dj i0mt of tal i Q5 or �l 91Q 395-1900 thirj 10
•... A - t.-• mar - .. . •.- , - is conai _rat same
� i. �, .1� ., � '.-, •' , . .' Y Certified Mill
as no Qbi ectiQD f you have. ken JclQr.S led ,)
IMIXtRAIMAK
Z understandLiftthat a pier,
dock,
mooring pilings. breakwater, boat
oe, Tare or o i access unless set ck a wai'red by midis(If youf wish
from area of pyou $ initial the appropriate blank
to waive the ee�bac)t, gust
below. )
i
I do wish Co waive the 15'sztbaCk requirement.
I &Ism wish to waive the 15'setback requirement .
1
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Print N Omso. County
0� 3 - 0 (37
Telephone Number {with Area Code
Outylost County Plannieg Depart
604 Collette S'eeet
Jookionvillo, NC 2.8540

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