Newman, Barbara 78835C

MA /-DREDGE & FILL
W:GrENERALPERMIT
9 78835 A B © D
w ❑Modification ❑Complete Reissue ❑Partial Reissue Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant
to 15A NCAC (i % �-
Applicant Name Ill�i')Jl
a in
p9Ru{les itmched.
Project Location: County
Address
/e-
.SlP1tAJ
Street Address/ State Road/ Lot #(s)
Cityyc I �p-� _ State ZIP.P��
Phone # ( ) %p E-Mail
Subdivision
r
Authorized Agent (i nnP M � /��_
nS�,
Affected "CW O* y4 _
—MEW
Q lH A 0 URA
City
f 4
Phone # (_) River Basin
OEA O w
AEC(s): ❑ PWS:
Adj. Wtr. Body
ORW: yes / no PNA y�/ no
na man
Closest Maj. Wtr7Body
nkn
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) l
Finger pier(s) l
Groin length
number
Bulkhe Riprap IengtF 4
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boaz ramp
Boathouse/ Boatlit
Beach Bulldozine
Shoreline Length (��(rf
SAV: not sure yes a
Moratorium: n/a yes
Photos: y n
Waiver Attached: no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
4
statement on back of permit"
Fee(s) / Check#
cJr
(Scale: _ -36 )
❑ See note on back regarding River Basin rules.

CAMA / DREDGE &FILL N9 78835 A B © D
GENERAL PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue [-]Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality 1 ,py1
and the Coastal Resour es Commission in an area of environmental concern pursuant to 15A NCAC ©"I 1 / �•L+
IN RuI s attached.
Applicant Name 4 Project Location: County o -S 00)
Address k' Street Address/ State Road/ Lot #(s) 3(3
City p State ZIP 3,?/ y
Phone # , ) �7+& E-Mail .� Subdivision
Authorized Agent f� /jil MAXfn�. ��S(.r City l aZIP
Affected ❑CW —.&ttW ,OTA _" ❑PTS Phone# (_) f River Basin
AEC(s): ❑ OEA ❑ HHP ❑ IH ElUBA ❑ N/A Adj. Wtr. Body —LY!A 1
Signature ** Please read compliance statement on back of permit"

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: —1 Kb j rcl tvC, om n
Mailing Address _1-� �r1 �.��liI- I%t
P� 117� (,Od,5 - «da
Phone Number: 14,1 - 785 7
Email Address: hijewirri 1 (016061;
I certify that I have authorized Ma i of i41),5 L617'Q %2
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: L�C 1 (00 / 1
at my property located at �13 6nj my View Drive,
in 01,)5& (tJ County.
1 furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application. ----------
Property Owner Information:
Signature
2n rb(-1Ld Ak tyluc� n
Print or Type Name
Owner
Title
r/i
Date
This certification is valid through ► I
?d $11DZ)
Ckk 3 5 S q
RECEIVED
JAN 2 0 2021
DCM-MHD CITY

i hereby certify that I own property adjacent to
Property located at (name of property owner)
on (Address, Lod Block, oa etc,)
(waternody) to : .
IuRY' I ovm mart ty) N.C.
The applicant has described to me, as shown below, the development proposed at the above
locati �+
�i nt1� J f I have no objection to this proposal.
G�i✓ z __ I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill fn descr/p8on below or a /tech a site drrMng)
wa1VER S TioN
i understand that a pier, dock, mooring pitings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived in
me. (if you wish to waive the setback, you must Initial the appropriateriparian
blank belowby
.)
I do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(Property Owner Information) (adj
acent Property Owner Information)
ArQ�y
'Va"Cl for one calendar year after signature* (Revised Aug. 2014)

1 traby that t own �0
op q adjacent to
prop" tooated at 1f 7`l! )2'r!' : r` F 8hN Ot P
on -- (AddfsK Lost Blast, o Ott.)
(W&terbody) and `' < N.C.
"com has described to me, as shown below, the dev lopmont PrOPOWe2 VW above
'•aFaffidrr�
n, ----1 I have no objection to this proposal.
�t -
L I have ob*dons to this PMPosal.
DE5CRIP110N ANOtOR DRAWING OF PROPOt.O
SED DEVEPfitENT
(tndiWdtral P PP"Ing d eve 0 Ont must fM in
ptlon Wow or attach a she drawing)
t understand that a plat, dock, WAt1ings ngR SECTION
must be Set tack a minfmum dieter W of 15. from my area of rl
oat r3Z brva tM, house. !i , or sten
You sweat to wave the Setback -'you must Infidel ft a , 3 unless waived by
appropriate btar:lc below.)
1 do wish to waive the i 5' setback reauirenlam.
1 do not Wish to waive th 9 5 a setback requ{rertsenY.
WfuPa?W Owner Infnrmatinnt
I �wlYer tntormttion}
Nam
i5
'Vx6tl fc one raptendar year actor signe ure• (Revived Avg, 2014)

Project_
Subject
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By -
Page
Date
of
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