Smith, Marie 78847C

i XCAMA / ❑ DREDGE & FILL
GENERAL PERMIT
New ❑Modification ❑Complete Reissue ❑Partial Reissue
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
Applicant
City_ 14-pC _ � State ZIPJ X5
Phone # (,k),W 133 E-Mail
Authorized Agent
Affected ❑ OE r' A
AEC(s): � OFA HHF ❑ IH
❑ PWS:
ORW: yes P! n PNA yes
Type of Project/ Activity
❑ ES ❑ PTS
❑ UBA ❑ N/A
W 78,''7 A
Previous permit #
Date previous permit issued
B CO D
Project Location: County =(S)l
Street Address/ State Road/Lo
Subdivision
City .561 HEms,' T n I (n ZIP
Phone # (_) IRiver Basin 6�Itii t L�GI
Adj. Wtr. Body nat ma unkn
Closest Maj. Wtr Body f f SCE L
Pier (dock) length--r-----
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) /✓� n ��� 7 _ -- t---
J Groin length
number
Ll
Bulkhead/ Poprap length L -
r-
(Scale: 1
1�
avg distance offshore_7_.
max distance offshore t -
Basin, channel
t
cubic yards RECEIVED
Boat ramp'.—
Boathous Boadift _ ✓ X _ rrnCD t 2021
Beach Bulldozing I DCM-MHD CITY
Other
Shoreline Length
SAV: notsureyes no
F `
_i
Moratorium: n/a yesOno
4-
Photos: yes
Waiver Attached. yes
A building permit may be required by: ���Y ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions (1 j� Y'PAS y i n ` I1 nI A h(�S. T� }�Cirrr .� 1 (�
gent or I t Printed Name s � - PermltOff cef s Print d Name//\
naturd PI erect complia ce statement on back of permit" Signal re
SiM
Application Fees) Check# Issui gD e

®INCAMA / ❑ DREDGE & FILL 9 78847 A B O D
9 ENERAL PERMIT Previous permit#
New Modification ❑Complete Reissue ❑Partial Reissue Date previous permit i
❑ssued
As authorized by the State of North Carolina, Department of Environmental Quality py
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
Applicant Name f I IQ� I e, 7 1�1� Project Location: County—caz
AAA— 194 ,S yyf'Abi �pf,/I IG Street Address/ State Road/ Lot #(s)
Phone # �L),L/fl'_E-Ma l
Authorized Agent
Affected DCV r'A
AEC(s): DOEA HHF ❑IH
❑ PWS:
ORW: yes On PNA yes O
Type of Project/ Activity l QJw�
Pier (dock) length
Fixed Platform(s) --
Floating Platform(s) l' -
Finger pier(s) / '—
Groin length
number
Bulkhead/ ftiprap length
avg distance offshore
max distance offshore
Basin, channel
Boat ramp
Beach Bulldozing �-
Other
❑ES ❑PTS
❑ UBA ❑ N/A
IShoreline Length
SAV: notsure yes no I
Moratorium: n/a yes no l
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
( Note Local Planning Jurisdiction) , t __
Notes/ Special Conditions :V it
or Apf' I tr mteo rvame/ -� t
Subdivision
City 561 I f tin' f/ ZIP / �ry
Phone # (_) River Basin ��f1i 04
Adj. Wtr. Body C' ppp �A-' J net ma unkn
Closest Maj. Wt.. Bodyf
(Scale: fi l ;�: � )
' _i _
I
i
I
i
RECEIVED
FEB 12 2021
_DCM-MHD CITY
I
I
Permit Officer's
I
i
❑ See note on back regarding River Basin rules.
1( (le
Si natur��le*se read compliarfce statement on pack of p�er�mn-'--
Application Feels) Check

��XCAMA / ❑ DREDGE & FILL
ENERAL PERMIT
New ❑Modification ❑Complete Reissue ❑Partial Reissue
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
Applicant Name
Authorized Agent
El Cw
�TA
Affected
'
AEC(s):
� 0EA
d HI F
❑ IH
❑ PWS:
ORW:
yes no
PNA
yes 'V
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) /
Groin length e�
number /
Bulkhead/ Riprap length
avg distance offshore7_
max distance offshore
Basin, channel
cubic yards
Beach Bulldozing
Other
❑ ES ❑ PTS
❑ UBA ❑ N/A
T
Shoreline Length
SAV: not sure yes no
Moratorium: n/a yes
Photos: yes no _
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning Jurisdiction) (�I
Notes/ Special Conditions fir) 1 f
IUX)
N9 78847 A B 0 D
Previous permit #
Date previous permit issued
I
Project Location: County (_,�2 ��f
Street Address/ State Road/ Lot #(s)160
Subdivision
City .56, 1—k�' ZIP / /�
Phone # ( ) IRiver Basin Wtii 0q
Adj. Wtr. Body 1 (nat ma unkn
Closest Maj. Wt.. Body —
So L
orA�pJca�itPrinted Name v Permit Officer's
X,:ent
nature ** Please read compliance statement on backof permit** Signa�
`,1-
�0
Application Fee(s) Check # Issui g D e
r 2�
(Scale: / � . U )
❑ See note on back regarding River Basin rules.
110�IIns 0 114
11110,
Date

to ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
n_.
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0
I hereby certify that I own property adjacent to /70/yIWS Prot /}lwkll7o 's
(Name of Property Owner)
property located at l (vfJ .5l,Lv��2t3�
(Address, Lot, Block) Road, etc.)
on 13AvG SDJl d in 5iu� r A Alc. )PS"/7- , N.C.
(Waterbody) (CitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
�2'.--'>
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
proposing development must fill in description below or attach a site drawing)
n
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i
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�v.
�- 145f my
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If 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.
(Property Owner Information)
Signatur
Mle-6r.1 t ,nwfhl
Print or Type Name
S�UtG
Mailing Address.
Se1[E�— /JJ1A Nc zfi's
City/State2ip
2s"2- 2V/ —5123
Telephone Number
z - R-a OX/
Date
( jacent Property Owner Information)
c�
Signature
/h\/t D W I Ll_1 S
Print or Type Name
tom, b, i3ox 11 la
Mailing Address
5r-Aa1ca-ae'-rU w)c asses"
City/State2ip
;Z5,A.342,C�Sc�y'
Telephone Number
2-q_2-1
Date RECEIVE"
VU $ O00 (Revised 611'/96110 2021
Ck� IILI)DCM-MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to HyMC' eS /70101f Milrtrtu 's
(Name of Property Owner)
property located at / lRU S%aoe1 R
(Address, I
on Sop* Scum in _
(Waterbody)
The applicant has described to me, as shown below, the develo
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROP
(individual proposing development must fill in descrip0
II I " 1 131 15'Iw I;
andinr
N.C.
\\
F- aPp lksui �V! �`
C XIslift� ��� LLr4-S E I(i5Wj Li46
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If 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.
trropeny owner mrormauon)
rn n _ D --7
Date
Date
(Revised 61I N012)

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