30419D - Memory

0 CAMA / DREDGE & FILL N° 30419-t
GENERAL PERMIT Previous permit#
> % New Modification Complete Reissue Partial e.eissue ' Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources f),/ //� J riff ff /
and the Coastal Resources Commission in an area of environmental concern pursuant to I5A NCAC T 11 .
F j /�/J WI
attached.
Applicant Name -dill ( ,�A/ 1 em.;'j`y Project Location: County /Lk✓V /-1 i.4 �(
Address 0 A t 4 v I S to f‘ Street Address/State Road/ Lot#(s) 9/3 Cc(n y ( U r-,N
Citye( A1 o r v State /1/C.ZIP,� kf�
�� s 3
Phone# ( ) Fax#( ) Subdivision �
Authorized Agent City CrQ '//n (Jp A 3 Du t,it ZIP
cw iz3;EW gTA J(S LPTS Phone # ( ) River Basin r
Affected '4 ? P-e.t/
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body /+\,J t-tf P GI. v ' �-:'.-•-,ti �n /man /unkn)
❑ PWS: ❑FC: ^
ORW: yes /'no PNA yes / n9 Crit.Hab. yes / no Closest Maj. Wtr. Body r'7 /
Type of Project/Activity �0 I ir,-,C 4-. 5 0 e ?ul/-(/I c.4-cl a// l c CI //-/::?' A4 d,.vu, J o T x4�+,J.,, ,6 J/1/(Ace
1 5DJ 4.s10. /n/tr Li d `
/4 r i /GA LJ /��t�'4
w,•0•01 cT C X0 1'4 3 .6v� cl on /�,/---IAsfi e Y T 1.1-4/
r
Pier(dock)length Q It.*y 6' � _. __ D `,J 4- / r •d -t p
2Platform(s) I S C. tt 'l e•
Finger pier(s) © 1
Groin length /14l) a ✓1) T r.,t-'.� I.-- '
number _._.. -
b-tiMi crt pr(r w+l` k ' T
Bulkhead/Riprap length 7+ L
avg distance offshore __ Ci ) y Ja • hi
•max distance offshore .4' 1 'u AP
i 1 1.4
Basin,channel , -- —
cubic yards V
Boat ramp
Boathouse/Boatlift
� rt9 -
Beach Bulldozing F i -_ — _ -- 1 -
+ / / O' 14Zf6o
OtherFL4 i.)Ik (? x )
I i t
16\\
Shoreline Length ril / I /A/
O i
SAY: not sure yes no _ __ �_ i ,•_ ^,
ll / ,,/ 1
Sandbags: not sure yes no b f T f , PT 7' - t C I , A r.. . .
Moratorium: n/a yes no '>✓'r•1,.(, S
`.
Photos: yes no < ' �� .
Waiver Attached: yes no - -----------A building permit may be required b (� !+/� . n Li See note on back regarding River Basin rules.
y:
Notes/Special Conditions P11 (04 L f T/.,,} D 4- " ) • //0 3 1- -/ki• //l)J 3 sX/!/ 4Pp/7,
1 i c r /C / )i , A4 /I s ' �xceeci Corobtik 8ev, 4 Pt r //e4d Au;£ . 1Ai/
-Otr�c--b, n > A ii 6 ( U4 irk /S F A 4r
/nf/dQ Pat eo r /d•
orr C3rr183 ( /. %ie
Agent or Applicant Printed Name / Permit Offi r s mature
Signature **Please read compliance statement on back of permit** Issuing Date Expiration Date
iA Application Fee(s) Check# Local Planning Jurisdiction Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief,certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar-Pamlico River Basin Buffer Rules Other:
Neuse River Basin Buffer Rules
If indicated on front of permit,your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office(252-946-6481)or the Wilmington
Regional Office(910-395-3900)for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District Washington District
Mailing Address: 1367 U.S. 17 South 943 Washington Square Mall
1638 Mail Service Center Elizabeth City, NC 27909 Washington, NC 27889
Raleigh, NC 27699-1638 252-264-3901 252-946-648 I
Location: Fax: [phone] Fax: [phone]
(Serves: Camden,Chowan, Currituck, (Serves: Beaufort, Bertie, Hertford, Hyde,
Parker Lincoln Building
Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
2728 Capital Blvd. Counties)
Raleigh, NC 27604
733 2293 / I-888-4RCOAST Morehead City District Wilmington District
Fax: [phone] 15 I-B Hwy. 24 127 Cardinal Drive Ext.
Hestron Plaza II Wilmington, NC 28405-3845
Morehead City, NC 28557 910-395-3900
202-808-2808 Fax: 9 I 0-350-2004
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves: Carteret, Craven, Onslow-above Onslow-below New River Inlet-and
New River Inlet-and Pamlico Counties) Pender Counties)
Revised I0/05/0I

GENERAL PERMIT
t'o ?lT'T'^ l7P
•
FIELD REP: 4 Pk/' f °'
APP FE... l
PERMIT NO: �� COUNTY:
"'C DESIG) QW 1 E 1k/ p ) es WATER BODY:
APPLICANT(iAME` J O�)( L Al trytc.
ADDITIONAL NAME(S) :
MAILING ADDRESS: - ^
PHONE:
CITY: STATE: ZIP:
PROJECT LOCATION:
INCLv CITY OR LOCALITY - (WHEN DIFFERENT FROM MAILING ADDRESS)
DEV ARE : . 0 a\ PROJECT DESC• I -at/SAT (X) : LONG Y
(_soc ( � _ _ _ _ _SD - � _ _ _) G - - 25 .. c.
- - -)
• CODELENGTH WI
DTH DEPTH CODE LENGTH WIDTH DEPTH
MNT• ( _) (- - - _)
CODE LENGTH WIDTH DEPTH CODE LENG Ho WIDTH DEPTH
GIMP,. � D '0,��1//
J 6 SQUARE FaEE T ) P Yv 2° ) P kit/ LIP)
CODE SQUARE FEET CODE SQUARE FEET
ACTION EXPIRATION
DREDGE AND FILL REQUIRED:
CAMA MAJOR DEVELOPMENT REQUIRED:
************************************************ ****************************
CODER FOR AEC DESIGNATIONS
"OH" — Ocean Hazard "C'nT" — Coastal Wetlands •
" " - Estuarine Waters • - "FC" .— Fragile Coastal Natural/Cultural
"ES" — Estuarine Shoreline "PW"
- — Public Water Supply
"PT" — Public Trust : -. "OR" — Outstanding Resource Water •
CODES FOR PROJECT -
IP" Private, usually an individual - -. . "F" Federal :
'C" Commercial - - " -- "L" Local Government
'U" Utility - . -: . "H" Housing Development
' " State".,: - • - • . - .- _
S • "0" Other
- - - • _ CODES FOR DESCRIPTION - • - ' -
'll" Bulkheads, Riprap ' "16" Utility Lines -
12" Piers, Docks, Boathouses . " r�
- :. _ - "17" Emergency Repairs .
23" Boat Ramps -
18 Beach Bulldozing
14" Wooden Groins - "19" Temporary Structures
1S" Maintenance of Basins, Channels, Ditches - .

•
TAmmi.1:2•COor:S Fon NI.:11'WORK on M.1N1'KNANCI;
JI)Imensions le led fir mare fret units ulhrn,he al,lyd•l TAM P:1-Co1)I:.S FOn IMSCn11t1':O\Or UI.STI'nur.1)AREAS
CODE TYPE OF DEVELOPMENT 1, (Oimnslens hi s,O,nn•frrl unless nlllrrulse nnt,dl
DESCRIPTION EXAMPLE J 5
MAJOR SPECIFIC '
"AC". Access ehennel;canal length, width, depth "AC200,20,-4" GROUP IMPACT DESCRIPTION EXAMPLE• i "AR" Artificial reef length, width "A11200,50" .
"AS" • Artificial seaweed length, width • "AS500,100"
' "BA" Beach or est. access ' -- "DA" "WS" * Wooded swamp "WS450" I
' "DB" Boat basin, slip length; width, depth "UD150,50,-6" "CY" Cypress "CY150°
„D11„ Bulkhead length "DI(150" ".GU" Gum "GU150"
BL Boat lift length; width • "DL25,15" "CE" Cedar "CE150" I
. • "BN" Beach nourishment length; width "DN1500,5O" "SH" Maple • "SN150"
• "BP" Boat ramp • length, width "DP100,10" . • "PO" * • Pocoain "P0250"
"BRM Bridge length, width "DR75,50" • "MF" * Maritime forest "11F175"
DS Boat house length; width "Ds4a.20" "UM" *
• High marsh ^)(t1390" '
"BW" Breakwater length "BW150" • "JR" Juncus roemerianus "JR30"
' "CC" Cable crossing • • length "CC275" (black needlerush)
r "CE" Condo expansion • units hew,existing "CE45,40" "SY" .Spartina cynosuroides • "SY60"
"CG" . Campground length, width "cG17s,400"- (salt or giant reed grass)
"CO" Condo 1 unite, height "C064,45" "SP" Spartina patens "SP35"
"CV" ' Culvert length, width "CV60,15" (salt meadow grass)
"DO" Drainage ditch •
length, width, depth "DD900,12,-D"' "Ds" Dietichlis spinets' "osso"
' "Do" Dolphin ' number "D04" (salt or spike grass)
"DS" Drystack storage length, width, height "DS200,75,50" "SS" Salicornia ep. "5S38" •
"EL" Pier "L" head • length, width "EL10,20" (glesswort)
' "FT" Fill basin, slip • length, width, depth "FD300,50,-4" "LS" Limonium sp. "L5110"
• "PC" Fill canal, channel • length, Width, depth "FC300,50,-4" (sea lavender)
"F11n Fish house - • length,'width "F11150,75" "SC" Scirpus sp. "SC20" '
"FI Fill, general ' length, width, depth "FI300,50,-3" 4
(bullrush or three square)
•
"FR" Fill for road length, width, depth "FR975,50,-2" "CJ" . Cladium Jamaicense • "CJ27"
• "PS" Floating structure length, width- fuse this only when (saw grass)
• no other code fits) "SA" • Spartina alternaflora "SA75" '
• • - "GR" 'Groin length; width "GR200,2" (salt mars), eordgreae)
"I(O"' Hotel, motel complex length; width height "1(0450,75,50" • "TY" Typha ep. "TY32"
"11W" Highway, street length, width ")(w1000,50" (cattail)
^JE" . Jetty length, width "JE30,2" "BF" Borrichia frutescens "DF42"
"HA" Marina 1 of slips "MA50" (Eva oxeye)
• "ME" Marina expansion • slips nog, existing "ME15,20" "IF" • Iva irutescens "IF76"
"Hi" Mitigation length, width "HI50, 5" (ma: ih elder)
"VP"
flooring piling number "11R5" - "PH" Phregm,-ea sp. "P1f60"
lion-pier 1.rrgth, •i,1,1*.it (use this (.n:y when
no other coda fits) ":.lit * Lo'i Mcrel, "LT150"
"OP" Outfall pipe diameter in ", length "0P6,2000"
NOTE, This is not a sewer line extension unless it .results "SA" Spartina elternaflore "SA30"
in a discharge to state waters. For example, a WWTP (salt marsh cord grass)
effluent pipe would be "0P"
' "OT" Other --- "CT" "HG" * . High Ground "1(0750"
(includes spoil disposal)
•
"PC" Pipeline crossing diameter in ", length "PC8,450"
"Pt." Parking lot length; width "PL100,50" "OW" * Open Water (Use with plats. . "oW900^
"PT1" Pent mining • •
acres "P1150" mooring pilings etc. where
"PR" Pier or dock length, width • "PR160,5" there is little bettors
"RR" Rlprep length, width "RR150,5" dlsturbonce.) , ,
"SC" Cable, pipe crossing **no longer Used** +��
"SD" Subdivision i lots, total acres "5042,50" "SD" * Shelled Water lkh ad "SB550" `
"SE" Subdivision expansion • lots new, existing "SE20,50" (Used for n etc.ede,
"TE" Pier T head length, width "TE20,6" excavation etc, where
there -is a major alter-
ation to the bottom.)
I
. noon * Beach "DC150"
"ON" * Dune "DN200"
"GB" * Submerged grassbeds "G875"
"WL" * COE designated wetlands " 1104 75"
(Use whon•othor species ,
are present. not list- ,
ed elsewhere).
...___ ...A.. .,«t.. .n,�• • •-, pre not nit'en.

4t Ts %--,y 1: �•i34�"s- -,;;74, sZs-eett•- : ... t " t.
k ,ew bModifimtion . - Complee1Zeissue DParttaBaiaete e
- - - � .T ... sly' A•'c' 4 Yf
-;: . - Dateprevious permrtlssued
authorized bytfie'State of North Caarrolina,•Depa�ment of Environment and Natural Resources a .. ' 3r
and the Coastal Resources Comm�ion to an area of environmental-concern:pursuam to IbA-NCAC- - -• • -_y. - � 0-"= -7 _
--/--- --- _ - - , - - -- ,` _ . nes atmched.
\pplicant'Name •••- -t7'-(C M-en'1�1� Project Location: County: (.,. i • ter �k
address"• �.� = l''`�' '( SU'r Street Address/State Road/Lot#(s)-.• 9/� nu ( - U r'I it„;..•
..tty:: (;r e e_ et State ZIP � __-
hone-#:(-_}-- ---.. .— ( -- — _- Subdivision- -- -- .:._
I✓ax#-
kuthorizedAgent ` • -- •._, . _ -_- ---..._ . . ._. ... _ City CJ,r•>i l-.,, 1 Gu L -
. �...._ ty � G } - ..ZIP
effected TA J S OPTS Phone# ( ) • River Basin CK Pe,. . e
OOEA OHHF ❑IH ❑UBA ON/A /y� 1 r 'V
kEC(s): Adj.Wtr. Body ! N,i r--rfe V%� .)r' CJ--Lt!; ( /man.%unkn) ` :
O PWS: OFC: i
DRW: yes / no PNA yes / no Grit.H ab. yes / no Closest Maj.Wtr. Body /V✓ -�
Type of Project/Activity C..0Rl71c�C.� .17 r r Oce/f tt•C,t-d QI /ICC //.F/' 44JwurJ o- - xt� ia,a • . , /{kc.,(�
O/l cz ' r-bliI •1r ,F!'>/1r -><�I •.- �2t-r j 4tiw --6 0-r C X(.) ..1 .t .4../ltirClic► on .I:::4--1AS(dcale:Pr'p`'r"1 )
Pier(dock)length i^P wa V#:".1,X r15 a / / 4 l 4. .--, �n > D %).t. ' ... : •. ... ; .. -
Platiorm(s • ' . . f .j Ili ! t, f . , i t 1 I 1 I ! ! ( • I "! I i i_ I i! i 4 f ..• % •
Finger pier(s) ' ' •' i ;/ i f i I I I !. i ( ; 1 ( I i .
Groin length - f S j✓`J 7 t ," i i I ! i - i I- ! i I .i i I , i I' i
/ • I i1 i j� ! • i 1 t 1 1 ! i I I l i 1 I. I ; .
number f7 yv( �C pY(ir IA"t1„ !'` ; 1 I I , -1 1r1. I 11 I I I ! ! I i' I I I
Bulkhead/Riprap length 50' I r : i r-t ; •II i i 1 . I 1 1 tI 1 I ! • ( I I '1 'I -I "..-1' t 1::•1 I. )•
avgdistanceoffshore ' •0 51Ti G .-�!;4 i I i 1 -i 1 1t I I 1' I ! I I
1 ' i. ! I I I I ! I ; i 1 1 I w
•
max distance offshore b, b S1 I ! rf' i I I + I ! i I ! I . I t- I -I I" I
Basin,channel 1'< �` ?`t `r'� ' I rI I I I I i I I I I--•11 I. I ``
' ! ! I i i I I ! i I. ! ! ! III I I I d •• I -I I I . . ••1•'.. 1• -P- I I ••••I:.I -j '=:
` +rJ� 1 i 1 l i 1 1 1 • I
cubic yards- - L` I I I i I: ! 1 I I I : I ' 1 • I 1 1 ! I • t.. I .I -- l I•:.•.1 I .'! I - _:,!..
• I-•i • ` I I I i ' .I " 1 1 I , . 1 ! I' •Boat ramp. 1 i i ! 1 I I I i •~f Z , ! I .:"I t ' / 1 i • I 1.. I I `' I y:
Boathouse/Boatlift - i ' ! I 1 I i j(oI 1 1 I I I I I I : ~r
1 I 1 I i-.:-I.,I •.I {• I I- I'.. -;;I;.1 .,,-
I IS` - - _ 1 I t I 1; N' P4..I :1 ! I 1 I: I. ',ei
Beach Bulldozing ' � � ! ' 1 t ' I I 1 f I {j. 1.
1
''� l •?\ i!v l0i : I I t i �jzeii a I 1 '1 .1. I . j ! I. ! 1 I I- I I -j--I' -1- { •i'
Other1 ag.•...).Jn s. ai- 1 1 \. I( 1' n ! 1 I I I 1 1 • I -1 I I I i- -1'
i . , . mini. t f-( IE'v1l 1 1 / I I I- 1 :•1 I •'1 •••1 1 . 1 :I I' :.I••
•-1. .I - .1.,:
r
' � I ( 1 I !t 1 1 I _ I l 1 1 I
..Shoreline Length 1 : N_ i !I ' 1 ! ! i' 1 / II
o i f / . /, I I 11 1 I /� I ��r/J fi,�..
SAY:- -- .-notsure -yes :no 1� ). ' r "� _mil I 1 : I ' i 1 i I I I 1 l I S
i Tf�,l.a I I ,I r, , i I 1 I I ri 1),'J 1/ I 1 j I -1 -f^ - 'l'/fa1,,/ .„.
Sandbags:;:'notsure es no i ) ; ' h k J •
-Y ,:'���. (�/i�/ I L`r- ��y �J i I� if.��itcl� � I •I. I .1.. 1 ...1. j 1•.•:I -�
Moratorium- n/a `yes rio • !7(tlicu CI, I - t I 1 i I I I I I
. • yes -_no I f`. , . • 1 '(1 1 ' I 1 I 1 I I 'I• 1 -1-..A,.. I:- -1; : '
_-Photos: I .., : I. ; i
! , 1 '. , 1 i 1 I i I I 1 I• 11 1 1 1 1 1 1 1 :' 1 r 'I I ! 1 -1 1 Waiver Attached yes_ no t 1 - :_.A
A buildingpermit ma _be required b : - : ! ...rt
may.be ❑�S/ee notebn back re ding River Basin.rules.,.: '.
Notes/Special_Conditions .piT �4 d ! I'/a•n ) D`f 1 1�.- //D. - •-.4- 9 N- /.A J) .-.: // t'PP/4 - 4
Pr r r i( r,,-r"i, .7"4u /( ,. � X Ce e ci (?o r //'s 4 PPR, r /leo � '. 4(4 e ,�/91/ =';
Cap i• I JC''!Z'A ' it ! / .•9-[- a-r %fra )4 sic r- L Mi/C/P Par • r i orf: 1 -
n / a� L�rrr����. 7r.11e.. ^�
_�
Agent or-Applicant-Printed Name ' ermttOffi rsS•i re ry: ._ eat a h,„v*�
_• .:. ,. ✓.+ 7. -�,r + s_ �f'.�:Ga,..��f4 •l'2:�� �n � o� �'� .} t :`r.� •
c a t* 4 �
Signature leasereadompliancestatemento bckofpermt " Yy r . r fie(�xs
t
IF
'�•V r J /r /^� . � s jf/ 3
AppiimtionFee(s) , Check# LomlPlanningJurisdrcuonr n -. a r , Rover File Name „. , r•

�oRO Wc2T�[o�
_ ,. 0-kw zooZ
e-A/41- ,
-me now xe-4
,pair /1//,. ecgoo : /ee: Otiattim B6fal
, t.rifip
d#/y/A'6 /cm Ay Ow /0/,/r, X
U,ot4raoo. P/f/v J7-A4 /) T7,./ ,may
Mni/G lou d") ra //cz? 1 EZ /,v My
/.9eziu/9.6ze- , /e/C
/eo iP,oex, m? 7X9T /l ve- .limos 40
,v
,f.dp at/Mite 09770/t/ /�,te emie;
der IT 21L 41/oT"&Z r. ,B ai a /ti
/k o74 S fr ���2 Me`ss,kk res7-6-i24.,4y
df/�/,e,eb
r rr/da,6B 46' teepticsr d "fwo/e ,r04Wrc rov
-To= 417 6-)9Aor ro tkGouJ 7o /,vct'citsE-
/L1y GAze&v To /902 s9 lr r fT i
zr y"ii S 4/i,/A/ ,9 of 4 f rrfc� .1,s • v�
4s 5fio All
63-'6.. •
oaz -- _aye Pee- icikez _me Ar yoke._
c*-416- - -icloivvideile7A/ce 7a ier /efieed 144
- eO /�
- - . ' I4" 0. -/;i0AfeT-A-Jr, /-.5 - .- D' !-
.ser -z-F;#.0)-47r we0 ;----*1
, ..g,t9ecT' 1
,45
Isv
� I � 1714/-
! ! ! ! 11 111 111

_. Atztc- .veiv& 1 peiriur w-, Iof/7 . /filie/v /Pre/uy- '
_ ...„,!, _..
fie" 7ic_/f-zevieializz. e
i 1 ___,
Rt z69-sr /5"ir pysipe, ewety Al&fterAW, 4i.ett.A9-? NL: ._
mezz eO/Vfebrx .1.0- 44.6 . s_ ie 3-7-ire-7,g. oe04'-'1 i ;_._.
. . __ ._ . expteg/I_ENrr• ,
• ! •
t 4_)( 20 E_O__4-714,0G_DoCK._. - _ ._.. -
. . _. _ . . . • _ ..
0 ,
. .. . _
•
_ _ ._ _
-..
112 54)
..
--- - - .
. \--- ./".°
• - _
• _ _-_ . _ ___
•
ii
_ ___ . • , .
. i :•
,
. .
4 .
, .
. •. ; ; el .1-F—'•. . I
. . ; • .
.
I
; 1 ' I ; . • , • • • • 1
, . !
I . .
• , I ., 1 ,
. .
, 1 i
• I I I !
I
. '1
_, 1-1,- ' • :. I I i ,
i I I I
. .
. 1 Ic.tu.1,K,vkE Alt ,
i_,___11 • , i
1 1
: • , . . ,
I 1
, . , , . • •. .
_• , • . , i 1 1 1
' I i I 1 I ' ' i 1 • 1 ! I
II
I I Il_ealH51
, .
1 .
i ,
1 il I
1 . 1
I !
i ! !
tA ,
...„..0 I 1
1 , ,
I ,
•
! , !
I
I ,
, I
I ! ,
, .
I
I ,
1 1
re .
.. . ... . . „ . . ..
I . . •
I _
- - _ ._ —Mb
. . .. . , _._ _ ..... .
__., _
t 1 , .•• 4.0 -
•.
. . .._ .__ ....._... . . ,
I .
.. •. .__.1 -- . .
I • . Alp, ____

AMA/ '_1 DREDGE & FILL N? 30419-.
GENERAL . PERMIT
Previous permit#
lew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources A/ / /� J 1/7 C
and the Coastal Resources Commission in an area of environmental concern pursuant to I5A NCAC l `1- `` i�
Rules attached.
Applicant Name -J Li/(,e /V�.em.�� -Project Location: County A)(„ ' /-k .t v �(
Address •.3,0 O t M„,,,' i S n n _________ Street Address/State Road/Lot#(s) /3 cc,„,,10 F
City C, y-Et4 S‘, f.- State_L.ZIP'X'2/10 3
Phone#( ) 'Fax#( ) Subdivision /
Authorized Agent City C4 r- l/,t-1 IS " (ih ZIP
Affected NCVN W e<TA • AfS ❑PTS Phone# ( ) River Basin C'pe_ �e•tr
❑OEA ❑HHF ❑IH CIUBA ❑N/A
AEC(s): /�
Adj.Wtr. Body /r\\I r�e G r� oc) S3.M.ti
❑PWS:no ❑FC: ? I (n /man /unk
ORW: yes / PNA yes /cp Crit.Hab. yes / no Closest Maj.Wtr. Body /'�r W w
Type of Pro'ect/Activity CP .1 it ca '�- 5 0 Pi- 6vI1{Ie4.i1 c / Ac J //-1L 44 dwur-I o .--.e...}�tJ,/„ 6„I/k e,,,(,1
oil 5Dt1 7 45- /r /Cr ii ,r IA 0-/Q4. W cl 0c c )qj /„(',/ju/kIteaci 0„ 4„4-hi.s(itCle7Pr'pFr4-
Pier(dock)length i ! / )
Platform(s) P lQ�'�� . . j / I C I ! t--— p'1_,_
j !
l i I j i I
• (d.... T ; I i I i Lj
Finger pier(s) i ; , 1 i i-r : j- 1 j -
Groin length !/ S.-(�_-(,a ✓l Tj riiCr r i 1 i 1 — I I j j number !i 1111 L j j ! j ! i I 1
Yh j 1 i
Bulkhead/Riprap length 50 j-"1( lip,1_ j 1 / I i__ 1 � 1 I — �—-
avg distance offshore 0 ✓4 {•.70 j i - I _ j - + 3�
max distance offshore 1 .i i ! 1 �' / ! ; j 1"4- f i
Basin,channel j 6 i Y`�7q I j I 1 1 ' I j
K.
j i i j c i
I
cubic yards L-1 i '_-11_ 1 1-1 ---
Boat ramp { i• ! ' i I
Boathouse/Boatlift - — ' ! _1- j
1 I 1 i I- i 1 1 1 I j - -
Beach Bulldozi j 1- ';
- I - j !t i . 1— 1 ' i j i ! 1 ' 1/ /jg /� 6. 0 - 9qz 62 —T- ;
Other104frK` h X �( j j __ _.__ I ! _ ! i j i i_. j
J 1 1 l i
! L-- 1 ; ! ! � 1 r . 1 j j j -
i
Shoreline Length ; ( // _t -- -+--- ',
SAV: not sure es no - 1k4 1 . �� i I I .----1— , , i j
Sandbags: not sure` yes no !�1 1� ._ _ ;: 171p i :BBfCk,Atia �- - i i..-I F C l•/Lt.
fi
/ j
Moratorium: n/a yes no Cfic.i�.. - '�I 1 _ ;- im
- I.
Photos: 1 1 ; ' --F- ( ! .1 1 1 1 j
yes no : _ i 1 i I
Waiver Attached: . syes no •! ' i 1 j J I ( i Jt� I 1 I j t - 1 '--.. Ili
u
A building permit maybe required b : 1 ,/ ❑See note on back re ding River Basin rules.
piT (Del a 1,1/o.,t,) 1)`1- ') H• `/D Oh( /it 3 3 5 // el p i
pt..r lcA 'It 9A i( i)--- ./ exceed Caro //it F'ec(,4 Pt' r' `Ie4.et. '.(e ,. Ail
Goa tr.) `0'n ck/1 6j ( 4 /Ck // 33 ` `
�7" 1/lflaCp rr rt. Carrc �,� l•ne
„.u. ,iE A . M-e. MoRy
Agent or Applicant Printed Name Permit Offi r'sSi ature /
Signature lease read compliance statement o ac-k of per it'd Issuing Date • Expiration Date
1A Application Fee(s) Check# Local Planning Jurisdiction Rover File Name

•ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Signatu.=
item 4 if Restricted Delivery is desired. X -11 s �9.ent
III Print your name and address on the reverse , ._,I id jj arri, dresse
so that we can return the card to you. B. Received by(Printed Name) C. •at of Deliver
• Attach this card to the back of the mailpiece, LAN;)
or on the front if space permits.
D. Is delivery address different from item 1? 0 Yes
1. Article Addressed to:
8 A r7 a_ rA I`(C y 11lA4 i r� If YES,enter delivery address below: 0 No
163 l4+R(oi ) ,A(ken ue
Du«ttAnA 3. Service Type
N L Certified Mail 0 Express Mail
❑'Registered 0 Return Receipt for MerchandisE
7-7
6 0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7001
(transfer from service label) 1940 0000 0640 1270
'S Form 3811,August 2001 Domestic Return Receipt 102595-02-M-08:

UNITED STATES POSTAL SERVICE".... First-Class Mail
/ Postage& Fees Paid
PM USPS
„ Permit No. G-10
r
• Sender: Please print yoarriarne, address, and ZIP+4 in this box •
.SLLLtA/tEititoRy
2,060 AAA 56 J")
C
(143

•ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1, 2.and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. 0 Agent
• Print your name and address on the reverse X / Mario, ❑ Addresse
so that we can return the card to you. B. Received-II I Pnn:d A e) C. s. e of saf er
• Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is delivery address different from item 1? 0 Ye
1. Article Addressed to:
�A If YES,enter delivery address below: 0 No
�t/e-s.(//�6(/1//A /t . 14D1-1(DA/
2gbNt«r� W 1R
AN2(E R 3. Service Type
AA//C� Certified Mail ❑ Express Mail
! " Registered ❑ Return Receipt for Merchandisf
0 Insured Mail ❑ C.O.D.
( 756 ' 4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number
(Transfer from .rvice I- "
3S Form 3811,August 2001 Domestic Return Receipt 102595-02-M-08

UNITED STATES POSTAL SERVIC _*114/4 ,_ �- -RrsTCIaSs Maii -
- Postage&Fees Paid
`" Pt1 s USPS
- .� , ( Permit No. G-10
L.r I•9
• Sender: Please print youro:Ime, address, and ZIP+4 in this box •
J U L1E IUIEkte)R y
2006 AAA Dsd.4v
N �
7ws • .
or %.:G jrr�rj�ur�r�rt�«rirril�rur��r�tlir�r�t{rijr���irri�+rr�r�rrf

I. . •os a ervice
CERTIFIED MAIL RECEIPT
(Domestic Mail Only: No insurance Coverage Provided)
3
- .71.1.11.111MMIMIM
9
3 Postage $ P \p.0Certified Fee (e<1426.--\\
�� 7
] Return Receipt Fee c JD' t
] 10
(Endorsement Required) _ - ,_ a era
3 Restricted Delivery Fee
3 (Endorsement Required) Jt aoj�
] Total Postage&Fees $ / ( 1 ��08
r
Sent To O
9 •, n r7Le Obi/Li• 6AA(7e1D OvaTERsiiii
RStreet,Apt.No.; I , f/ r
3 or PO Box No. I/ 3 AA A p(6A A v/7 o J
3 City,State,ZIP+4'tx(R44` Air ,)7'7D'

;ertified Mail Provides:
IN A mailing receipt
■A unique identifier for your mailpiece
■A signature upon delivery
■A record of delivery kept by the Postal Service for two years
nportant Reminders:
■Certified Mail may ONLY be combined with First-Class Mail or Priority Mail.
■Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
■For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt, a USPS postmark on your Certified Mail receipt is
required.
■For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery".
II If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
NPORTANT: Save this receipt and present it when making an inquiry.
MA n4 nAnc

U.S.Postal Service
CERTIFIED MAIL RECEIPT
(Domestic Mail Only: No Insurance Coverage Provided)
1
3 Postage $ �A 27ga9
g Certified Fee
7t
Return Receipt Fee
(Endorsement Required)
• Restricted Delivery Fee
• (Endorsement Required)
3 Total Postage&Fees $ 3 9 Li OF1S"--
r
Sent To
4 VIR6(.4)/A J19. focuuDA'/Street,Apt.N
3 or PO Box No. 2qO 'v lfY,i /V.►i./C T A. U6k O12 oA 6
6.3 City,State,ZIP+4 AA j61CRA 275/
I

;ertified Mail Provides:
■A mailing receipt
•A unique identifier for your mailpiece
•A signature upon delivery
•A record of delivery kept by the Postal Service for two years
mporranf Reminders:
•Certified Mail may ONLY be combined with First-Class Mail or Priority Mail.
•Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
•For an additional fee,a Return Receipt may be requested to provide proof 01
delivery.To obtain Return Receipt service,please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt, a USPS postmark on your Certified Mail receipt is
required.
•For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery".
•If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
MPORTANT: Save this receipt and present it when making an inquiry.
S Fnrm 1111111 Jarman/ 711111 fRaunrcal ir17505-M.ni-7d75

t4 , t 1 k
O.
A
A O+
A
OW..
• ar A
• F w
•
.g1 Cl
0
--...1
z\
Q\ 1 s 01; 9237
4> k
Z
t
IN
(‘'‘ --------il--------__
VL
-VA cl
el W ?1
S9Nt7irj 340 au
N
0
/
�b5OZ1 >ID K► 9Mlbo7J
1
3fii7 av31-i I?4 - -
r

b� _ t • 1
: +. , e ¢.Al
.r 3. 1,',.
{ i . T I
y
ffr
K • ' _
� e • a ;
:,_
' � .i _� -i .;�,��,'i:mo -5
sl , ; _ ,_ ,._..; l' i ''''
h _ 3;
I
r 1
✓ r
." -
pli
.
•
•
fir: If` _ .- .. _—.. 'r` -
—
it
; __. _
,� 2 _ �. of _ „/-r
. .— „., -
.1 ,.. _
.7,....
. , .
. ., .
._ . -....__ .., ,_,
. ..: - : -...,„_-_,._ „._-. ..,,, . ..._,
,....pc.,..,,,,t.,..,--,.:
,(.. - . _ ;.,,..... :....„ ,.........r ..-...„
, _ __;__ ,;v_ .,. ,,.... ..„,..„,... _,..„._ ..,...
.___ __ ... , , .. _
- . - _._ _ .2....--;i-, ,r;.,, _:._,,,,-.,
,. __,_,..__.:_ -e-- ,,,..-- - , , k.
i r ' I 1
• +;; (lip #r'
1.4 i
� i! °
-:"1" [ [ _ -'''-
- .Y, ' 1 4. -...; ... .,,,'..,.. ', ,..;2,i, \,;,',.._,, :::::::37:
r
` - I yam. �Y
T.
I.•
I _� L 1H yrT�
{ I r 1 I � In �1• I _ _ , l Ct'r
1 r
it
1 i _ , �' Sv
i

• DIVISION OF COASTAL MANAGEMENT •
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of individual applying for permit: ' u UE 4 eMD2y
Address of property- 713 CAVAL DoiVt Meet 1 N4 ,&scff A/C
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. (A description or drawing, with dimensions, should be provided with this
letter.)
•
t/I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, North Carolina, 28405 or call (910)
395-3900 within 10 days of receipt of this notice. No response is considered the same as no
objection if von have been notified by Certified Mail.
•
WAIVER SECTION ••
-
(Does not apply to bulkheads or rip rap)
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandba Rc must be •
•
setback 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
•
` 1! I do not wish to waive the 15' setback requirement.
-V3t;
Date M/1- M . 734TT/
(xTrt � •
Print Name /
Telephone number with area cdtie
•
r', EIVE
APR 2 2002
DIVISION OF
COASTAL MANAGEMENT

r_
ECEg 0
APR 2r 2002
DIVISION OF
COASTAL MANAGEMENT
1

r rt /7 ./ry .tiiv".
ET D Co
0
1 IL
FLOAniJ6 70CIS ? 6O4
rte off ---mod 9 b 0
ptLIA16s
RAM P j' AO
,
N C1 0
P,
Q1---\
128 a
k
6A-zeo --> In
i
o•
Ul
a
PIER
7 r.
ECE:vE
1..v APR 2 2002 _
DIVISION OF �.
4 COASTAL MANAGEMEN
$l)lx(14017)
..... •
)< - zo` 1 -
< so'

• ,
•
•
•
•
•
441.1101.1111101111
•._
111;
•••
•

66-85/531
3100
JuIle A. Memory
2006 Madison Avenue
Green517oro,NG 27403
piPay to The WiL4 $
oRder -
Nik)a_ars 19
CENTURA BANK 01\
GREENSBORO,NC 27401 Ul •YiCil
f oK ,42ü4-
I: 531008501:01, 131, 147 / 10 3 0