GP68223_Richard Prata_20170907

`MA'
[?'I'c I DREDGE & FILL
3
GENERAL PERMIT
441 �w
Previous permit # B C D
PA,,New E]Modi , `ication lComplete Reissue
[-]Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental
concern pursuant to 15A NCAC
'-)
M Rules attached.
Applicant Name t"), r,
Project Location: County
Address ... ... . ...... ..
Street Address/ State Road/ Lot #(s)
17( A
City State ZIP . . . ...... ........
. . 3 '3- ......
Phone # ('1'3A )�'!""E Mail
. . . . ........ ILL - - ---- --- --- ----------------
---Subdivision �A�' r
Authorized Agent.... 0 04- k
I
City� ZIP
[M Cw 1,q E,W M PTA [,.S E S V�J PTS
Affected
Phone# . . .... . River Basin
) - --- 1-1-.-" Lu : A- J,
Ej OEA D HHF IN [1 UBA El N/A
AEC(s):
- Z
Adj. Wtr. Body- Y 4,71 4N, C 0 anjunkn)
E] Pws:
0 RW: PINA
Closest Maj. Wtr. Body --A ---------- . . . .. . ........ . ..
yes yes
Type of Project/ Activity YA' � <'x
"j,C J,"'
a."v,
(Scale:
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
f
Finger pier(s)
Groin length
ber nun)
r
T I
7
4,
4
1 . ....
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
Cubic yards
Boat ramp . ........ . ........ . . ............
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV. not sure yes
0
Moratorium: yes n
Photos: no
Waiver Attached.yes L-- J—1 J 1
A building permit may be required by: See note on back regarding River Basin rules,
Note Local PlanningJurisdiction)
Notes/ Special Conditions "",Ili <
C

I N
AP—JACOT-91PALRA-1,11OPH 1TYQ-WNgKST 'tUMEM
I I)Oeby ooriffy that I own property Adjacolit to --1C --"q
(Nama'of Pr pert owner)
pypporty located at_-:3-5-0�L(e_W_j
Wool k t taA
(f)L ' - AM
Nic.
or)
Tho appllcan.t hpa described to,mo, as shown below, the fl.avoloPment Oft)PoaOd atthOobovo
loc" Mtl"- I have no objeofibii to this, proposal.
I I have obladflons to this P.rOpol'iil.
1J9$CR1PTj.ON AND)OR DRAWING OF PRO.rJ�80 ONVELOPM)MT
(ifidliddlialp,roi)oslng.devolopinptltmlls�itil) Ili Ooscriptlon b6loW OrOftfich ft $Ito 4AIM119)
We
U) MAJ
tz),
j/ p
,cAa
o
x,k-�e.d-
(j
WAIVER. AE_ClrION
I undorajarld that o pier, dock; mooring pilings; breakwater, boalhouse. Yfl,or groin must be set
backa rnihirrium distance of 16' from my area of riparian -accaos U11108b Walve'd by Me. Of you
wish to waive thos6tbaok, you Musi Irliflal tile appropriate blank beloir -)
I do Wish to WOIVO (110 1 W Getb6ck reqUliretnont.
I do not wish to waive the 1b, saft qck requirement.
-�(pr'p e I -t 0 -or Infornotion
. Ywfl
Ddie
Information)
(RaVisod 611812012)

P OPE ly MHE&S-UTENgNT
,pjAC.F-NT RIP_AR11APR0PE ' RT
I hereby certify that I Own Property adjacent to
(NaMO Of P1?130rtY_1w"Iff
I I _OJ4_ :�
located at
ME
In --i.—ifay r-
N.C.
d at the above
s shown below, the development Propose
The applicant has described to me, a
1 1
00 7
1 have no objection to this Proposal,
——
i have objections to this proposal.
---- DESCRIPTiON ANDIOR DRAWING F des PROPOSED DEVELOPMENT
f fill in eription befog or a ifach a SHO drawing)
(individual proposing development fnlus
W
W VER SECTION lift, or groin must be set
I understand that a pier, dock, mooring plllrll;—,b—re—akwater, boathouse,
back a minimum distance of 16 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 16- setback requirement.
I do not wish to waive the 15, setback requirement.
(Adjacent Property owner In orm 0
)rt owner Information)
v
CU1UJ2-rigi%N
CA/1
Pli"t o�rrvnNaiP'1'01rVV0N8M0
99
5-,Y-lstatealp
7
(Revised 611812012)

MC 01vislon of Coastal Met. Habitat Impact Computer sheet
Appiloant: 1\ I Q - Permit
Date: "A
Describe Wow the HABITAT disturbances for the application. AN values shoWd match the name, and unlita at measurement
found in yow Habitat coda shast.
DISTURB TYPE
Habitat Name Choose One
(Applied for.
Diettirbance, total
Includes any
anticipated
restoration or
ter Impaots)
final
=6.
Excludes any
Irn (Anticipated
restoration
ancYor temp
(Applied for.
Disturbance
total Includes
any antlalpated
restoration or
tpmn frnnanklamount
(Anticipated final
disturbance.
Excludes any
restoration and(or
temp Impact
11" Dredge [I Fill [I Both [3. Other [V
Opey, U-)4RIr Dredge 0 Fill 0 Both Ej Other Eg
0 S
o
Dredge 0 Fill 0 Both 0 Other [I
Dredge [I Fll[,D Both El Other El
Dredge[] Fill E] Both [I Other [I
Dredge 0 -Fil[E] Both D Other
I Dredge El Fill 0 Both ❑ Other [I
Dredge ❑ Fill 0 Both ❑ Other Ej
Dredge ❑ Fill 0 Both ❑ Other 0
Dredge ❑ Fill Cj Both [I Other [I
Dredge D Fill 0 Both [j Other [I_
Dredge Fill 0 Both 0 Other 11
Dredge ❑ Fill [j Both rl Other [01
Dredge Q Fill ❑ Both El other ❑
Dredge ❑ Fill ❑ Both D Other

Date
Name of Property Owner Applying for Permit:
L af
Mailing Address:
I certify that I have authorized (agent) C14 _.)
_01 (dh TI �,Afqto act on my
behalf, for the put -pose of applying for and obtaining all CAMA Permits necessary to
install or, construct (activity) (A20- GI
at (my property located at)
This certification Is valid thru (date)
Property Owner Signature Date

MA