80314D - Repola

0ICAMA / il DREDGE & FILL N° 80314 A B C 6
GENERAL PERMIT Previous permit#
flew ❑Modification ❑Complete Reissue ❑Partial Reissue 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 I 5A NCAC ��k I�©()
I ❑Rules attached.
Applicant Name S V� 2C 7O lC\ Project Location: County nOVe-C.
Address 12.1.4 r/,ty2 7a(11+ ID( Street Address/State Road/Lot#(s) < ,'E
City State ...ZIP 2-'8116
Phone# e1o ) 7_611-'Z E-Mail Subdivision V,m 4— t-tialr,c?{Authorized Agent I it & Lest-iTS City (A.D-11,1A-A J-Ni ZIP 2�j140.1
Affected ❑Cw IP EW 1 -PTA ❑ES ❑PTS Phone# ( ) River Basin CE(Z.
AEC(s): ElOEA ❑HHF ❑IH ❑UBA N/A Adj.Wtr. Body ivt!J'cMnt CA&4 (nat /(n/unki
❑ Pws: ATv-��S
ORW: yes � PNA es no
Closest Maj.Wtr. Body
Type of Project/Activity 'T-1&54 .QP r1e5,,-.) dC - T `'r)<..t\Al
(Scale: 1"= Zvi )
Pier(dock)length
i1 1 '
Fixed Platform(s) /7 7 "f
1 _jp) I
Floating Platform(s S')CZ.O I
Finger pier(s) 4'I Q —i
i
G oin length
(...." iTiNf?")
umber _
Bulkhea iprap length —— „k ;. \r� I�
? ` I I
avg dis ce offshore ! 21�
max distan offshore i j f
ACT
Basin,channel ‹i 4
I I
cubic yards • i 7 2.0494,viowl.
_ ' '
Boat ramp I T (/iZ�) .1 , I I
Boathouse 4p 4" —.-.._......j-._ -- --
ea ,.._ ___ 1 - — --
i l
Bea Bulldozing _._ ' 1__ , {
T •' { f
Other I \ lvjpa
1s I I
Shoreline Length / C� ` i 1 s •
1 ; I
SAV: not sure yes el) �,�. I I 1
I
Moratorium: n/a yes Jy (/ i I
....� —_rOtka rN _.1-
Photos: yes n 1 _ ; 1 ;
I TI i' +"C._ `o4'+-°1Jr _—C_1 I
Waiver Attached: yes -A building permit may be required by: 6 `\O \4:f.JCf- CO-_vj`f . U See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) 1 GI f ,��++
Notes/Special Conditions r Z,�j V� 1 m(-kw& '`MQ . At ( Vu t izco,
1(r(4Q, j r.tr rr e e(airc #( k•f ,
JQ Appli t Prin d Name Permit Officer's • a $,13,Z1
• 12.13.2.1
Signature ** ease read co p nc statement on back of permit** Signature , 1

0 ❑CAMA/ ❑DREDGE & FILL N° 80314 A B C
GENERAL PERMIT Previous Permit# °
>'( DNew ❑Modification ❑Complete Reissue ❑Partial Reissue 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
(� _ ❑Rules attached.
Applicant Name DI`GIY`J. 2(po(C Project Location: County c.,.(
Address 1 ZL( r cA" T6iv+ ' ) Street Address/State Road/Lot#(s) I l-:
City \ytiNte. '(OrN State 1+ ..ZIP ZeL(G9
Phone# (1'' ) . (-T-1--,..�t -/ E-Mail Subdivision Sµ it j ty‘-k ci,,, c
Authorized Agent �,:ew-S City (,c._),i iA.A \y-cam (.' 1,\C, C 2 Q..71-1C`1
Affected ElCW `(i`]EW IX PTA ❑ES ❑PTS Phone# ( ) River Basin ( F R.
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body T- Pat (A.., (nat / an /unki
❑ PWS:
Closest Maj.Wtr. Body /T'jL"--)
ORW: yes / no PNA yes / no l -�
Type of Project/Activity -, ''LA-.) dCUC k�S k i T kr
' t (Scale: ) /'z Z0( )
Pier(dock)length
Fixed Platform(s) ,'> i- I i i I I - pFloating Platform(s) eXZ� 1 1
Finger pier(s) glJ '
i
`�
Groin length 1
dumber — — ———�_. I
Bulkhead/�prap length } — _._. y�(1 _ T
avgdis ceoffshore T t' (� � \ I
max distan offshore j &U'-- {e� _c ?
Basin,channel f S4P',''1N�1 N __.'
cubic yards i - L I ?'rkO '5ei6w(E
Boat ramp ' `Z!:^�
��
Boathouse/ oatli ��X� j -- ---._...._._- j_ f I. . , * 1
ij
Bea Bulldozing t ZH
Other I t
Shoreline Length f/ ( 1 1
SAV: not sure yes ® \.‘reis,V4.0.A
Moratorium: n/a yes !� •
���
Photos: yes yesAT. . ....._..._... i
Waiver Attached: 1 4 44 ' 17 o 4- ) , 1 1 = ___ _ !
A building permit may be required by: )tJ.&) r10,(Nd•1e C. (.0-t-w\}�/ . [II See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) . t
Notes/Special Conditions� I -Ic e xn Z5 FOR pr �< ax (�Q , 1 '\1 t o H4,1700
!.'!4.( . c I!i�l. �{ ',' adLt(&X re l:(Gic & \ .
, �yu, L- \5 y� cc.
ent or Applicant Printed Name PermitOfficer's • aye
\ceD
Signature **Please read cornpliancd statement on back of permit** Signature ' 1

GENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
X Name of Property Owner Requesting Permit: _J li,/�j,�
)K Mailing Address: J2Y ..i-_nJr,C Porrfi Lk
_ l i 1,04w Ix Z
i
Phone Number: 9L01 29 7-- - '7
Email Address: _Sat/aff,eittFnRbgal•CfssOm
I certify that I have authorized CK g'iCK .b(O LLC cm 7144 4.Ek1/$
Agent I Contractor
X to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: F7'- 1J /r)M F s(-4
R4r_Th Ri t v)>)(G)/Y:et AO'
l
y at my property located at /JV /V-f—rf I/T J. CAC
X in AkA✓/141..beR County.
I 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:
l • elute
...51No‘r__ C1\ S
Print or Type h me
SC no
Title
X1 , zI
Dale
k This Cert1ficalion is valid through I I •

DJ CENT RIP /NpROrERTy_OWNER STATEMENT
I hereby certify Ihpl I own property adjacent fo
property located eI____/,"V ,l'" , (Hama of P►opnrty Ow or)
(Adtlrnes, Lot, flock,Roast,ntc.)-
ona2n,(.l _Jh d 1 , in lA.)/�_r,,/VLi art �i��_ , N C.
(Waterttody) (City/Town and/or County)
XThe applicant has described to me, as shown below, the development proposed al the above location.
-- I have no objection to this proposal.
I have objections to this proposal,
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(I di idb al propos/ng development must fill in description below or attach a site drawing)
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( WAIVER SECTION
I undersnd that a pier, dock, mooring pilings, breakwater, boathouse, lift o groin ust be set back a
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.
(#431/.. I do not wish to waive the 15'setback requireme .
(Property Owner Information) (Adja e P operty Owns rmation)
kfacM
lure �'Sign`
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Print or Type Name r,n [ ?-f
l o Type Na
f //ti/rr� � ,alhng Address
l,/a�Mrlini 6 ' Ait.�.6' / WkLw4'fr- c w 11C- is-re
Crly/Siate/Zi „City/Stale/Zip
g 7 61 (d-74K- CI (s1
Tele ho ,e Number Telepho a Number
CG ��( )0 b/ 7 Lj
Dare
Daft
(Revised 6/18/2012)

6Q,1ACINIMIEARIANXNOP.ER1aSWIEREAlg ftl
I hereby CNIMy Thal I t+wn property Adjacent io,_„f, hli g v,,A p f7r
(Name of Pr.porty r)
litar'ellY 10e-Med IN....0. r fq:6.t.. PI.:14e 6/1. .....
(Adelrias, Lot, Mock,Angel,Mc.)
(m r _JJ'i,_1 A In IA)!/.f}/.11.4s.L , .. N.C.
(Waterhn4y) (City/Town andlor County)
X'm. sci1esn has described to me, as shown below, the development proposed at the above locston.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
R nvt6 id�l r gosInp d velopment must NI In description below or attach a sits dewing)
eoloetit
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WAIVER SECTION II
I � - . ' • a pier, dock, mooring pilings, breakwater, boathouse. !ft, or groin nfust be set back a
mum dials - 15' from my area of riparian access unless waived by me. (If you wish to waive
the setback, you m initial the appropriate blank below.)
I do wish to - the 15' setback requirement.
I do not wis to waive the 15'setback requirement.
rty Owner Info lion) (A7 P r Information)
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Pont or T Sig we
Irpe- Name �� �
nl a Type Name
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itaeless At �ua,1; gddreu
.t�5O7 /`� G)JLm1l.ds 6 740 Al
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