Pruitt, Christian 78877C

/��`KCAMA/DREDGE & FILL () A g © D
6?NERAL PERMIT Previous permit#
New DModification FL- Complete Reissue uPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality -may f �j
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 0 / P a "'
rt; r _ Rulos'�7g'ched.
Applicant Nffa�nym/e�_ U r{{�}�� V %�_ Project Location: County �'L'_.`_ ---
Arlrirocc / Y J S f �7 t� ;1 i Ei—j Street Address/ State Road/ Lot #(s) laim e_
Cltyl?i'tf� 11nnli r� O StateIV L�-ur_tD4
t •Z
Phone # ( „) J -Mail _—__ . _ Subd vlsiogmm _
Authorized Agent G1}L��j___ Cif' --- ZIP
�i CW VL �S .V "A .O PTS Phone # () _� River Basin
Affected f
�o� HHF ❑IH UBA --NIA
AEC(s): Adj. Wtr. Body .�_sj -i t��
ORW. yes eo� PNA yes no Closest Maj. Wtr. Body ,J
Type of Project/ Activity J
/ r�
(Scale: ✓„ � )
Pier (dock) length .._.
Flared Platform(s)-
-
FloatingPlatform(s) t'._
Finger pier(s),_ 1
Groin length
number
-Buirehes Riprap length
z� 4111
avg distance offshore_
/
max distance offsho re
' ;mil , / ✓'a�W+'(�
}1
channel
cubic yards
Boat ramp
Boathouse/Boatiift__�r-
Beach Bulldozing_��__�__
OtherSI
=- .._.. ._...
Shoreline length 1i
SAV: not sure yes Cnno
Moratorium:
Na es�
Photos: yesWaiver Attached: yes
A building permit may be required by: tir See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) -
Notes/ Special Conditions V
-'
e r piican[ Prin[ ar��_. Pennit0(0<er dote Na
l
Si nacre „elease read compliance statementon back of permit`* Slgnatur
--
pplicationFee(s} Check# 55ui Date Exii1rationbate

��CAMA /,DREDGE & FILL � � `/ 7887�] A B © D
ENERAL PERMIT Previous permit#
ttt New ❑Modification ❑Complete Reissue El 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 NCACy7P • 1 I ©LY
—�- P �}— Rules a ched,
Applicant Name C I S 1 Ii 1�(d j I I 4 Project Location: County_ Phi P�
Address 9� L5a fiyx- 1 ec� k BALL Street Address/ State Road/ Lot #(s) ayl/( ii
Phone #
Authorized
I:B�rFml
c
ZIP
Affected Li CW 'ETA Ai S ❑ PTS
AEC(s): Ll OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes no PNA yes no
Type of Project/ Activity [A-0 R2. V�
Pier (dock)length
Fixed Platform(s) n
Floating Platform(s) l
Finger pier(s)
Groin length
n mber�
u kh Riprap length—'
avg distance offshore
max distance offshore
Basin, channel f
cubic
Boat ramp _
Boathouse/
Beach Bulldozing
Other /
Subdivision
City ZIP / 1I�
Phone # ( ) River Basin/!, e k
Adj. Wtr. Body nat kn
Closest Maj. Wtr. Body
Shoreline Length
SAV: not sure yes j n
Moratorium: n/a yes no ' I� ❑. '.
Photos: yes no t --
Waiver Attached: yes n — t
A building permit may be required by: - El See note on back
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
IN I r t I, f
e r Applicant Printed Name PermitOfficer Pinto Na
Si nature **„J?lease read compliance statement on back of permit** Signatut
pplication Fee(s) Check# IssuingDate
!�
(Scale:
I � Z )
River Basin rules.
/ (
11%

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requestitiing Permit:
Mailing Address: l Z
Phone Number: `/ /' q " ` -q / - �63�
Email Address: sc*(��r 6sa� �= , kjt-cc
s-'�
I certify that I have authorized �CV ` MkT-t�
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
S6A W L L L 4N51/ LL
at my property located at _!90 �A`� TC-
C in y:C((s-+ County.
A)ELO
�>k
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 I formation•
Yl,/ dve4� Te
Signature��
liif/?/�1f�U I P61 rl
Print or Type Name
Molpe-
Title
Z—Z'
Date
This certification is valid through J�—1 2-0 i_.. -2

I hereby certify that I own property adjacent to Le,121j— 1 L' l { J s
( me of Property Owner)
property located at ( (� SA5 2
F . S , lA'4),A L (Address, Lr, BloLk, R,opd, etc)
N.C.
, in CAY5Z
(Waterbody) (Clty/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatln
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill /In description below or attach a site drawing)
�✓I S �� �>'� {a Gliadl � ��Gd'` l lh �roy� D N S 11 "17 .
P
WAIVER SECTIO
I understand that a pier, dock, mooring pilings, boat ramp, 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.
or
I"I -LAk�u DU J
Z/,?-?1zt
'Valid for one calendar year after signature"
(Adjacent Property Owner Information)
Z
Telephone Number/email address
L-Ll�y/
Dare'
(Revised Aug. 2014)

I hereby certify that I own property adjacent to lf���7 / i�-i S' LC(1 t i t s
property located at C �- i L ' '
K C AA)AL L (Address, L , Block, Road, etc.)
on in < N.C.
(Waterbody) (Cl own and/or Coun )
The applicant has described to me, as shown below, the development proposed at the above
locations
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be syet back a minimum distance of 15' from my area of riparian access unless waived by
me. (If yo +n ish to waive the setback, you must initial the appropriate blank below.)
V/ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
is
,-�/ '-5 J t c-'
Telephone Numbers ail
Dale
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Date*
(Revised Aug. 2014)