Mulgrew, Robert 77128C

CAMA / ❑ DREDGE & FILL
ENERAL PERMIT +1
.KNew ❑Modification ❑Complete Reissue El Partial Reissue
NO- 771 `? 8 A B cQ D
Previous permit #
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 ©— f
ules attached.
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
City �f� State —NC, ZIP
Phone # (gQ)q7741 0 E-Mail Subdivision
Authorized Agent �! City �[ I � ZIP
❑ CW W �T S ❑ PTS Phone # ( ) River I. Basin �fi(ol
AffectAEC se: ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body C
() 6DITan Junkn
❑ PWS: 4
ORW: yes(/FY PNA yes /0 Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length /" 1(
Fixed Platform(s) �x�
Floating Platform(s)
Finger piers)
Groin length
number
Bulkhead/ Riprap length ../"
avg distance offshore loo�
max distance offshore /
Basin, channel lole
cubic yards100,
l
Boat ramp _.
Boathous �tliff
Beach B Ildozing '_
Other boa S 1
Shoreline Length
SAV: not sure yes n
Moratorium: n/a yes no
-Photos: yes Un
Waiver Attached: yes
A building permit may be required
( Note Local Planning jurisdiction)
or ADDlicant Printed
(Scale:'
IN
by( ���� �� See note on batik regarding River Basin rules.
0%11
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's
VSignatre
Dat O�(f Ex irati Date

AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
�S'2 a 3Cs if�d
Email Address:�_ qM�; c
I certify that I have authorized �w1'1 A.5 L.+W re-p C' e ,
Agent /Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: mou p c?ea-4 I S+ `fo
at my property located at 1 I 6 � 4- e•., %J,
in County.
1 furthermore certify that 1 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:
6 W AA e- h
Title
Date
This certification is valid through I � / - 0 / 1020
RECEIVED
i
JUL 01 2020
DCM-MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Ka,�4` VVI : o-�►�! 1 ma's
/y (Name of Property Owner)
property located at C�
(A dress ot, BI ck,pod, etc.on <! - Ct�,e,;�. in , N.C.
(Waterbody) (Ciwn and/or County)
The applicant has described to me, as shown below, .the development proposed at the above
location.
I have no objection to this proposal.
hate_objections_to_tttis-pr_oposal_—_____
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Alp gxl2
• Borer I
0'((� hn
Wert
r I
*'WAIVED SECTION
I .understand that a pier, dock, mooring pilin s, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my a1a 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.
(Pro orty Owner Inf rmation) (Adjacent Property ' owner Information)
APr�tntor,,
e Signature
lame Print or, Type Name
—T a'lin
arlrn AtS4 II `� G / Mg Address
ri?eamos- zr
City/State/Zip City/��tate2ip
o %<3 - �-7- y� �` RECEIVED
O'TeTephone Number Telephone Number
Date Date
(Revised 6/1Qr0M7MHD G,

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Rpy M ; C_�j��R _.'s
(Name of Property Owner)
property located at
(A dress ot, EI ck, o d, etc.
on (!9'« e" , in , N.C.
(Waterbody) (Ci /Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loca n.
t — I have no objection to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
�bpgx12 ,
• // ��rer 0 !�P_4rvg
�trf� hn ge
0ere,
.r I
#-WAIVE* 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 a}�a 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.
(Adjacent Property Owper Information)
Signature
Aarls ��(
Print or Type Name
Mailing Adores
Or�� 3 f
City/Stat Zip'
RECEIVED
Telephpne Nu ber
G - 11 ". o.2 0 /, A) � �� . U JUL 01 2020
Date Date
(Revised pG,i> )HD CITE'