52644_LELSCHI, FRED_20090724

CAMA / Ci DREDGE & FILL
GENT L PERMIT Q(J Previous permit #
ul dew odification ❑Complete Reissue ❑Partial Reissue r Date previous permit issued
5fAs authorized by th tate o arolina, Department of Environment and Natural Resource
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7V (I .J i
t , [j -Rutes attached.
Applicant Name Project Location: County xil i'
f ( _ Street Address State Road/ Lot # s
Address_ (---t-�����--�'� i` t � f / O_ _ —_-
City State__ L_� ZIP
Phone # Fax # ( ) Subdivision
} r
Authorized Agent City t l ZIP
Affected aeW
AEC(s): ❑ OEA
❑ PWS:.
ORW: yes /"
EW EkPTA ❑ ES ❑ PTS
HHF ❑ IH ❑ UBA ❑ N/A
❑ FC:
PNA yes /
Type of Proiect/ ACtiviIi t
. 'Pier (dock) lengthy
Platform(s) I
Finger pier I,
Groin length
number
Bulkhead/ Riprap length F
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp _
Boathouse/ Boat
Beach
Other
Shoreline Length
SAV: not sure yes ono
Sandbags: not sure yes no "L
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no --�
A building permit may be required by:
Notes/ Special Conditions
Oil
^�
Agent or Applicant Printed Name,. {
Crit.Hab. yes / no
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body —
note • .ng Riv r Basin rules.
t
Permit0/fficer's Signature
`�' � ( ICA
�
Issuing Date
Expiration Date
Local Planning jurisdiction
Rover File Name

r
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 1) 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 (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

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CERTIFIED MAIL - RETURN RECEIPT REQUESTE
DIVISION OF COASTAL MANAGEMENT 111 2
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
,,
Name of Individual applying for Permit: Lths,C 44®reread
Address of Property: aQQ UI A-p QaA 0'—Z _
�Jc ak�59
(Lot or Street #, Street or Road, City & County)
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.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call [phone] within
10 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags
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.
(Applicant Information)
4 X Do tc��w- S�-- lfI/ J
Mailing Address
City/State/Zip
2�Lt3-a-0--59g8
Telephone Number
�01ga8
Date I I
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
Date
City ®CIS

ADJACENT RIPARIAN PROPERTY OWNER STAT e
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHO
JUL 2 9 2008
I hereby certify that I own property Yadjacent to (Name of Propertyoj®h,gad City DGM
wne
property located at palm 40J'.'C-
(Lot, Block, Road, etc.)n n
on `^� Cl�W- , in y in , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his -proposal. I understand that a pier/mooring pilings/boatlift/beathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Applicant Information)
��t �•(o (7 ��cPr�f-cr��&(`J
Ma
ilingAddress
A ��
qL,-' .- ayq
Telephone Number
U i3
Date
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
Date

CERTIFIED MAIL •RETURN RECEIPT REQUESTE�,����� VV
DIVISION OF COASTAL MANAGEMENT , IL .2 5 2008
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: L�ehsdt,t Mor®heaig otk� DcIv,
Address of Property: aOQ C-'{^ U,� pla
(Lot or Street #, Street or Road, City & County)
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.
f I have no objections to this proposal. f
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call [phone] within
10 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags
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.
(Applicant Information)
� Dolr-�fir S�-. NiAj
Mailing Address
City/State/Zip
9 L4 3--a,�a —59
Telephone Number
6l1 4/0S
Date T
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
Date

r y ADJACENT RIPARIAN PROPERTY OWNER STA ,: � �.,
(FOR A PIER/MOORING PILINGSBOATLIFTBOATH, ,
JUL- 2 9 2008
I herebycertify that I own property adjacent to �'—d L�", 's
fY p P fuls Ity Dcm
(Name of Property Owner)
property located at 0 o w 0'�
( ' ' (Lot, Block, Road, et'c.)nn nn
on `� C111t , in W 111t 11 , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring pil4ngs/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
-------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Applicant Information) (Riparian Property Owner Information)
Mailing Address Signature
ity/State/Zip Print or Type Name
q LA -�- a� a -S
Telephone Number Telephone Number
U1 0-Y
Date Date

I Complete items 1, 2, and 3. Also complete
A. Si ure
item 4 if Restricted Delivery is desired.
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1 Print your name and address on the reverse
El Addressee
so that we can return the card to you.
B. Received by (P 'nted Name)
C. D to of Delivery
1 Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
D. Is delivery address different from item 1?
❑ Yes
❑
If YES, enter delivery address below:
No
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❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee)
❑ Yes
Article Number 7007
2680 0000 7222 7325
(Transfer from service label)
S Form 3811, February 2004 Domestic Return Receipt
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r ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
V JUi,' 2 7 2008
I hereby certify that I own property adjacent to�
Aty DCM
(' 1 (Name of Property Owner)
property located at �0 `A3 &o, ' ,
I 1 (Lot, Block, Road, etc.)
on C&IUt- , in W.XJ-A,On ,N.C.
(Waterbody)
(Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
_/ I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
-----------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development) '1
(Applicant Information)
Mailing Address
ity/State/Zip
'zLA --�-
Telephone Number
U
Date
c�-
Print or Type Name
Telephone Number / U
C
Date
a

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
7 2008
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATI914,1WAIV.,ER FORM
Name of Individual applying for Permit:
Address of Property: a0Q
(Lot or Street #, Street or Road, City & County)
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.
I I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call [phone] within
10 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags
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.
(Applicant Information)
-t X S�-- lei J
Mailing Address
01�. tijc. a 9 y b -�
City/State2ip
a-59S9
Telephone Number
�/I glo8
Date
(Ri art ro rty Owner Infor ation)
-
Signature
Print or Type Name
-7; 9-���"�5��6
Telephone Number
Date

FREDERICK LEBSCHI JR 5 2
Pay to the
Order of _
>\ xceedfinancial
credit union
800. XFCU.222 xhu.or8
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For
1:3 2 2 2 7 54901:000000 LOLL,
10,1.ra Clarke
1108
90-7549/3222 -
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