46041_PARDUE, DERALD_20060705

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APJIA,/ rr_ 'KEDGE & FILL
A7 ,t 1
lei 4603 1
XG Ei�IEI � PERMIT
ew ClModification ❑Complete Reissue
Previous permit #
[...'Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment
and Natural}Resources --7L/ //w
'TIT
and the Coastal Resources Commission in an area of)enironmental concern pursuant to15A NCAC
Applicant Name_ GC ir'd d ��rL t
- -- l ulees aattached.
(, 410-4-
Project Location: County /
Address-_ s—/�(7 N ��� �!�
Street Address/ State Road/ Lot #(s)
City - / - State ZIP__
�� ��� �/-�a•�
Phone # J�'��T
Fax # (__)
Subdivision
Authorized Agent Nl"J
_ City_ ZIP
Affected ❑ Cw �!W P ` ❑ ES ❑ PTS
J/414co
Phone # �) River Basin (�
❑ OEA ❑ HHF -1 IH ❑ UBA 1 N/A
AEC(s): /
f Adj. Wtr. Bgdy G r� 6O k�04
❑ PWS: CIFC:
ORW: yes / no PNA yes � i .
man unkn
a
osest Maj. Wtr. Body Q�'K ✓
yes / no
Hab.
Type of Project/ Activity 4c) r ,.
Pier (dock) length___
Finger pier(s)
Groin length
r
number I
--4.
I
,
Bulkhea / Riprap length
avg distance offshore
max distance offshore i
. _ .-..
._..._
If
I
Basin, channel I
i
i
I
-
cubic yards
Boat ramp
I
i
1
-
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAM not sure
I
yes02
Sandbags: not sure
yes
Moratorium: n/a
yes _I
Photos:
yes V
Waiver Attached:
yes
A building permit may
be required by:
Notes/ Special Conditions
—
(Scaler T5 )
❑ See note on back regarding River Basin rules.
IY le /
d It -
Agent or Applicant Printed Name
Signature *"` Please read compliance statement on back of permit
PermitOffi ign tune
h A
Issuing Date Expiration ate

r ' 'b6/02/2ee6 19:a4 9196322599 SCOTT C EARP DDS PAGE 01
9E/07/2006 09.32 25272E6075 PEaNBARNES PAGE AI
� I
W' ACENT RIPARIAN PROPERTY OWNER STATF.'%MqT
hereby cert;Fy that 1 own property a4jacent toG�'Ivl ! �� ��%�„�•s
(Name of PropWy 0WOW)
prod located at S ! N 4-
I (Lot, Block, Road, ate.)
..I"Sov�.p yy��
on 1�^- �..�._ , in rL� - ♦''"'�` t FaM It:r=JI N.C.
(Waterbody) (Town and/or Courtly)
: � ti! t�/Cir..,, r.y.t has deacribeo to me as ,shown at Wiocation; '
and, t4ve no objections to his proposal
!:DESCRIPTION ANTYOR DRAWING OF PROPOSED DEVI✓LOPhItNT
I (To be filled in by 1ndlvuOual proposing development)
�I
►✓ 'y-�,a l I L^v O �ar �r'1' 0 1 -S 1-� p r or 2,5 i >tCae-r.- f.f �, �'0
� s�J
Y DCM
�- - ................
Print or Type Name
0//f �s�r
Tclz phone Sumter
Datc: g

ii
I
p r,- pe rty
on
l
loc�tit�n, aii
must be seal
+ waived by
D:
sTA:i'EA EN r
(FGR A Pfp'RIUNCO VEXED BOA 7-1,]I7)
eby t~;ci;y that I awn property adjacent to
,s
cnte pf Proper
Osraer.)____
ited at
(Lot, Block, Road, etc.) cr$ +�
(Taira aad/'orl
s desc ib to .me, as shown below, the deve!op(new he, is propcsing at thhat
I have no objections to his prcposal. I undersra.nd that a pirir/urcovered beat lit,
ck a minimum distance Of fifteen feet (IS') from my;area of tip+uian ac --3s uniess
� f i
wish to waivethe s-etback requirement.
( 9Q wish to waive that Setback requirement.
--------------- — --------------------------------------
A, -D/OR DRAwD;O OF PROPOSED DEy------- -------------_.
t"p'o be JW dr an by im4iv du,axl P �- r� ELOP Y�LF—,I:
b FcsiRB das�e.f+�tnenc}
i
L �^' � a t w+ �a}• O �= s h v its , `, .c, r ' !�
n city ACM
� Stgr,ature - ;
i
Print or Ty,,= iti,',rne
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I ! T�f�pilOflC' P�!'.11i11?Pf
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