32981_HAYNES, C LEE_20021029 (2)

CAMA / ❑ DREDGE & FILL NY 32981
GENERAL PERMIT Previous permit#
ew ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC O',W /ZC�
les attached.
Applicant Name ° < Project Location: County
Address Street Address/ State Road/ Lot #(s)
Cityayt>'// State A/C ZIPrf Lan
Phone # (_qL0) _�32;7- Zqj j Fax # ( ) Subdivision C-Wlele-4 aZd 6s•A-A.S
Authorized Agent City - 1?J uls ,/�� ZIP_ 2r1 SED
Affected ElCWW CTA ❑ ES ❑ PTS Phone # (Q �0) 3 l 7 — 29q5 River Basin
❑ OEA ElHHF ❑ IH ElUBA ❑ N/A
AEC(s}: Adj. Wtr. Body 6-cale /i 64 (nat man /unkn)
❑ PWS: ❑FC: ,•
ORW: yes / PNA yes / Crit. Hab. yes / no Closest Maj. Wtr. Body rS� lh't�
no no
Type of Project/ Activity (L�r SA Z Ci- 3',r 38 C j��'2 f [ �� �� �' S� % r s /, %
(Scale:W
Pier (doE4C) length � rk3Fi' � ----. —_-- . ~'`� — � '�,
Platform(s)
Finger pier(s) J
Groin length
number -- - - -+ - ._ -- --
Bulkhead/ Riprap length I � i ---- _
I
avg distance offshore ��.(( t ;
max distance offshore IL( C
1 .
Basin, channel --- _ - ----Tot Ct
cubic yards �� k� ��Pi4�L' RIC
Boat ramp i
-- - --- --- - Cf, C
Boathouse/ Boatlift--
i
Beach Bulldozing
Other
Shoreline Length ��Od
SAV: not sure yes
Sandbags: not sure yes no
Moratorium: n/a yes j ,rre
YYY )
Photos: yes no
Waiver Attached: yes no Q------
A building permit may be required by: &/Occl t! o,
Notes/ Special Conditions
Agent or Applicant Printed —Name
X
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
See note on back regarding River Basin rules.
.i - 1� �/7 //
Permit Officer's Signature
/o-Z�i-o
Issuing Date Expiration Date
Local Planning Jurisdiction er File N

w C LEEK NES
BARBARR PH, 910HAYNES 2999
jos PLEASURE BOAT LN.
SNEADS FERRY, NC 28460
TO T11E C Q�n i of �j���/1oNMr�NT
DER OF
vN�nL
-7654
66-7489/2531
o900016862605+
DATE
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Marine Federal
Credit Union /1 --
Jacksottry}}��ylle. NC 28541.1
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0161313 2 6
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4893 ;0900�-- ---.
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATZIFT/BOATHOUSE)
I hereby certify that I own property adjacent to �U� �L �j'c�� /��/3 i L Is
(Name of Property Owner)
property located at
'G
114 L %cISc2L-oAT//Y
(Lot, Block, Road, ei
on C/t/SCo (cvL)/yT/ , N.C.
(Waterbodv) (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
p lings/boaffift`boathouse must be set back a minimum distance of fifteen feet (15') from my area
of ripa
rian access unless waived by me.
!/ I do not wish to waive the setback re
quirement.
I do wish to waive that setback requirement. OCT 0�� �'jol
DESCRIPTION AND/OR DRAWLNG OF PROPOSED DEVELOP_MEINT:
(To be filled �n by indi-LFroposing development)
mint or 1 ype Name
Telephone Number
Date:

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