66749_General Permit_20160211

OLAMA / KDREDGE & FILL 11 i
GENERAL PERMIT Previous permit # $'New E)Modification ElComplete Reissue OPartial Reissue Date previous permit issued
thorized by the State of North Carolina, Department of Environment and Natural Resources J I -
) -/ / I tll""""'-
ie Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC �." , J - I/-
vDRules attached.
ant Name M all , I j4 V1 I �'t Project Location: County
-ass 1', o Street Address/ State Road/ Lot #(s)
t-) S a 5LE t t ZIP
E-Mail
0 # O-A, Subdivision
>rized Agent City —
ZIP
El CW JOPTA El ES El PTS Phone#
ted River Basin.
El OEA 0 HHF El 1H 0 UBA El N/A
s): : El PWS: Adj. Wtr, Body— nat r ma .1 "nkn
Closest Maj. Wtr. Body yes ,f"no17)' PNA yes,//'ny
�"� A
of Project/ Activity i-4`4 V
,111Z -
(Scale:
(dock) length ....... �f
d Platform(s)
teinrg Platform(s)
in length
pie1r(s)----------,f--L—
'.7 --7=—
number
.... .. ..........
Mad/ Riprap length � _ L -- � . _+ r . ...... . ......
avg distance offshore
i(chan 1,
........ ... .... .
cubic y ands
Lt ramp
Boatlift
-h Bulldozing
1 7
-eline Length
F: not sure '7Y. �no
II
tos: no.17 L t 4
atorium: n/a Y, no�
.-Y
T 1`1
ver Attached: ye" ng �_--L-L
ullding permit maybe required by:_(,
9te Local Planning jurisdiction)
Special Conditions
/A V\;
U See note on back regarding River Basin rules.
PermitOfficer's Printed
Please read compliance statement on back of permit"
4tu,,e 1,.!aso read compliance statement
OIL
Check# Issuing Date Expiration Date

ADJAGgNJ RIPARIAN PROPERTY OWNER STATEM9NT
I hereby certify that I own property adjacent to ?I-Ide VeAlAt%>J/
(Name of Property Owner)
property located at 1�g ceZr 1-:22 -
(Address, Lot, Bloc ,Road, etc.)
o n 64 4 V e L. alle'-v
in ei�e
(Waterbody) (City awn and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatio!).
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)
Dredge an area to provide a 6' MLW channel allowing access the existing dock and thru passage in front
of the dock. DredgingWill be an area of roughly 15' wide X 85' long providing a channel beginning
approximately S' before the SE end of the dock, along the dock face, and outside of the NW end of the
dock/piling. The channel will curve from the NW corner of the dock towards the deep water channel.
RECEIVED
WAIVER SECTION DCM.- MHD CITY
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15l from my area of riparian access unless waived by
me. flf 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.
(Property Owner lnf7ati3O n) (Adjacent Property O�imor Information)
,
7, z,
§&gnature tigna'tiure
RA u) h V, *
Print or Type Name PfinTor Type Name
16W
Mailing Ad ress Mailing A ress
ell -'At
CV&1afelZip QtylStatelZip T2 5-,�
lb A lqelA 12.'L<P /Y"i It V'�" C".1
Tale no Numniail address Telephone Numberlemail address�/e
& 1"hh6lz -
,6a(e Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

AQJACE!JJ RIEARIAN,PRQPF,&T—YOWNER S!&19ME
I hereby certify that I own property adjacent to M.h Ae,4 4- �e-,vivllfd 11-c b'mjs f &s
(Name of ProDertv Owner)
property located at A
e�
on ell (Address, Lot, Block, Road, etc.) &jA N.C.
A,6..Ve. in Yeeil Pjob�� �t 4: a
(Watsibody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
X _ 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)
Dredge an area to provide a 61 WIN channel allowing access the existing dock and thru passage in front
of the dock. Dredging will be an area of roughly 15' wide X 85' long providing a channel beginning
approximately S' before the SE end of the dock, along the dock face, and outside of the NW end of the
dock / piling. The channel will curve from the NW corner of the dock towards the deep water channel.
RECEIVED
WAIV SECTION DCM- MHD CITY
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 16'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 151 setback requirement.
I do not wish to waive the IS setback requirement
(Prop" Owner Inform on) (Adjacent Property 911rftr Information)
Sr t Signature* R
xe xAA-eve
Print or Type Name, PtInt 6r Type Name
/ mz? �L A 7—
oa_
Mailing Addmss AA� ti %ai in g Addips
Akaj 4Lt�Llvj
Q Tate/z 0 o citylstatealp
Z/Y �e 60
Telwhone Numberl email ddress Telephone Numberl email address
Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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