Ismail, Mohd

®❑CAMA / ❑DREDGE &FILL NO. 74905 A B C D
9ENERAL PERMIT [ Previous permit#
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality 1
and the Coastal Resources Comi fission in an area of environmental concern pursuant to 15A NCAC
r k ❑Rules attached.
Applicant N� i e i `' t r �� Project Location: County
Address Street Address/ tae Road/ Lot #(s)
City_ State ZIP
Phone # ( ) j f ( — E-Mail Subdivision
Authorized Agent -- '_— -- City T ZIP
❑CW :SEW
I�f.PTA ❑ES ❑PTS
Affected
Affecte OEA C HHF
1 ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA
yes /' no
Type of Project/ Activity
i
Pier (dock) length_
l
Fixed Platform(s) T4i
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic
Boat ramp _
Boathouse/
Beach
Other
Shoreline Length
SAV: not sure yes Rio
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required b
( Note Local Planning Jurisdiction
Notes/ Special Conditions
Agent or Applicant Printed am
Signature •`-Pleaseread compliance statement on back of permit"
Application Fee(s) Check #
Phone # ( )_ . . _ River Basin
Adj. Wtr. Body _ _ (nat /man /unkn)
Closest Mal. Wtr. Body
(Scale:
� .. ♦_. El See note on back re7rding River Basin rules.
It
r
PermitOfficer's Printed Nam
i
Signature
Issuing,Date` I Expiration Date

ADJACENT RIPARIAN PRbPERfY OWNER STATEMENT
I hereby certify that I own property adjacent to Koiti Z� poo' I 's
(Name of Property Owner)
property located at a1 3 5-7
on loE—'nroieo CR6EK
(Waterbody)
HILL A e W C
is, Lot, Block, Road, etc.)
in M11C e*t *'YtET N.C.
(City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
x QI have no objection to this proposal.
---- --------_----Ahav_e_objections to-this-pr-opasaL__ - —
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site iva)
v1oaJIn) mock
2,nie. MAY 0 6 2019
DCM_MHD CITY
21�
-54 Ar4fiii Dr
OPP-CaA-+eIVt —
WAIVER 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 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.
(Property Owner Information)
r
o �, r•T fi ,s tea, i _
Sigvture
rint or Type Name
Telephone Number
5 --3 --1 (�,
Date
(Adjacent Property Owner Information)
a 94�*
Signature
CcrrAaETtI A, 14 7-e1-(AaC-(-
Print or Type Name
Qi3 STAG //It 1jetur-
Mailing Address
CA CAerEkF_"7 No -28591'
City/Sta
'1 U � - terLip 5 77 - So 54
Telephone Number
'(- 5 --)Arty
(Revised 611812012)

9:43 oil LTE •
Jet_Dock_2225f Catalog.pdf
MA 1\\k& l
W 1 Y\C r\
RECEIVED
MAY 0 6 2019
DCM-MHD CITY
c j%'ii �F RS, L zafr. Rost Dark
Site. 1 1,9" wide t 25, jong
(`Lihcs. 1 ? 1
Item No IXI I.1 O—C"C'• WX)

ADJACENT RIPARIAN PRCPERTY OWNER STATEMENT
areby certify that I own property adjacent to 's
(Name of Property Owner)
party located at
�j, (� (Address, ot, Y )
on \ C l �o S� \ , in I k, ad, e , N.C.
(Waterbody) I (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatipn.
�` _ I have no objection to this proposal.
I have_ohjest o..o-s_to- this_pro{zosaL___
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
tioa-4-UoCk RECEIVED
�yn MAY 062019
�� DCM-MHD CITY
z �.5
s-lj, r
WAIVER 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 area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
M-R_ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
l
Si n tur
1_
Print or Type Name
216
Mailing Address ,
f ftp� �uP
C2-Z- ip 6 41 t4 3 (c) q
Telephone Number
H�.
(Revised 611812012)