Waren, William

/ ❑ DREDGE & FILL
-+
NO. 75906
A B
� D
®L(cAMA
ENERAL PERMIT
Previous permit#
iNl e v ❑Modification ❑Complete Reissue
❑Partial Reissue
Date previous
permit issued
As authorized by the State of North Carolina, Department of EnvironM
nta%uality
'
I ) N C 'i
/ f
and the Coastal Resources Commission in an area of environmental
concern pursuant to 15A NCAC
,
r�
ules attached.
Applicant Name �' j I ! �� �� 1 f L
Project Location:
County
Address 1
Street Address/ State
Road/ Lot #(s)
/ )
Cityi State i i(. ZIP
Phone # E-Mail
Subdivision
Authorized Agent .
city—.
ZIP
Affected 7EWTA DES ❑PTS
Phone# (i)
._ River Basin
AEC(s): o❑HHF IH ❑UBA El
Adj. Wtr. Body
(nat
/man /unl<n)
El PWS:
ORW: yes / Jo f / PNA yes /
Type of Project/ Activity
Pier (dock) length L_1
FixedPlatform(s) 15 =5, 1 E:1
Floating Platform(s) �
Finger piers) %-j kc)L1
Groin length
number
Bulkhead/ Riprap length
avg distance offshore '---
max distance offshore - -
Basin, channel
Boat ramp,
Boathouse/
Beach Bulldozing
Other 1
Shoreline Length ,
SAV: notsure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no --L
A
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant
Signature "Please read compliance statement on back of permit *"
Closest Maj. Wtr. Body
(Scale:
❑ See note on back regarding River Basin rules.
PermitOfflcer's Printed Name
Signature
Application Fee(s) Check# Issuing Date Expiration Date

DJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at ) II Set T4« Cn
(Address, Lot, Blop)C, Road, gtc.)
on C ,_0 , In cep 'Y . N.C.
(Walerbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
Iota'
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVEL PMEN
(Individual proposing development must fill In description below or,4iachAlte drawing)
RECEIVED
OCT 16 2019
DCM-MHD CITY
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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 16 setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) C�Adj�aent Prrop/fir(/� Information)
LJA / l
ST$ Y rk --r b_ �.k.rt^t �g�///fir ✓.�&� .✓ / 1'S i�7L� 1.
Date
tefelZJp City/Sfet 1p
r a 2.32' 3 57L /
hone NuMlemapaddmss Telephone Num erllemafl ddress
1� roc J'
(Revised Aug. 2014)
*Valid for one calendar year after slgnalure•

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 6 . ) )' A" �� r� `^ 's
(Name of Property Owner)
property located at 1 I t Sc� Tfc--- L,.
(Address, Lot, t3lock, Road, etc.)
on (�i'�yJa S o..� , in zugV -t- , N.C.
(Waterbody) (City/Town and/or County)
The epp nt has described to me, as shown below, the development proposed at the above
locati
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVE T
(Individual proposing development must till /n description below o9rattac5o site drawing)
RECE/VED
OCT 16 [pig
WAIVER SECTION DCM MHD Cl rV
I understand that a pier, dock, mooring pilings, boat ramp, 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)
(Revised Aug. 2014)
'Valid for one calendar year after signature'

0 fD
LJ
T section will be I8' W x 22- Deep
Covered portion of pier will be 18'W x 17' deep
Finger pier will be 24' feet long, 5-6' wide
3Vo
Walkout (excluding T section),-37G'L x 6'W
.�$2. .ba.l t, jL.
8 %L pilings for shelter, 8 for the 2lifts
RECEIVED
6011og Slats
OCT 16 !U'i3
DCM-MHD CITY