61666D - Pelican

PC -AMA / DREDGE & FILL
3ENERAL PERMIT
DNew ❑Modification ❑Complete Reissue ❑Partial Reissue
M Eli
Previous permit #
Date previous permit issued
rrized by the State of North Carolina, Department of Environment and Natural Resources
Zoastal Resources Commission in an area of environmental con rysuant to I SA NCACKTR�
ides attached.
it Name Project Location: County t nth, AA.-4 - .alw
Street Address/ State Road/ Lot #(s)
1:Kj4ylr state_'_ zip ,^ _, .s
/C Fax # ( ) '� Subdivision �
*f�fr1q 5
cedAgent fille4Az,W
�tL�d<,, City y,l , ew-e 4 ZIP
❑ CW AW VISTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
yes n� PNA yes Crill yes k,15
Phone # ( ) �'� River Basin Z
Adj. Wtr. Body G nat
Closest Maj. Wtr. Body h � /l
f Project/ Activity /'2l�
(Scale: /'�
>ck) length
n(s)
)ier(s)
:ngth
ember
id/ Riprap length
,g distance offshore
ax distance offshore
hannel
ibic yards
mp
use/ aj � J(/�
3ulldozing
ie Length
not sure yes
gs: not sure yes
rium: n/a yes ("%
Yes
Attached: y�, no / ,/
ling permit may be required by: 7hvty 7 41 LV� ,, 4; 0?4' &Oe4.1 .� See note on back regarding River Basin
n / el -

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to I Gt v rvIJ r I!Lr' s
(
property located at L,Jq )( A/V, V I , f L,ame of Pr rty Owner)
(Address, Lot, Block, R ad, etc.)
on n,.,V" //1.,��'m i in r d;l� LSD . N.C.
(Waterbody) ( /Town and/or County)
The applic nt 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)
, y i s 1 �' c�✓�dcr 4,
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 m initial the appropriate blank below.)
FC I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property wnerInformation) (Adjacent Prope Owne Information)
� -SDP
.14gyu tire
Print or Type'rN,,Iar Pnt T Natr►q
Y
Mailing Address�v � M fling dress t
'11 Il ti C 83
Ci1rState/Lp , -_ eqip
/
Telephone Number Talanhnnc n,,, , tio.

I
Em
RECEIVED
DCM WILMINGTON, NC

Y + AS
-v
RECEIVED
DCM WILMINGTON, NC
MAY 1) 0 �ui3

e items 1, 2, and 3. Also complete
Restricted Delivery Is desired.
ar name and address on the reverse
ve can return the card to you.
its card to the back of the mailpiece,
3 front if space permits.
Iciressed to:
cif (� iKP Bch
t one W i ��
a�Vaoeapr •
au�e
A. Sionature r`— - v�
X�ooe X
❑ AddresllA
B. rcgived by ( Pri W Name h C. Date of Deiive6
1 .� 0 n S /�_Ll )i 'N
D. Is delivery address different from item 14 a
If YES, enter deliv ry ad ess below: ❑ Q
p �
3. Service Type o(�SL[
❑ Certified Mail ❑ Express Mall
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
amber 7012 2210 0002 0115 6097
from service label)
811. February 2004 Domestic Return Receipt 102595-02-M-1540
„1 ",ti'
- - - - - FOR SECURITY PURPOSES, THE BORDER OF THIS DOCUMENT CONTAINS MICROPRINTING
CAROLINA MARINE CONSTRUCTION, INC. 66-456f531
Ph:910-793-4143
3600-E South College Road, PMB 326
Wilmington, NC,28412 DATE
IF I v
R OF
FIRST BANK
WILMINGTON, NC
II1008 2 S,BV li:0 5 3 104 5684
82%1
$ '�00
1 UAUTHO ZED S
(Domestic Mail Only: No Insurance Coveraqe PrcN
For delivery information visit our website at www.usps.
LOTVV
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to.
! r3 Postage $

kpplicant: II1'cd'k La-4,dfh Permit #:
late: � 111 1 �(p
/0
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
ibitat Name
-t;" - ---
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/orternp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
(((7U
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑