38958D - Giese

CAMA / - DREDGE & FILL
PENFRAL PERMIT Previous permit# hl f.4
(flew ❑Modification -Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources —74 ' r� O
oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC Ej Rulgo attach
Named {"G Project Location: County
2- AJ Street Address/ State Road/ Lot #(s)
S fi✓✓ State
% ZIPZ&i (O
t� Fax # (_) Subdivision tea
ed Agent /J 1,A— City 5 f ZIP
❑ CW ES ❑ PTS Phone # () River Basin W
/ Q�
[IOEA ElHHF ' ElIH El USA ❑ N/A Adj. Wtr. Body O W /� ! / na
❑ PWS: ElFC:
yes no PNA � no Crit. Hab. yes no
Closest Maj. Am Body
voC"
f Project,/ Activity ��� � �
*, . (Scale:
,ck) length `-5 f
Z >ier(s) 3 ,�
angth .
amber
id/ Riprap length_
,g distance offshore_
lax distance offshore
:hannel
ibic yards
not sure yes o �—
ags: not sure yes
orium: n/a yes
s: yes o f_..
r Attached: yes o {
ding permit may be required
❑ See n eon backAegakling River asin

5 -i �
----
CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Name of Property Owner: (sJ kig p�S
Address of Property:
(Lot or Street j#, Street or Road, City & County)
Applicant's phone #:(q,toS3 q-44-j,0 Mailing Address: ..,U2 yt.(,,:4r
i nereny certify that I own property adjacent to the above referenced property. The individual applying for this pet
has described to me as shown on the attached drawing the development they are proposing. A description of draw
with dimensions must be.provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCT
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive I
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the.same as no objection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or Iift must be set back a minimum distance
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' set back requirement.
I do not wish to waive the 15' set back requirement.
krroperty uwner Information) (Riparian Property Owner Information)
y a� %>� .Q
Signature
C> oMe4- b, C-ieS2
Print or Type Name
Signature
A-( berg- T lA ci n ck
Print or Type Name
_111 AAc or the
Mailing Address
(047E Drty#-Sapk
Mailing Address

4.8m I a4&
$62'1
M
IV
4
®(-1.9D)
m(—I.80)
=(-1.40)
(-1.20)
_o
I�
m(-287)
FULLARD
m(-2.30)
m(-240)
CREEK
2.30)
I�
m(-2.10)
I�
I
I
I
5
MATE MNt
. ^
-- —
TOP �-IAMIi
/ - -
B0�
- - - -
-30-BUFFER
T
4.9
III
CHADWICK SHOPS
SEON A
PG.
tedMB.
3pd
4Ox40T
---
I
5.2m
prroposed
ve
REitCM4hp
k
5.4e it
LOT 81
1B. ' Ili. 47�
�I
0.39 ACRES
I 6.00
0.2 f
I
m�
Sm
I
-__
z I.
m•0
L -7
7.tm, I
R
V W.2
[607]
7
75' AEC
., --LOT 62
1n
N
A
W
w
tj
N
fir' M.E.L.-
CORNER OF
EXISTING DOCK o
( FULLARD
/ CREEK
I VICINITY SKETCH I
( NOT TO SCALE )
SETBACKS
PER ZONING
FRONT 25'
SIDE 8'
REAR 15'
LEGEND:
EIS = EXISTING IRON STAKE
EIP = EXISTING IRON PIPE
EPK = EXISTING PK NAIL
NIS = NEW IRON STAKE
R/W = RIGHT-OF-WAY
= CENTERLINE
= PROPERTY LINE
[607)= STREET ADDRESS
® = POWER POLE
=OVERHEAD POWERLINE
(-1.e0)= ELEVATION(see note #4)
05.4 = ELEVATION NAVD88
NOTES:
1. This Property is located within an 'AE 8"
Zone per FIRM # 3720428800J
Effective 11/03/2005
2. approx. normal water level= 0.50' NAVD 88.
3. Approx. low water level 0.00' NAVD 88.
4. All elevations shown in water are relative
to normal water level.
NQ DAIE DESQRPIKxd BY
1 05 7 2 odd omr dock.hM*%*iw I SLB
9
ohP1 ohP1 ��-
- ohpl --

1
pplicant:
ate:'
Permit #: 3 8' ,
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen
fund in your Habitat code sheet.
abitat Name 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/or temp
impact' amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated finE
disturbance.
Excludes any
restoration and/
temp impact
amount)
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 ❑
Dredge ❑ Fill 0 Both ❑ Other ❑

- _- -,_-rq, W.
■ Complete items 1, 2, and 3. Also complete
A. Signature
item 4 if Restricted Delivery is desired.
X
❑ Agent
■ Print your name and address on the reverse
ILAddressee
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
B. PPeived by (Pn' d Name)
/ I ie
C. D to f Deli ery
'�
`
or on the front if space permits.
.
Air
l
1. Article Addressed to:
livery address different from item 1? ❑ Yes
if YES, enter delivery address below: >12 No
3 V�Yg cinc a pare �{-.
3. Se, ice Type .
win
q^ j 1�• C .
i:1' Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
2?'j 05 ❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Ex08 Fee) ❑ Yes
2. Article Number 7011 2000 0002 2766 0048
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-154`
( ■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Aced to:
* S3^I
XM❑
Agent
Addressee
B. Receiv ��rinted Name)
C. Date of Delivery
J--')
I' IJ
D. Is delivery ad&� ss different from item 1?
Yes
If YES, enter delivery address below:
❑ No
3,z)137
3. Service Type
Cis E% 5
J l
f � •
.2
❑ MCertified Mail
Registered
❑ Insured Mail
❑ Express Mail
❑ Return Receipt for Merchandise
❑ C.O.D.
2. Article Number
(Transfer from service label)
PS Form 3811, February 2004
4. Restricted Delivery? (Exba Fee) ❑ Yes
7011 2000 0002 2766 0031
Domestic Return Receipt
102595-02-M-1540