53918D - Stancil

JCAMA / ❑ DREDGE & FILL
.ENERAL PERMIT Previous permit #
4Kew ❑Modification ❑Complete Reissue [-]Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
-oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 714, j L-o ( )
ules attached.
it Name JA AAES LEI tUG 1 L Project Location: County tsp1h KGy'' 1 cv-
_215 Strvc1L, Yam.
t Lrt.-J AJ &TZ2N StateAIC, ZIP
` (910) F'13 -- L1 4 Fax # (—)
:ed Agent
-y `u . i ; ' -OTT T 1,5-T j
❑ CW CAW FQ*TA El ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
Street Address/ State Road/ Lot #(s)
OV-12- le-IQ(cs I�-yNN
Subdivision
City 0 ZIP
Phone # ( ) River Basin L
Adj. Wtr. Body i�ASTULPJ
yes / PNA yes /,W& Crit.Hab. yes / no Closest Maj. Wtr. Body
f Project/ Activity LkTTWo Y1 Oz �1 K CL or r3-ry- tXLs lNh /Za9T
(Scale:
Eck) length Z 301 X -41
:ngth
amber
d/ Riprap length
g distance offshore
3x distance offshore
hannel
bic yards
np
ise/ Boatlift
lulldozing
ie Length
not sure yes sAo _
;s: not sure yes
num: n/a yes
Yes rtd
Attached: e no
` &P®r f Z
ing permit may be required by: o/ K
LL ry &/ ',A- i
❑ See note on back regarding River Basin ri

i 6(:� I, VC-/
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/ ooRING PILINGSBOATLIFTIBOATSOUSE)
I hereby certify that I own property adjacent to 1aMGS &nd S e-mis- . fMC;l 's
(Name of Property Owner)
property located at bb 11 KINGS LYNN DKIVE
(Lot, Block, Road, etc.)
on EaS4ern CJ'\&nnel , in Oak -TsiarA , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: Qi0 - gq - g�s3 Mailing Address: 3`IS S�anc�l )V-
L�lr�
—7
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (I S) 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 not wish to waive
14f--, do wish to waive that setback requirement.
-- - - -----------
W DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be f lled in by individual proposing development)
.5fe a. Aca ed-
(Information for Property Owner Applying
for Permit)
------------------------------------------------------
(Riparian Property Owner Information)

Division of Coastal Mgt. Habitat impact Computer Sheet
licant: G / L,
I7L-Z"tIi-it-: 5LCII�
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
)itat 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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
91
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 ❑ Both 0 Other ❑

JAMES V. STANCIL
JENNIE P. STANCIL
HM. 910-893-4054 CELL PH. 910-891-8153
345 STANCIL ROAD
LILLINGTON, NC 27546
I PAY To THE
ORDER OF_
M6; 1299
DATE / �O
-
FIRST
BANK B0
uwnor c.�wouran zr,,�e
MEMOp1:0Sr104568�: 3730 2086 1 299

NER
ADJACENT RIPARIAN PROL NERT V OW B STATER ENU
(FOR A PIER/MOORIIV G V
r � JT ��tii.. J`/ �A/�C.I l �$
I hereby certify that I own property adjacent to -�
(Name of Property Owner)
property located at
6611 K►NGS LYNN DRIVE
(Lot, Block, Road, etc.)
(_ j„anne.[ Nk— -LS►anal , N.C.
on EAS�"f-t'n , in
(Waterbody) (Town and/or County)
34� ,sfa�►c,'1
Applicant's phone— Ql� "�� 1 S3 Mailing Address: N� Z 514
n
He has described to me, as shown below, the develond thata ier mnt eis oo png pilings / boatlift 1 boathouroposing at that location, se
have no objections to his proposal. I understap
must be set back a minimum distance of fifteen feet (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 not wish to waive
�1 J I do wish to waive that setback requirement. - - - -- --
— ---------------------
--------------------- --------------------------------------
POSED DEVELOPMENT:
DESCRIPTION AND/OR DRAWING OF PRO
(To be filled in by individual proposing development)
See a-ffa clued
--------------------------------------- --- -------------------------------------------
(Information for Property Owner Applying (Riparian Property Owner Information
for Permit)
3q 5 Signature