53108D - Regensburg

rCAMA / DREDGE & FILL
1E NERAL PERMIT
New .Modification Complete Reissue -Partial Reissue
Previous permit #
Date previous permit issued
-izbd 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 , j2 ��
ules attached.
t Namef) Q,`Qf, Project Location: County 1 CAG.
State ZIP2-1
( ) �5 ' 3D ax # (�) tZ.78� �,JS� j
Street Address/ State Road/ Lot #(s)
;bJ504 F• �i Z,�Z -
Subdivision
ed Agent r..Tey(5' 44V.t1r- ' j( viefeVlkJF- City ( 14,7:�ru pq,,A9 ZIP
❑ CW ­�rtW N4TA ❑ ES ❑ PTS Phone # ( ) River Basin i `-
OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body V `AV nat /r
❑ PWS: ❑ FC: , � )
yes /) PNA 0-"I/ no Crit.Hab. yes / no
6-Closest Maj. Wtr. Body
6.
Project/ Activity 12(Z 1 �%FYTt!T Ex_ , V-) Xt b 'V em 1 6i:26"j r:!r-
(Scale:
rk) length
,(s) joy xgi i?C��-1,ir'Vn+cr
ier(s)
ngth
i/ Riprap length
distance offshore
x distance offshore
cannel
)ic yards
ip ,
i
�Ildozing
Length i7�(
not sure yes ,tlSj
not sure yes
cum: n/a yes o
yes (hod
lttached: / no
r U 'v,C
ig permit may
required by: O P-W— U5IAZ\� ❑ See note on back regarding River Basin rt
Special Conditions at -�- &�ww�wau-.,in

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORINT
Ifame of Individual Applying For Permit: ,
cqz
Address of Property: 3 5?nq (z - YG,-.4.4 Q�
(Lot or Street #, Street or Road)
G 4' i f-S-/O"J
(City and County) -
I hereby certify that I own property adjacent to the above -referenced property. The individu
applying for this permit has described to me as shown on the attached drawing the development th(
are proposing. A description.or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coasi
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-72
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If N
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.
Sign Name
Date
��.1/T bt rh •� T
Print Name
r
Z7

T
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Aichael F. Easley, Govemor James H. Gregson, Director William G. Ri
Authorized Agent Consent Agreement
ko(" rto�rinle �,�,��r,,�
e M�t�n is hereby authorized to act cn i
(Printed Name of Agent)
order to obtain any CAMA permit(s) required for the property listed below. The authorization is lii
ecific activities described in the attached sketch.
)CATION OF PROJECT:
3&U FE olarti4 Dc.
ZOPERTY OWNER MAILING ADDRESS:
PHONE NO. - ,3 3L-,27 5 - 3c��
JTHORIZED AGENT MAILING ADDRESS:
PHONE NO.
gnature of Property Owner:

Consent for Use of General Permit 7H.1200
Lot Number/Address: ,�$�-i
County: P-)Pt.k)Cj1 C,,
Criteria:
(check all that apply)
a'Primary Nursery Area.
Qr Less than 2.Oft deep.
❑ Greater than 2.Oft but less than 3.Oft.
❑ Submerged Aquatic Vegetation.
❑ Bottom habitat.
Comments:
Derision:
Issue General Permit
❑ Elevate to Maj or Permit
Subdivision: Wk
/-6 0
NC Division of Marine Fisheries Representative
Date

omplete items 1, 2, and 3. Also complete
�m 4 if Restricted Delivery is desired.
rint your name and address on the reverse
that we can return the card to you..
ttach this caid to the. back of the maifpiece,
on the front if space permits.
ticle Addressed to:
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*B.by
❑ Agent
❑ Addressee .
d Name) C. Dat of Delivery
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D. Is delivery address different from item 1? LJ Yes
If YES, enter delivery address below: 11 No