54094D - Duch

CAMAJ -_' DREDGE & FILL
3EN ERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue El 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
Rul hed
t Name -FY-A I
'Po. Pax 35g5
1 i i o _ StateN C� ZIP
`() Fax#( )
:ed Agent Ed a V N Yl
❑ CW [X EW �A PTA ES ❑ PTS
❑ OEA ❑ HHF ❑ IH _ UBA ❑ N/A
❑ PWS:
yes-/ no PNA
❑FC:
�yes/ no
f Project/ Activity
! y,
( L\ t VU C }
ck) length
,(s) q x Ao'
ier(s)
ngth
mber
d/ Riprap length
distance offshore
uc distance offshore
cannel
_
rip
ise/ Boatlift
ulldozing 1 p
r Vt "
z Length
not sure yes rno
s: not sure yes i' J
ium: n/a 1 es no
littached: Yes( no
Crit.Hab. yes / no
vy es attac
Project Location: County N( L d f hi I i C. V'r r
Street Address/ State Road/ Lot #(s)
Subdivision N
City S(A rK-( ZIP o28ta
PNonne # (� LL )59L- 53%(c River Basin l /
Adj. Wtr. Body C�({V1t'1I�{�GUnA (nat
Closest Maj. Wtr. Body i W w
(Scale:
ig permit may be required `� by: ��(� (no Y C ❑ See note on back regarding River Basin
Snnr�oi e'—Ai«i— lot VC A Al 1 � n. 1 —L r I r-J 1

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NCDENK
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F Easley, Governor Charles S. Jones, Director William G. Ross
Authorized Agent Consent Agreement
6-V -- - is hPrehv a, �thnri,Pri to a n m,
(Punted Name of Agent)
in order to obtain any CAMA permit(s) required for the property listed below. The authorization is lime
specific activities described in the attaches! sketch. -
LOCATION OF PROJECT:
%411 M#9o--3 Saukd %1<�
�✓1 /41J4
2, U
PROPERTY OWNER MAILING ADDRESS:
PHONE NO. /�y � � ` � � - 81
AUTHORIZED AGENT MAILING ADDRESS:
PHONE NO.
Signature of Property Owner:

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
Name of individual applying for permit
Address of property
b� �Zvnv �
I hereby oertify that I own property adjacent to the above referenced property. Th
individual applying for this permit has described to me as shown on the attached
drawing the development they are proposing. A description or drawing, with
dimensions should be provided with this letter of notification.
Please initial below if you have no objections.
I have no objections to this proposal. %^d17✓J `��Oc'LS
If you have objections to what is being proposed, please write the Division of Coas
Management, 127 Cardinal Drive Extension, Wilmington, N. C. 28405 or call 910
395 3900 within 10 days of receipt of this notice. No response is considered the
same as no objection if you have been notified by Certified Mail.
WAIVER SECTION / V
I understand that a pier, dock, mooring pilings, brea er,boat house,lift or
sandbags must be set back a minimum 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.
DO NOT wish to waive the 15' setback requirement.
Signature & Date
RECEIVE[
nrT 1 9 7nnq

DIVISION OF CI
ADJACENT RIPARIAN PROPERTY
Name of individual applying for pem
/
Address of property 6 6 I &A
I hereby certify that I own property ac
individual applying for this permit he
drawing the development they are -
dimensions should be prc_-
Please initial belov _-
I have no objections to
if you have objections to what is beinc,
Management, 127 Cardinal Drive E) �p
,within 10 days of receipt p _ -
1 same as no objection if you
�O
WAn -
I understand that a pier, dock, moorir
sandbags must be -set back a minimal- -- - ---
unless waived by me.(If you wish to a _- - -
appropriate blank below.)
I DO wish to waive the 1
I DO NOT wish to waive i

F AND S MARINE CONTRACTORS, INC.
P.O. BOX 868, TEL. [phone]
WRIGHTSVILLE BEACH, NC 28480
PAY
TO THE DATE/? � ZL- Q C 66-85/531
ORDER
OFF
C
RBC Bank" DOLLARS 8 wd
FOR ® )Af--/`'
its 0 0
0 380 i Ill l:0 5 3 1008 50l:0 2 7 200 580 II• -
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