52551D - Doern

CAMA / -+ DREDGE & FILL
iENERAL PERMIT Previous permit #
New-MANfication _ Complete Reissue Partial Reissue Date previous permit issued
zed 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 ll``• �� r�fJ
Z Wes attached.
NamekPiJ t&,J -e Do otz Project Location: County 311 N,, fc r/C It
% 3 144 (, ye L o9ye, Street Address/ State Road/ Lot #(s)
i f P '�s 4P,9c. k State ZIP 2$
N)64-2$,51rFax #( )
d Agent -5-42,r,1n
❑ CW QfW C�PTA EtES ❑ PTS
❑ OEA ❑ HHF C IH - UBA ]N/A
❑ PWS: FC:
Subdivision
City.1 SQL. 4t�?4c�i ZIP 2
Phone # ( ) n River Basin Lc>
Adj. Wtr. Body 9/ c,i �✓ (n©
,esPNA no Crit.Hab. yes / no Closest Maj. Wtr. Bod
—rto��> yes ' y �� G✓G✓
Project/ Activity�1
(Scale:!
o length "�..
')
r(s)
;th
ber
)R prap length/2�
listance offshore
distance offshore _L�—
nnel
yards
�/ Boatlift
Idozing
Length_ 2,7
not sure yes
not sure yes tt
m: n/a yes
yes
ached: yes �p
permit may be required by: 1u "S!/ , G�OHc El See note on back regarding/River Basin
pecial Conditions /T/ 1 Curl L� 7`O� � 211110,0 �S W p1/ Af H,//
.—

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
lame of Individual Applying For Permit: K'e n Coe [/-I
address of Property: 713 L"I. rd 0a I l-- le
(Lot or Street #, Street or Road)
(City and County)
hereby certify that I own property adjacent to the above -referenced property. The individu�
pplying for this permit has described to me as shown on the attached drawing the development the
re proposing. A description or drawing, with dimensions, should be provided with this letter.
y I have no objections to this proposal.
f you have objections to what is being proposed, please write the Division of Coasts
'Ianagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3901
Within 10 days of receipt of this notice. No response is considered the same as no objection i
ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilinft
gs, breakwater, boat house or boat lift must be se
ck a minimum distance of 15' from my area of riparian access - unless waived by me. (If yot
ish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 1 5' setback requirement.
I do not wish to waive the 15' setback requirement.
L7 42z10
9
p Name Date

(Scale-,/
36A'NIA / RREDGE & FILL
"ka"'ERAL PERMIT
ew OModification OComplete Reissue OPartial Reissue
Previous permit #
Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources r�� //6
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
attached.
�y f)
'v Project Location: County Y U-0--r 4/i G
Street Address,) State Road/ Lot #(s)
3
t t _ Stata %s__ —',: ZI
Subdivision
fget]t �tiK City ZIP �y
❑ CW lew'ba*A—eeS--OPTS Phone # ( ) River Basin Lac
❑ OEA ❑ HHF ❑ IH ❑ use► O WA Adj. Mr. Body �� GiJG-J na
D PWS: ❑FC:
yes /�,� FNA no Crit.Hab. yes / no Closest Maj. Wtr. Body �/ L✓�
F Project! Activity► /?CQ�I�e�x �S ^1G /`.��Gi-✓G lac. /1s�E9�
ck)
1(5)
,ier(s)
rigth
mbar
pW Wgd'
distance offshore_
uc distance offshore6-
%annel
)ic yards
np
se/ Boadift
j�
jildoang
9 Pei .. may be requked br��^[ ��� .��/itC /`� ❑ See note on beck regarding River Basin r
1pedidCAndkkwuL L G'�,/, �. �� 7A /l ao i9s A ,,2// olf

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Jame of Individual Applying For Permit: i�'e Y, Coe f f1
address of Property: �Z 13 [4J. 111(U ► 0 1
(Lot or Street #, Street or Road)
(City and County)
hereby certify that I own property adjacent to the above -referenced property. The individu,
.pplying for this permit has described to me as shown on the attached drawing the development the
re proposing. A desction or drawing, with dimensions, should be provided with this letter.
ZI have no objections to this proposal.
f you have objections to what is being proposed, please write the Division of Coast, -
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-390
vithin 10 days of receipt of this notice. No response is considered the same as no objection i
ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be se
ck a Znmiinimudistance of 15' from my area of riparian access - unless waived by me. (If yoi
Dish he 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.
AINCKW&

A*A
MCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Easley, Governor Charles S. Jones, Director
Authorized Agent Consent Agreement
'Nilliam G. Ross Jr.. Secret
�a ►Ni 1'Yl �C,( ,(C
is hereby authorized to act on my behalf
(Printed Name of Agent)
o obtain any CAMA permit(s) required for the property listed below. The authorization is limited to the
activities described in the attached sketch.
)N OF PROJECT:
co Y10 Ave .
t?egC h 0C
TY OWNER MAILING ADDRESS:
AY0e
PHONE NO. 716— 'N �_d cS S / S
IZED AGENT MAILING ADDRESS:
�C IUC 60
N� ql0- 3-11,2yS-
of Property Owner:

--___--_ _--- EA DS INC
- KH
VARNAMS DOCKS BUCK ES & BULTATES
1574 SUPPLY, NC 28462
910-755-6561
TO THE J
ORDER OF
D- 69
DATE
I $ 62�(
PANY
BF1ANc, o BANK B0T BBT?acOinM ']
a .its
00052, ?92
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