50376D - Falby

CAMA/ 1 DREDGE & FILL ��',
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
orized by the State of North Carolina,Department of Environment and Natural Resources 1
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7.Yi . 12.&0
❑Rules attached.
' �► 6 L J _&)it tL mt Name Project Location: County
ss Street Address/State Road/Lot#(s)
State ZIP gl.dieS ( j l . \L7L.,(a?.47 0'0
# ( )- - _ Fax # ( ) Subdivision
rized Agent "f °`,i �--S (L-.L'i Lk,w`\ tkk City°kV ISLi -...i) ZIP Z '
?d ❑CW ctW E PTA ❑ES ElPTS Phone# ( ) River Basin L U n
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
): Adj.Wtr. Body 1/I (_ . 1.
PWS: ❑FC: Ai wYV
yes /no PNA Closest Maj.Wtr. Body
U yes /6 Crit.Hab. yes / no
of Project/Activity A. L-`Y) i' ._t i1 T' G-i�.i -n1--)(r L-1-c..
(Scale: I u
'dock)length
l . I I
rm(s) ' i I f
i I I
:r pier(s) {
11111111 I 1 { 1
number
read/Riprap length
!!HIPII!iPIIlIi1IiiiIII!1c lfl • jfl
IIIHIiHHIH
rairliiiiaiginillill111111011111111111.11
cubic yards ■ 11.• ,. ■.'■ I ■ I ■■■ 11•11111
ramp _ ` ' • ' ISM I,��, I en- 1111
,ous Boadi !L • $ (Z 'ilinit,ei ' I �� .�,� Uh Bulldozing ' imismon
r ii
1 MUMNIIII li� �MMINEM 1■MM , ■
dine Length
not surees no
Ii!
ililili
gags: not sure yes no
Corium: n/a yes no. IlL
no
:r Attached: yes no , 1 I
(ding permit may be required by: ()A j/ I St-fil--4C ❑See note on back regarding River Basir
c/Snerial Conditions f ( _-- (. CA.)47/17 UPS n F 7 44, 1 ZOO, 1...06 tit-. 5 Jr`j"T - ' ::Th

V
v�l
Jt
0
`L_J 'o
`-s1 u
U ci
O I
-- - I
S

DIVISION OF COASTAL MANAGEMENT
- ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: n,.cItrJ Fo
Address of Property: Po? F ei Or.
(Lot or Street#, Street or Road)
Oak J/C„? S 'VC a -L/ ,S
(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 descri tion 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 Coast
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
lock a minimum distance of 15' from my area of riparian access - unless waived by me. (If
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.
1 105
Sign Name Date
Print Name A

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: Ric 1-)c,rc) rc J by
Address of Property: //c2 E 'sIc;nc Or
(Lot or Street#, Street or Road)
Oq 4' -775-47,,c1 'V-C. cq(
(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 Coast
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
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.
Sian Name JJ' 1 i Date
t? �:.:>c
Print Name • .
ile c933 1// / kien .ID

AY.:':YA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management William G.Roy
chael F. Easley, Governor James H.Gregson,Director
Authorized Agent Consent Agreement
Cons is hereby authorized to act on r
(Printed Name of Agent)
Drder to obtain any CAMA permit(s) required for the property listed below. The authorization is lir
ecific activities described in the attached sketch.
)CATION OF PROJECT:
IC E. 551a,/ d L
Qq/21s ,-/ AZV. (s
ROPERTY OWNER MAILING ADDRESS: -
lO ! 1 S/oi :-1 of .
n 1 5-koci /V C . „plc.Q
PHONE NO. l70' 79' Ds3
AUTHORIZED AGENT MAILING ADDRESS:
PO vy 10 (07 /
oull- r«A AIc'- S(A,/
PHONE NO. k) — W z�
Sianature of Property Owner: i

SHORELINE MARINE CONSTRUCTION 5344
PH,910-845-2224 66-112/531
PO BOX 10671
SOUTHPORT,NC 28461 /- 3 - o7
TAY
1, „d„,/. A/C/0 $ woo -.1
� d Cal/offUll,.., Back
°°
BB&T BRANCH BAN G(?kND TRUST COMPANY
1-800-BANK BBT BBT.com
,` c / -Y /4/ t-l/"2-7f l
1:053LOl12LI:000510L7534 ?aii°05344