53952D - Halsell

CAMA / DREDGE & FILL -
3EN ERAL PERMIT Previous permit#
New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
)rized by the State of North Carolina,Department of Environment and Natural Resources �u
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / Tx •
_ Rules attached.
it Name �2('�G �c-t LSE 4—f-- Project Location: CountyC. ►.7SLJ
d 1"l: iZ� U L Street Add ress/State Road/Lot#(s)
,1) C e:t-{,1 State 0 L ZIP Z aL t o 9 L A •- rZ•&.
( ) Fax#( ) Subdivision
zed Agent City30LAS L V-) ZIP 2-2-9
i ❑CW CAW l 'PTA ❑ES ❑PTS Phone# ( ) River Basin VII--i I
❑OEA ❑HHF ❑IH ❑UBA ❑N/A 1
Adj.Wtr. Body 0 r✓ 12-'r v e ((---- t4
❑ PWS: ❑FC:
yes no PNA yes no Crit.Hab. yes / no Closest Maj.Wtr. Body 06,�' 12, El a�"
tf Project/Activity ,-_.-y ii ' ` \ ? I L sz,A"T ►—'L(' i. 'r L X �'L 4J(,----
Szo.)(TLL' q J�.r \ `-,v,- i_T '-T (Scale: \ —
ack)length
: I
I ,
I j t
pier(s)
.... , , , ,
ength I L
imber
ad/Riprap length [14 , +
rg distance offshore -.-.. \
ia _-_
x distance offshore : — _ 1
:hannel \ 1 ` � B ice. (7 Y{L sj� Is)6— - C
w
67-3N,,.\\ 1\ � \
ibic yards Lit ' `
nip _ 2X 12 ' LIfT
u;e/B lift )Zj I�—
3ulldozing �r�` ( j '
SST Si:._ L 1
I hhi („)__
I
ne Length i i L
not sure yes
i
gs: not sure yes i ...)
1mum: n/a yes „� ��` •
rl
yes l ( i
, Q L...Attached: yes .
ling permit may be required by: ©ice 51—�4:. ) L. --Cs v"cv-7'`1 See note on back regarding River Basin

- tIETURN RECEIPT RE UESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
'he purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual or
idividuals listed below. The CAMA General Permit application procedures require that applicants provide the Division of
'oastal Management confirmation that a written statement has been obtained signed by the adjacent riparian property owner
idicating that they have no objection to the proposed work or that the adjacent riparian property owners have been notified
v certified mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by a tnarin
Dntractor or other individuals acting as an authorized agent on behalf of the applicant.
his form was sent to you by the following individual or company designated by the applicant as an
athorized age, -. A
7/7`"G
i• zed Agent's Signature D e
une of Individual Applying For Permit: / f
[dress of Property: (Y 7 / �i>i v
(Lot or Street Street or Road)
(City and County) 7
reby certify that 1 own property adjacent to the above-referenced property. The individual applying for this permit
described to me as shown on the attached drawing the development they are proposing. A description or drawing.
1-dimensions. should be provided with this letter.
/J)-)' I have no objections to this proposal.
ou have objections to what is being proposed, please write the Division of Coastal Management, 127
dinal Drive Extension. Wilmington,NC 28405 or call 910-796-7215 within 10 days of receipt of this notice.
-espouse is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
derstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set back a
mum distance of 15' from my area of riparian access - unless waived by me. (If you wish to waive the
ick,you must initial the appropriate blank below.)
I do wish to waive the 1 setback requirement.
I do not wish to waive.ttte 15*setback requirement.

CERTIFIED MAIL - RFTLrR�1 RECEIPT RE VESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
The purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual or
individuals listed below. The CAMA General Permit application procedures require that applicants provide the Division of
Coastal Management confirmation that a written statement has been obtained sided by the adjacent riparian property ownei
indicating that they have no objection to the proposed work or that the adjacent riparian property owners have been notified
by certified mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by a marin
contractor or other individuals acting as an authorized agent on behalf of the applicant.
This form was sent to you by the following individual or company designated by the applicant as an
authorized agent: n[
02y,7� �;
Authori gent's Signature Date
Name of Individual Applying For Permit: /C;€l7 ��72.—/c.�i
Address of Property: �� 7 /3�Zv `�
(Lot or Street Street or Road)
P/ -W?c c ,c9g;‘
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individual applying for this permi
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.
7I/9L Al I have no objections to this proposal.
/ / P P
'f you have objections to what is being proposed, please write the Division of Coastal Management. 12'
:ardinal Drive Extension, Wilmington,NC 28405 or call 910-796-7215 within 10 days of receipt of this notice
Yo response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set back a
nininium distance of 15' from my area of riparian access - unless waived by me. (If you wish to waive the
aback,you must initial the appropriate blank below.)
I do wish to waive the i setback requirement.
I do not wish to waive the 15'setback requirement.
Avr•
�

4425
A
INC. I
30W PAINTING, / 66-19/530 NC .
1-327-3094 OR 330-0411 f7 �oz I
RU RD. DATE
IS FERRY,NC 28460 6667 nn V
v. Y
�b� 2� DOLLARS 8ft.
D� ,...=
FRED G HALSELL OR MARTHA HALSELL
merica''!
400$0. 't
, ryrn lflr.
e00
4425e 4053000 )196 .' 000681, 71121183e