52567D - Medlin

CF..1 /IA/ , I DREDGE & FILL
IEN ERAL PERMIT Previous permit#
New ❑Modification JJComplete Reissue LiPartial 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 I 5A NCAC 114 • ZtO
l•R"ules attached.
Name jog cn+Y AA% v LI Nj Project Location: County V &Prit:
2-06( LNE---A Lr.I Street Address/State Road/Lot#(s) LOT A-R
-NYV State NC ZIP ailL13 f( 3o ri'ci-t rz / v',D—
(4 j a) L lO 1(f11Fax#( ) Subdivision /S iM 406t L ( vv1/4. ()(+-2•
?,d Agent 1\C 1L (. LAAVVO1/4-IrS City i tkAA I sr ZIP z t
Cw E(W Q'STA Ci'ES ❑PTS Phone# ( q i g a n e"q I l b River Basin ( •1' 1-1?t
OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body A—A tA.A/V r
PWS: ❑FC:
es>/ no PNA yes Crit.Hab. yes / no Closest Maj.Wtr. Body /�w�
Project/Activity EL,T : 1 EYL /rLC11'flt3(6 OC CI.
(Scale: i f
1
)length3 X ! 4- A 1
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er(s) [ -1
�gth is E1
nber r " ' t— }
Ids>anceioffgsthore � 11 + t
i. L �,^ aL1fd , - i
K distance offshore i(t/ __ _4 at &AC :
annel "IIpi�.•� . , l e I —
iic yards ( '.
i
se/Boatlift
illdozing
�c 2DI '(C" ��_ s I
' _
Length 71 OCO ' i i
IMMEMNOMIMIIIMI
not sure yes -
>: not sure yes I / • 1 im L C` 'A—
ium: n/a yes 0
yes 1� 111_ U�� V 1 MN ��IU�U�
attached: yes no , �/_y� '''J - . 1
ng permit may be required by: f JG�I L r?CO. n See note on back regarding River Basin ri
c.•e,c.,I r.•..a>*o.•.,e A 1 I ( Clan l' i MS 11t- -71-E _ 7 - r i) I f�l fill Al-Pr . ' i i E\fV--

Letter of agent
I Z /z Z have retained Mark Clements DBA,Clemente
Marine Construction Inc,to make application for any and all permits needed to Start
construction on the work requested for our property or properties.
By allowing Mr. Clements to make such applications I do understand that this will in no
way relieve me of any obligations to perform all work according to the building codes of
North Carolina, CAMA, DWQ or any other state and or county ordinances.
' i ,, 7.4e4itz„.....,-
Si tore
/70)7; 4,6 77
date egAl_8Atoo
Contact information

DIVISION OF COASTAL MANAGhMEN
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FQRJ
Name of Individual Applying For Permit: r1 r o L /c ci l t 1\
Address of Property: I (,„ CC' i s 4 U r ecioLA L 0-1' A
(Lot or Street#, Street or Road)
yvcr 5 lea_ c_ • 641 de r C)(A,
(CitY and County)
I hereby certify that I own property adjacent to the above-referenced property_ The ill
applying for this permit has described to me as shown on the attaded drawing the developm
are proposing. A description or drawing,with dimensions, should be provided with tbic 1
`✓ I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-3
within 10 days of receipt of this notice. No response is considered the same as no obi,
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift
set bck a minimum distance of 15' from my area of riparian access-unless waived b3
you 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
fge 1y)(1//)4,0 )It 3 -2;669
S-� �'am d Date
C75 I\400'..t_5 n
Print Name . as

DIVISION OF COASTAL TMANAL i iziN �� A rLiTtrc� cnAr�
ADJACENT RIPARIAN PROPERTY O NtK NUilr1�ti. 11V1N1 VY Y,4\
Name of i 3 waaat V�e v r r+. . I \ecji
Loi-Address of Pro erty: i 5 C' F e-4c r y ��c� d A —c
F
(Lot or Street#, Street or Road)
_0
nt. S .Ca_ I /l/ L • Fer) (��'r n w"
(Citi and ounty)
I hceby certify that I own property adjacent to the-above-refeen erty_ The ind
applying forthis permit has described to me as shown on the attached drawing the developmm
are proposing_ A description or drawing,with dimensions, should be provided with this lc
I.have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-39
within 10 days of receipt of this notice. No response is considered the same as no obje
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat Lift i
set bck a minimum distance of 15' from my area of riparian access-unless waived by
you 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
3
Sian Name
� � 1 ZGk_be-kh 0 (. )l Jr:A
Print Tiamn NattrarabVsmilmm

2909-03-2618.52 » 9107703400 P 212
ADM OZTRIl'AR1AN_PROPERTY QyvNF1R NoflTCAnOWWAIV
Name of Individual Applying For Permit ,0 r,r r $k.► f j.ed i R
Address of Property:, ) eD 3 O F o r' Po a-of J4 14
(Lot or Street 0, Street or Road)
54a-d r
n
{City and wty) J
I hereby cat*Ike I mon partly adjacent to the. . The individual
applying ibrthis pansit/us dascribeato meat shown cm tbe attached dressing the development they
aro proposing. A dearaiptica or drawing.with dirnawkions,should be provided with this iatnetr.
Hume no abjection to this proposal
If yen have ebjeetlsas to what la being proposed, please write the DiVbilOtl of Coastal
Mansgemeat, 127 C.arnsal Drive fin, Wtfatisgtos, NC 23405 or call 910-395-3000
within 10 days of receipt oft notice. No response to considered the ss►me as no objection if
you have been Notified by Cared Mall.
l CN
I understand that spier.doh*,mooring Map,breakwater,beat booms or boat nit snort be
sat boll a asinimuuaa dletasee.t 15'ti+asi say area of rtparfaa somas-sale,.waived by sin at
you with to waive the s Sbsek,you enatst Ieitlal th4.appreptiato blank below)
I do wig to waive tote l$'setback requireaoon..
I I,lc wish to waive the 1 S'setback requirement.
( 3- 24 7
Sign Name Date
•
Vela_
AVA
latioNmake i DENR
Telephone Number with Area Code
S:1oatualahellstttpsri* roposty-frm .

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: )C, r o k_ } f E ci l t Cl
1
Address of Property: 1 5 0 a-e,-� 0 r eb c�di L-f Af 9
(Lot or Street#, Street or Road)
•
S lea_cl I en dP r ��u-rt
vvt -�
-(CitY and County}
I hereby certify that I own property adjacent to the:above-referenced_voperty. The lath
applying for this permithas described to me as shown on the attached drawingthe deve1opme
are proposing. A description or drawing,with dimensions, should be provided with this le
Lhave no objections to this proposal.
If you have objections to what is being proposed, please write the I)tvision of C
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-39.
within 10 days of receipt of this notice. No response is considered the same as no objei
you have been notified by Certified Mail.
111114
AIVER SECTION
411.411111
I understand that a pier, dock, mooring pilings,breakwater, boat house or boat lift
set bck a minimum distance of 15' from my area of riparian access-unless waived by-
you 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.
,, /// -
V-414%1- ;727,7?}
Sign N e • Date
✓r/AOk / hied/� �
Print Name • :� `:•

lc 14)
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Leas mobile home park 4/7/09
Total square footage on properties existing docks is 1790 sq, ft.
Total shore line is 1263 ft.
Total allowable footage is 5055 sq, ft.
RECEIVED
APR 0 8 2009
DCM WILMINGTON, NC

Lea's Waterfront Park
209 Lea's Lane
Hampstead, NC 28443
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