53925D - Normansell

❑�CAMA / DREDGE & FILL
ENERAL 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 �
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 2/' /2 O�J
C]files attached.
nt Name d Sv c/ 1 yCR p�,�,�Se L Project Location: County , ,G 4,,v„cwi c/e
;s .;J b l W/S le I O, k L9„, Street Address/State Road/Lot#(s) 5009,47 G
,fie, 49-49c fi State iC ziP,2 I//l.-
# (- -'O)3 ,`l' 72 7.5-Fax#( ) Subdivision
•ized Agent in", CGcif;vrt City ZIP
,d CW EW E ..PTA DES ❑PTS Phone# ( ) River Basin Z.ci n,,
L OEA HHF E IH ❑UBA ❑N/A Adj.Wtr. Body ad "L L,SLo v, /j tat.
C PWS: ❑FC:
yes / no PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body All')
of Project/Activity y,_ : L ii / t‘ p /e 4 0 GX
(Scale:
lock)length 96 'a( .f? ' -
rm(s) 2 Q c X �2 ��O ITPZl__.- � pLiitti
, , r
•pier(s)1 7 X 1/ f l'e .
length
.
1
lumber 4 i J a' 4�4- i lei q
r Y I. � , {f [ "',
.ad/Riprap length ru 4 0 4 !in' ' v v 1'
lir ''' I
ivg distance offshore l.,A •
nax distance offshore
ti '''1,11A- ' , yr
channel - 0,
:ubicyards "lilt �j -�' ( �` .4. Y I I
amp — J J 0'u � 'i s�, ` _ 1 ! a 4Ouse/Boatlift 1 v i 4 N
Bulldozing 41 i
Isle de i,.) - A
`� `� — —
Pi 'I Ta/, .� 01(2 li L,s 1 7 1 , ' .
V
//tt 1
- --
ine Length 'L? , Li a if '` 0 4 III _
Y i
ei not sure yes 7�5 V ! _ I V ro>
ags: not sure yes ? !
V FI K
orium: n/a yes �io_ ` �,1, _� L I
.-.__
s: yes Co) fi }
� if S36 !?`�,.i 1t1 i °A/L 'Lg.,r e I l' L
2
r Attached: yes C
ding permit may be required by:Se4 ni Se 4 g/A C 4 I See note on back regarding River Basin
Fri 1 /'_

! 61C/I vt i
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to U-11A-Pci Norm kSe ( 's
(Name of Property Owner)
property located at (..0+ JO 53C2 C'AK i-A( )
((�� (Lot, Block,Road, etc.)
on NA P ld( S i r�� , in S01,6et ?x L, 6CO►JSiaick C.U, ,N.C.
(Waterbody)J (Town and/or County)
Applicant's phone#: {ip-Si Ilag5 Mailing Address: .36 T'u + C4_ L*rJe
►lsetbc.►.�N L 2g 1 S
He has described to me, as shown below,the development he is proposing at that location, and,I
have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet(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 not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying (Riparian Prop rty Owner Information)
for Permit)
Tw i.cteo, OAK K 1- t
Mailing Address Signature
C. _ ( A l / 1 nil/_ D \A M./J/' > ram. `C"n

AirA,
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr.,Secretary
Date 8 -11- - o9
Nan3e o Property Owner Applying for Permit:
,\ i C kotit if ' 1 . AJOIWIcias-e/
Mailing Address:
4-- 4 (, [ c,J( clw ot( Oc,it 1-44
cic ,�-f-� act i C �R G?
I certify that I have authorized (agent) ? 1A ) Coore1_ to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) p,,(Z ,
at (my property located at) 5 3% ''r a%,cFed 6hht LA-toe,
This c rtification is valid t u ate)
j / S---)i-0/
Pr perty Owner S grfature Date

........__.._...._..........._ ----RYAN D.COOPER 66-7704/2531 863 4
NCDL 8375610 08614320179
PH.910-443-4829 DATE ��3 V
P.O.BOX 1393
SHALLOTTE,NC 28459
4� J� 1 $ 2OOPAY TO 1/CDETH ROF pp,
�� /� DOLLARS U
i (N v
il
State Em to ees' Credit Unions
Supply,North Carolina
81 GP 32, --*CDc ,(71___
2614-- -- e(5"1--
': 2531770491:086L432'0L- '90 6 34_- ...WV/SLUE
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