54071D - Ward

-tAMA / DREDGE & FILL
3ENERAL PERMIT Previous permit#
flew -Modification Complete Reissue III Partial Reissue Date previous permit issued
rized by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to ISA NCAC /41, 2 OOG
1441otes attached.
it Name,.;-,' /„, .://,1);:o 440acl Project Location: County 6,21,frors,,,/.t ,`
s , 1 j 1 /y!o/j G,.+Pys0 S. '1 Street Address/State Road/Lot#(s) S'9't
Pr9,v 1'SLe 6.0,4c,4 State,[., ZIP.2 7 94,9
,#(91,0)3 yy-.TST1y Fax# (_ ) Subdivision
ized Agent City ZIP
d cw EW ,PTA aFS PTS Phone# ( ) River Basin 1 N,,,,
OEA ❑HHF ❑IH E UBA ❑N/A Adj.Wtr. Body 6/ LA) -1CL na
❑ PWS: ❑FC: 62/ /
y- no PNA 0/ no Crit.Hab. yes / no Closest Maj.Wtr. Body �/
of Project/Activity 0 QL A f e L x i U,9 7 L, if
(Scale:/
dock)length ( i 04
-pier(s) I I
length
number otA 3 I.
ead/Riprap length � ..
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Y
avg distance offshore '� O _
max distance offshore I .k �`—" Q341
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channel • I 9' "M' ,..ems
:ubic yards 10 1 t
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line Length 7 2 i
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ags: not sure yes nod \.. — — j—V_...-........ T..— ' i _ ' 1
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:orium: n/a yes _ O
s: yes * P rt. �. . -
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r Attached;)< (yes-) no I0` R , I
ding permit may be required /
1.1 by: .P�..r J L-e a0,'e-/1 / 1-1 Seenote on back regarding River Basin
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kdjacent Riparian Property Owner Statement Page 1 of
Adjacent Riparian Property Owner Statement
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to '` // C ' X 's
c� I Name of Property Owner
property located at /73 /1c/ ' ,,(/ c ,
Lot,block,road,etc.
' '/z'�(� t/6 �4, , in �(;eee '/E r 4 c ,NC
on �tC�c��'S -�
Waterbody Town and/or county
He has described to m _as.showahelow._She _v_e_lopment he is proposing at that location and I have
no o je ons o�iis mposal. --�
I do not wish to waive the setback requirement.
I do wish to waive the setback requirement.
r/'
Description and/or Drawing of Proposed Development Ca iIra'G'e&IJ
(To be filled in by the individual proposing development)
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GARLAND F.WARD 10-06 2873
SHARON B. WARD
910-579-3594 65 19/530 NC
1938 NORWOOD ST.S.W. Date 2304
OCEAN ISLE BEACH, NC 28469-5605
Pay to theA
Order of
_ Dollars 8
Bank of America
ACH 053000196
IVP
:0 3000 L961: 23700 L0 7 786 311. 28 73
C-;PS4Ort► (br.Co.)