53935D - Wylie

1CAMA/ ❑DREDGE & FILL
ENTERAL PERMIT Previous permit#
INew ❑Modification ❑Complete Reissue Partial Reissue Date previous permit issued
rued by the State of North Carolina, Department of Environment and Natural Resources 2/1/
> ,/
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ,/,N. 2U0 G
L7Kules attached.
nt Name C/7tiit L1_ d /7474?y,f',z.'/ J{, L✓//i 4: Project Location: County /�re u -� _v '- •'c
s 1 /t 4. t)r.�/r�f (t d, / Street Address/State Road/ Lot#(s) / .2 r%p G
t4g.c`! 1/-, State-V C ZIP &.2.27
#(401 5.- 1--cjroZU Fax#( ) Subdivision
izedAgent (. A,9 77_ City !'of)•✓ T/c 'We`' ZIP 2 Y/
2Lrf ! /I2 rE /
d CW L].EW n L PTA ES PTS Phone# ( ) River Basin 11r77,1
OEA LI HHF L IH UBA N/A
Adj.Wtr. Body f l-V Gt/ (nay
PWS: E FC:
Closest Maj.Wtr. Body ,9/ ill/-
yes / no PNA yes / no Crit.Hab. yes / no
AProject/Activity ,jl c i eft, ,,j G p, L,.•y c /o 6�C i_si,,,, ` F�1. pi a'''' -`1,fe4.7
U ,,
(Scale:/
ock)length E,.,�;s;*,
m(s) tt 5/.../..,- — — •� 'Il/ —.
I'pier(s) N
,—
length � — 2. — —
umber , `y1r IN
:ad/Riprap length � � '`.{/�
vg distance offshore I �L
iax distance offshore
i
I
channel 1 s j
(i 'p�to r5 ---
ubic yards �' @
i
i
imp 1 __ 'A , ._.._ +.. — —
>use/Boatlift
I —j 1i I - —
Bulldozing I l �
,t .
V
k tA ;44_ .4- ii : 0 ____LL; ;a 4 64 ii.
to
ne Length .2 -,fir%— v
Ii a' .A. y .0 u4 ,l ,to t-
1 -not sure yes e ., /� 1 /
cgs: not sure yes 1 I
—
—
>rium: n/a yes t5i
yes ,'. l L. p 6—-+
•Attached: yes ✓�j f
ling permit may be required by: f3Q L,r S. Grid ((G,/,,1 )„..- I I See note on back regarding River Basin i
.--- - - ..- Ai , C _, a� .�-, - .- 72. .I-l.i - - - -

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)//
I hereby certify that I own property adjacent to / %5(' GlN��//!/t� 's
(Name of Pro ty Own
bt`)
property located at �L'� A C
- 11 (Lot, Block,Road,etc.)
on ,in ()TB ,N.C.
(Waterbody)r (Town and/or County) y Q
Applicant's phone# 7 1 1 q�Z Mailing Address: l tito)l
C�c/o f //c r��z7
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.)
V 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)
Se 9ca Jl 5
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
Mailing Address Signature
a di A _Zf2Z7 w R pv-1 y

8 22
c
renfeliS
CV -
ASNI)(--1 8
1
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1
_ LS CS ,._ .

Ari*41,,,A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
3everly Eaves Perdue James H.Gregson Dee Free
3overnor Director SecrE
AGENT AUTHORIZATION FORM
ate:
ame of Property Owner Applying for Permit:
ClActy frt4 via r4_ I / iSej
'ailing Address:
JCS Lee w��„ k
7. e 1.4 t7C 2S2z-i
hone Number: ( 7e4 zL7
;edify that I have authorized (agent) ( ljg..r 1&5 fictreti
I to act on my
?half, for the purpose of applying for and obtaining all CAMA Permits necessary to install or
instruct (activity) Ne,„, Q►�►�n�5 PO r f);es-
(my property located at) /b' 6 le' Y-t e k /2c/
is a-eQ c roc
his certification is valid thru (date) /V0
A

•
405WAS ONE CHIMNEY RD
RWAY CREATIONS LLC
1349
SW BS.910-619-0655
SUPPLY,NC 28462-2662 88-112/531
Yto th
n
e 1� /� Date
er D E (.0 Oa
Dollars ' on
(n� �;«"r.
D T BRAN CV
BBTTBBT,o PANYYCo)For C�P 3g3�j (Br.W4,L2Z —
':os3 Lo 2 ':000s 2 ', 23 ? Sti•O
COLONIAL CLASSIC•

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
,■ Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. ` (L 4Agent
• Print your name and address on the reverse X� a+��'Qv�?so that we can return the card to you. L
Addressee
Received lac• Attach this card to the back of the mailpiece, (Printed Name) C. Date of Delivery
or on the front if space permits. Degiel 171/,i ,, 9-0—OCj
1. Article Addressed to: D. Is defiivery address different from item 1? .ZYes
WO,A„ ( % If YES,enter delivery address below: 0 No
Wq 13rlly� , \II. 6o L F', a,-K/inilii� st-.
Li_oeAN
S-f-a ),
6-1-0- G 2 SS
3. Service Type
...//l ❑Certified Mail 0 Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail 0 C.O.D.
7009
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number
(transfer from service label) a g O 0001
4221 2060
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540