53149D - Foss

CAMA /5&PREDGE & FILL es
IEN ERAL PERMIT Previous permit#
Now 1Modification Li Complete Reissue ❑Partial Reissue Date previous permit issued
ized 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 —1 N• I icsz:
V t j
Q Rules attached.
Name �Q.\f �'55 Project Location: County ( two 4..�
1 ., . ��x L.1 Sy Street Address/State Road/Lot#(s)
i
na �\-J StateV3 C. ZIP L LILIS I ZZ 1- 0-1 L. 1-\v
n 1o)7 L-2S 3) Fax#( ) Subdivisi n..d Agent LL"I I: 7 City 10 eS 1414_ j� �,-NG. ZIP L $19
❑CW jW KPTA $ S ❑PTS Phone# �1,)LL Z"�3� River Basin C
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body" j. Pjp ` v. t L"- at n
❑ PWS: ❑FC:
yes /�n�o� PNA yes ii Qj Crit.Hab. yes / no Closest Maj.Wtr. Body j/-7PS�t'_ �'J".)\
Project/Activity L .X-(,pal L ,\IN .K �
� - S W (V L D'1 L \ 2 ' vv.l'-f_n-`r,-),P 4_
.S'C i t.) Qs- (Scale: ,►1_1
:k)length
+ i —
(s) f-
er s i -_ t -.....I--
igth I ( a ,
nber i -
`- _ f—
I/Riprap length tom 1
distance offshore Z i 4.,- _�_ _ I - 1
annetance offshore 1- -- l : �r �
C.A.IUI �rntirl
iic yards I G j
ip 1
se/Boatlift 1 i 1
i
____ 4
illdozing + d
C to 1.)ki:J; 7
Length t j
not sure yes WO* s i ' I i
t i ,
not sure yes I P `�
- —
'um: n/a yes I
yes j 1. 1
\ttached: yes io r
ig permit may be required byl"; SP%t t, -S-2-- c•4='• n See note on back regarding River Basin ri
Special Conditions

Authorized Agent Form
Date: 111/55/o
To Whom It May Concern,
I G
I certify that I authorize ,1 ,r�,,J f 4:•, rctitys to act on my
Name of Agent
behalf, for the purpose of applying for and obtaining all CAMA permits
/ 1Tc5,41 Bed 6
necessary for my project located at ;t f�/��
/ Address
Sincerely,
Prop Owner
`i/( 3D-as3v
Contact number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 3 of f's 's
(Name of Property Owner)
property located at la a /3o/i ,
(Lot,Block, Road, etc.)
on Aajuks Own poi , in Ta rr & Alder ,N.C.
(Waterboly) (Town and/or County)
ylv-ate-a s 30
Applicant's phone#: Mailing Address: A 0 1 P'Q.
3,4c.4 e;? 4i
He has described to me, as shown below,the development he is proposing at that location, and,I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
we, IAA II be LiAl� a /ieW v' L b4 hr I cvi- A A . Fs J
prody4-i-f, jvi5.1- 1'4 Rf,d— dC- esi51,64 hiAWypyi
b6- 1.40 off) ItA a k ProireAl ^t5. YvC ),roc_
biAl kkek S a,ti-GPI ow bc,
hpm Alsw*-r t14 5J4 t3, Ata SC, v-t- M Q eat
aN)-asjo -rivnk Raj c/
Ali(Information for Property Owner Applying (Riparian Pro rty Owner Information)
for Permit) '7Q ))073'tJ t 0(/1 f
. _ (9D11/1
Mailing Add -ss Signature

CLIFFORD J WEDDLE ' 93
KAREN C WEDDLE 67-231/532023720616806
DL 3501375 DL 3501359
l P.O.BOX 1037 PH.651-3647• �Z ��
MURRELLS INLET,SC 29576 1037 Date
Pay to the /,�G p/v .
$ ��d
order of ��/ v /"
Dollars �.•g��•�"
1�-
I Tip®,
CNB Conway WNW
4 National
BanK -no
o . out Carolina 295=
71
___.21,:AZ 4 '
LFor — / �__
:0S32023L8 :0237206L *' t• ' 3
Il cp5 q��� #.

SENDER: COMPLETE THIS SECTION COMPL ETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Si.'ature
item 4 if Restricted Delivery is desired. `4 , 1 _._V ( Agent
■ Print your name and address on the reverse �,� 1 al ID Addressee
so that we can return the card to you. Received by(Printed Nine) C. Date of Delive
ry
• Attach this card to the back of the mailpiece, i 7
or on the front if space permits. C' (C, Vim) ��' �� '�
D. Is delivery address different from item 1? 0 Yes
1. Article Addressed to: If YES,enter delivery address below: ❑ No
I r/—vn 14I,II k ams
O(P M,✓✓0..Sq J91.
1/1)i ims4,.6a
�UC� 3. Service Type
i i�3 Certified Mail ❑ Express Mail
(�/ Registered ❑ Return Receipt for Merchandise
In Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number
(Tiansferfrom service label) 7007 0220 0000 9644 7097
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A.,Sign u / 7
item 4 if Restricted Delivery is desired. X / 0 Agent
• Print your name and address on the reverse Addressee
so that we can return the card to you. Re ived
■ Attach this card to the back of the mailpiece, Y(Printed Name) C. ate of Delivery
or on the front if space permits. ` 2�"�
1. Article Addressed to: . Is delivery address different from item 1? 0 Yes
If YES,enter delivery address below: 0 No
y--oisl TOOrre6 l
l v. Boy
��(°� > G(JV� I(/ r 3. Serv' e Type
Certified Mail 0 Express Mail
- 73/3 Registered 0 Return Receipt for Merchandise
0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7007 0220 0000 9644 7103
(Transfer from service late,
Pc G.,r..,QRi I C,.i......._..,nnA _ .. _ - - .