50223D - Kirby

CAMA / _i DREDGE & FILL
ENERAL PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue El 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 I SA NCAC ?�,//69/ y 2*/J, g
L Rules attached.
t Name Project Location: County3g ti„/S(IN c k
Street Address/State Road/Lot#(s) /J t/ C`,,,,,t
State ZIP
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ouse/Boatlift - J
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ding permit may be required
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MALLARD DUCKS
HOLDEN DOCK& BULKHEADS
GREGORY A & DOROTHY HOLDEN
910-842-9732 HIS NCDL 4576438 HERS 5202642
1502 STONE CHIMNEY RD SW
PoteN -‘:(3 ES/
SUPPLY, NC 28462
PAY TO TI-IE $ g I
ORDER OF CU,
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BANKe,,,„ 662_25
Supfl)NC 28462
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•25 08 01 : 22p Greg Holden 8429806 p• 3
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. 25 08 01 : 22p Greg Holden 8429806 p. 4
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NO CA ON/W FORIvl
Name ofIndividual Applying For Permit
Address of Property_ / 1 G(O
(Lot or Street#,Street or Road)
(City and City)
I hereby certify that I own property idjacent to the above..
�PIYiAg�dtisperm�� edto me as � �'' The mciividil
are proposing- A F. own ontl,e attached drawing the development th,
drawing,with dimensions,s,should be provided with this letter.
--� I have no objecticosto this proms
If yea have objections to what is bei proposed,•
�a���7 Drive� please write the Division of Coas�
wif#iiu61©d*ys�� ��nation No response
28405 or call 91Q-395.-39
rut have b a by Cefr xd Maa'1 r o is considered the saint as no objecbio�c
•
------.�
I noderstrod That a pier,dock,mooring pthags,bit,boat house of boat lift must
set eka minitnata distance of 15' waren of -access--unless waived by me_
setback,you wish you most iiItial the appropriate blank below-)
• I lowish to waive the 15'setback
I do not wish to waive the 15'setback requirement
3 PC�D 5igtt Name Date
lam,
Print NRmP