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L II CAMA / !_!DREDGE & FILL z
GENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
iorized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC . ' 2.
(�
)Rules attached.
int Name trr\ QUI Ow) Project Location: County Pt. tJ 736►`L-
s ( ?Ayr r ....,- Street Address/State Road/Lot#(s)
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ized Agent "t--Z-M1..) n)6 City P5F1Z� &EA ZIP ZZLI4
,d ❑CW 4 ,EW PTA ElES ElPTS Phone# ( ) River Basir(l PL '
D OEA CI HHF ill IH ❑UBA El N/A Adj.Wtr. Body�SPa L- 4'1�1 A N AL (nat i
• ❑PWS: ❑FC:
yes / no� PNA ye Crit.Hab. yes / no Closest Maj.Wtr. Body 13PSc►l-t- �N J'
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lock length _
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pier(s) ===u_:
lengthh
camber _�- j •
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:ad/Riprap length MI=-■_.■-
vg distance offshore �- i
nax distance offshore M- INIM
channel -��1 +` 1
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ine Length T®(//_" , ®�.=
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Igs: not sure yes
Drium: n/a yes /csP-® ■_■ i
yes ♦ 11111111U-••••
-Attached: yes 4130'.011
ling permit may be required by: 1395' '- /S¢p G 4 . ---",U See note
+on back regarding River Basin
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ULIAN C BONE NCDL 2451839 2822 r
MARIE BONE PH.910-328-3226
1504 CAROLINA BLVD. G ss 3a 531
P.O. BOX 329167- D 531
365
TOPSAIL BEACH, NC 28445 Date
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
tme of Individual Applying For Permit: JUG I'C'V ' 1V f/1 ,c )1,i_1 Yn/
Idress of Property: ' =
(Lot or Street#, Street or Road)
7-0/ 7 ��/�tf /E 4/v Pam/
(City and County)
lereby certify that I own property adjacent to the above-referenced property. The individual
plying for this permit has described to me as shown on the attached drawing the development they
proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
you have objections to what is being proposed, please write the Division of Coastal
anagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215
ithin 10 days of receipt of this notice. No response is considered the same as no objection if
ou have been notified by Certified Mail.
WAIVER SECTION
inderstand that a pier,dock, mooring pilings,breakwater,boat house or boat lift must be set
:k a minimum distance of 15' from my area of riparian access-unless waived by me. (If you
ish to waive the setback, you must initial the appropriate blank below.)
✓ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
-C/7A5-
,gn Name Date
pint Name KCW4Zit!

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. X ' Q 0 Agent
■ Print your name and address on the reverse j� fTiY� rn_0 Addressee
so that We can return the card to you. B eive (Printed Name) C. of liv
• Attach this card to the back of the mailpiece, � , � 1,/� / �- /D n
or on the pent if space permits. W L fd (X�
7.4 D. Is delivery address dillfrom item ❑ es
1. Article Add 'ssed to: If YES,enter delivery` ss below: 0 No
, 941-Ar
��// " / ivv 3. erv'ce Type. /L ,ted(Certified Mail 0 Express Mail
❑ egistered 0 Return Receipt for Merchandise
❑Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article" 7005 3110 0000 0503 2052
(Transfer
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
SENDER:COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
ty
s
• Complettotelii ,1,2,and 3.Also complete 0 Agent
item 4 if Restricted Delivery is desired. ❑Addressee
• Print your name and address on the reverse Pi
so that we can return the card to you. B. -eceived .y(Printed Name) C. Date• 9.1 1
• Attach this card to the back of the mailpiece, L7. C �lS L r +4
or on the front if space permits. Ns
D. Is delivery address different from item 1? 0 :s
1. Article Addressed to: _ If YES,enter delivery address below: 0 No
1
Al gil)'�"`�iF)
roo el- /0
/� l�el Y/� 3. Se ice Type
IF��'�ylL/_ ��/�f / rt ed Mail CI Express Mail
ram"'� / ❑ egistered 0 Return Receipt for Merchandise
91-1.(4t_g#
❑Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
1
7005 3110 0000 0503 2069
PS Form 3811,February 2004
Domestic Return Receipt 102595-02-M-1540