50297D - Rudolph

LAMA/ El DREDGE & FILL ''
GENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑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 5A NCAC Z�
Rules attached.
it Name F- )1 c .�K. ,Q l..Pt\ Project Location: County P:.3 t 2 CZ__
(,,;it-= CA P 1 fL-a2 L Street Address/State Road/Lot#(s)
t;K`PYE:P\-i Statek3 C. ZI2�y'A'S 6 I-cr 3 SEA 01 a,)scti.. 1
V•( ) Fax#( ) Subdivision
zed Agent 1�. -��-r 4.L \ 5 CitySk"cLF (_Z1-`) ZIP Z1.1-i_L
i ❑CW ❑EW Li PTA ❑ES ❑PTS Phone# ( ) River BasinaiNP f
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❑OEA ,❑HHF ❑IH ❑UBA ❑N/A
❑ PWS: ❑FC. Adj.Wtr. Body oP Ski.,--) (nat )
yes / no PNA es no Crit.Hab. yes / no Closest Maj.Wtr. Body I o PS a�L S`' "I
If Project/Activity: S L. (,) X q -?-1. G i L-- t / ) )( i- D4 LE{
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(Scale: /
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ength . PSfl-LL °yIN iJ
_umber i
Id/Riprap length
rg distance offshore i i
lax distance offshore '
:hannel 41 1
ibic yards
I ► --1.- ' � "4.
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se/Boatl'
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3ulldozing
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le Length 25 i ' .i
not sure yes ®'' — 1 i.
gs: not sure yes (ID 1
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rium: n/a yes i P . .
yes P L
� no i i
Attached: �
ling permit maybe required by: <3h�� C.."-TN-1 • 1 See note on back regarding River Basin I

CLEMENTS MARINE CONSTRUCTION INC 1243
112 CIRCLE DRIVE 910-270-9110
HAMPSTEAD,NC 28443 Date 6-/
0i 66 30/531
365
Pay to the e,6'/7/L I $ I7G
Order of
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COASTAL VIEWS

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'1//'Lbt7ti tlb:24 yltlZbblkitti WILLIAM V ultKlt_ Ullb rkut tll/t
05 08 07:i6a mark Clement. 91.f1-270-9110 p. 2
CERTIFIED MAIL -RETURN RECEIPT REQUESTED
•
DIVISION OF CQASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIQN/WAIV R FORM
The purpoac of this form is to provide proper notice to you as an adjacent riparian property owner to the individual or
individuals i sted below. The CAMA General Permit application procedures require that applicants provide the Division of
Coastal Man gement confirmation that a written statement has been obtained signed by the adjacent riparian property owners
indicating th:t they have no objection to the proposed work or that the adjacent riparian property owners have been notified
by certified ail of the proposed work Often these forms arc submitted to the adjacent riparian property owners by a marine
connactor o other individuals acting as an authorized agent on behalf of the applicant.
This form as sent to you by the following individual or company designated by the applicant as an
authorize agent:
Authoriz-. Agent's Sisnature Date
Name of I iv-idual Applying For Permit: ,pl`,„,e Ca 1 A-11 41, A-CG'Giiioh
Address o Property: 7 l{#, ' lot 8 Sea ntvAmi In of u( '
(Lot or Street", Street or Road)
ir,, -P 6 / &er) d _
(City and County)
I hereby re .ify that!Own prove-try adjacent ro the ahnve-referenced property. The individual applying for this permit
has descr i. d to me as shown on the attached drawing the development they are proposing. A description or drawing_
with dime sons should be provided with this letter.
7. r-' J:, I have no objections to this proposal.
If you bu •e objections to what is being proposed, please write the Division of Coastal Management, 127
Cardinal t rive Extension.Wilmington,NC 28405 or call 910-796-7215 within 10 days of receipt of this notice.
No respo.se is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I underst,nd that a pier, dock. mooring pilings, breakwater, boat house or boat lift must be set back a
minimu distance of IS' from my area of riparian access- unless waived by rave. (If you wish to waive the
setback.,_ou must initial the appropriate blank below.)
4 1 do wish to waive the 15'setback requirement.
Al I do not wish to waive the 15'setback requitement
AliCligiirA_
F ./ - 1 r/ �' .�__�..�_
5ign - - J /Date NCDENR

lab/t77/Lt7tRy tl/:J/ ylt7L5blb/ti WILLIAM V t7ltriIL UU5 l'Al 111/k
Jun 05 08 07:46a mark Clements 910-270-8110 p•2
CERTIFIED MAIL -B�'h c1J7T REOUESTg2
AD E fi-RIPARIAN PROPERTY Q1�1ER NQTIFJ AT1QN/WAIVER FORM
The pun* is of this Ibrm it to provide proper notice to you as an adjacent riparian urvpeny oversee to the individual or
indlvld s listed below. The CA.�1A Oenertl Permit application procedures require that apptiatras provide the Division of
Coastal anarenent eettrd,ttation that a wrimen statement b hem obtained sited by the adjacent riparian property own:n
irlaiGatini that they have no objection to the proposed work RE that the adjacent riparian property owners have been notified
by cemfi d mall of the proposed world. Often these inane are submitted to the adjacent riparian property owners by a nianne
contractdr or other Individuals acting as an euthodized agcna ou Behalf of the:applicant
This form was rent to you by the following Individual or company designated by the applicant as au
authorised agent:
1
1
Autho Agene'a Signature Data
Name individual Apptyiria For Permit fete.,e 1' Ca 1 1 abler 4 1 �`"0�ph
Addres of Property: Zip !0t 4 $'Ct °&r I"1 k7(_Or
(Lot or Streit g, Street or Road)
(Gcv and Gounty)
I hereby certify'that I own property adjacent to the above-referenced property. The in lividual applying for this permit
has described to me as shown on the attached drawing the development they are proposing. A description or drawing.
with dissensions. should bp prrvieled with this letter,
�_ I have no objections to this proposal.
If you,have objections to what is being proposed, please write the Division of Coastal Management, 127
C'arrillal Drive Extension.Wilmington.`'C 28405 or call910-796-7215 within 10 days of receipt of this nonce.
No response is considered the same as no objection if you have been notified by Cirtifred Matt.
WAIVER SECTION
I unti muual that a pier, dock. mooring pWogs, breakwater, boat house or boat lift must be set hock it
minimum distance of 15' from my area or riparian access-lint wai1edk tilt. Of you wish to"save the
setback,you roust initial the appropriate bleak below.)
JI do wish to waive the 15'setback requirement
AVA
1 kiwi wish towaive the 15'setback requirement

/ti0/Lttib k7/:JJ W1LLIH 1 V la1tr it 1JL5 YHtat till
05 08 07:45a mark Clements 910-270-5110 P. 1
Letter of agent
1 'cn-(e 0-44.e t I P have retained Mark Clements DBA, Clements
M. '. Construction Inc,to make application for any and all permits needed to start
co struction on the work requested for our property or properties.
By allowing Mr.Clements to make such applications I do understand that this will in no
wa, relieve me of any obligations to perform all work according to the building codes of
No Carolina, CAMA, DWQ or any other state and yr county ordinanccs.
e CG 1 M\ Rivl GiU* h
name
Si tune
0 . 2 2-1I1S G, date J/1 .
Contact.information