50302D - Sink

AMA/ ❑DREDGE & FILL
ENERAL 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 15A NCAC I . j 2, 2)
Rules attached.
int Name l 'PSL`1 S10v- Project Location: County 0 f• LA
s 09 \I E. L.(\—' 1 , Lt>r,-)e Street Address/State Road/Lot#(s)
I
.,Og'PSI" 5 641- 1-•-/ state 4- ZIP Z- t.--1(o0 In V Lt C..r-b f3 L I3
tool() )'J O`r i Q3Z-- Fax#( ) Subdivision t7 Z-Po i Woof
ized Agent CityS►Jt ADS d. J\_7 ZIP oL'
d ❑CW )EW 5TA ❑ES ❑PTS Phone# ( ) River Basir#h i.LS 6
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body L v R t1r�<,, (...RLE-is
❑ PWS: ' ❑FC:
yes CO PNA no Crit.Hab. yes / no Closest Maj.Wtr. Body NGM/ (LTvE
)f Project/Activity L tJS 1-A L L . 1 D X ) Z- bo AT LI F I t" Ir-W> Lk x g c e c(`Lv
6-x_S1 L► ., b J G 1L (Scale: ��.
lock)length /jJ/
-m(s) ^-1 j
I ! _
pier(s) j I
length .
lumber
:ad/Riprap length l . 9
...i
ag distance offshore
t\L'
nax distance offshore 1.
i (�V v
channel
i �\ 'I -
.ubic yards "_
amp -�
Win,. I o � rz
•
Bulldozing } • 3C J '
�77 .
ii.
ine Length —7d � i �'" ` � {
411=it, yes no
igs: not sure yes t� ' ,��
,rium: n/a yes
yes no P L ` r
Attached: no
Jing permit may be required by: CUi•)5 lAt.,..-) C.-0v,.0-17 I I See note on back regarding River Basin
. . — 1 —( / , ‘ ,., I 1�_'.. •1 r� n/ rc .1.,fAk 1 Lw .-. \/ - ,

JOSEPH C SINK 1211
100 COUNTRY CLUB DRIVE
JACKS 910-409LE,NC 1032 28546 ?,. �5, ] 68-7497/2560
`DATE J
t
AY TO THE IQ C_ DElj cZ
)RDF OF 1 I &DOD t CO
) )—) ., ( I` ,�, . ��.DOLLARS ei '"
VAVY el
-EDERAL ..
credit Union
OR( i,�k, 6f 5030Z C^-)S oisl
4L
: 2560749744L21 Lem L25 97 0 3 ' L

108 15: 19 From:DCM MHD 2522473330 To:91032723E37 P.2 2
ALI/At.SJ \ 1 lul ♦LA'VI{ ay 1 a a-S„.a a...a�a - y . . • .auaw # A a w a u• aa�a . a
(FOR A PIER/MOORING PILINGS/BOAT,LIFT/BOATHOUSE)
1own property adjacent to 4*`1'r 1 ) ��`/�� S'
I hereby certify thati p j
(Name of Property Owne l
C31.operty located at
(Lot, Block, Road, etc.)
C I \\- in C\L_CO1 N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at tha: 'tocation,
id, I have no objections to his proposal. I understand that a pier/mooring pilings oatlift/boathouse
List be set back a minimum distance of fifteen feet (15') from my area of riparian accsss unless
aived by me.
I do not wish to waive the setback rcquircmcnt.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT::
(To he filled in by individual proposing development)
it
(BOPT-7- 1)0(-`c'
tib �
C )-.) )c
applicant Information) (Riparian Propert Owner lnforma:iton)

aS 15:19 From:DCM MHD 2522473330 To:91032723E37 P.2.2
A VIrA`.ass • a a as •1\.A♦ at * aaS.ra a.,aSta y . r • ,au a- vna wa aa •aai♦ a
(FOR A PIER/MOORING PILINGS/13OA ",LIFT/BOA THO USE)
I hereby certify that I own property adjacent tole` { v 1&4 --
\ACs__
(Name of Property Owner)
Dperty located at FC_I-trr)Vinsk `
(Lot, Block, Road, etc.)
N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at tha: location,
d, I have no objections to his proposal. I understand that a pier/mooring pilings/hoatli ftit.csathouse
.ist be set back a minimum distance of fifteen feet (15') from my area of riparian acc;ss unless
lived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
,,e)‘OA(
r3 14.)'ficti„ C
r
y -)(.
.pplicant Information) (Riparian Property Ow er lnfori a:ion)
c \ SE_LATV4 /*/ /
.Vionnhrrn