50236D - Smerko

CAMA / DREDGE & FILL -f4® 5
GENERAL PERMIT Previous permit# n (06.
iNew Eftlodification El Complete Reissue El Partial Reissue Date previous permit issued
prized by the State of North Carolina,Department of Environment and Natural Resources 2v�J�Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
'' Res attached.
nt Name kd- So + V LD Project Location: County V\A) MA NC/
s t ;/ f\Ak\ , i Street Address/State Road/Lot#(s)
A 1 Stat, A ZIP t 1"IlJ'1 l k,VI �'
0 ( . ) ax# ) Subdivision'�%�l(�(/rn///y((,/n/-I
4- -vk_. v
zed Agent _ }- ��� City � ZIP
t t
j ?.Cw p:EW TA ❑ES ElPTS Phone# ( ) Wle-- River Basin / b.
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body W S(Jr-ceL 0,
❑ PWS: ❑FC:
yes / no PNA 'yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body 1 y n btsYD l&Y\
>f Project/Activity VI 1 VICA-10-fl 61 i.s 1.r V 1 l�Y l;4 ( 1. ` 10 VL'Y \Y J r l Ut 1k- 6 V a u(1 C-7
Ir'1 )
' ^ t (Scale: 'r1 =
ock)length 'X W ♦ �j i w �/ V. -
fr r � L/
m(s) vit X V l' —r i
piers)
Ott' ee
I
ength ' . - '
umber rf)
ad/Riprap length I I j A,
ig distance offshore
lax distance offshore
:hannel j
ibis yards1--' --\P— — V —,—(1—F— _ Nti 1
use/Boatlift v V 1
3ulldozing V V' /j
. 0X
i
111
le Length -7/(1 \ - 'V , I V/
not sure yes o 1 1
gs: not sure yes 4 �// f l{
rium: n/a yes `( ! `
yes �p�I � _ � I
Attached: yes no - �J l u "r' + � ��
ling permit may be required by: t C 0 1 T� n 111 Ai j n See note on back regarding River Basin I
.. . .— .... .. n., IN. -i d `7 I\) W i. ...._I :V

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CERTIFIED MAIL • RETURN RECEIPT REQUEST 0 240�
DIVISION OF COASTAL MANAGEMENT
n °PTRTV OWNER NOTIFICATION/WAIVER FORM
"lme of Individual applying for Permit: S0Gf'Jce2
Address of Property: ilk 105 62�I �� PC✓
444 44n) H)4 'r
V (Lot or Street#, Street or Road, City & County)
hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they A "ccr nticn. r drew,n. �t:, --., }:.�n-. should be provided with this letter.
a.<<�proposing. +1�__+,_,,,_c._.! :l: t....ct yr:::1,�:with ..,��.�,�:. �. � J t•.3l.tt
I have no objections to this oronosal.
If you have objections to what is being proposed, please write the Division of Coastal
Management,400 Commerce Avenue,Morehead City,NC,28557 or call(252)808-2808 within
10 days of receipt of this notice.No response is considered the same as no objection if y ou
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags
must be set back a minimum distance of 15'from my area of riparian access unless waived by
me. (If you wish 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 t 15' setback requirement.
(Applicant Information) (Rip Pro ® Per Information)
9`d gr,59
Mailing Address Signa re
.11—". , �� ���yc�3 1Z..)

LHOitl am.7 dO13AN3 dO•
i
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2, and 3.Also complete A. Sign. . !�
item 4 if Restricted Delivery is desired. � ��/
Print your name and address on the reverse Agent
■ 0
so that we can return the card to you. _ 0 Addressee
• Attach this card to the back of the mailpiece, B. R•cei :: by Printed Name) C. Date of Deliv
or on the front if space permits. 5 _
1. Article Addressed to: D. Is deli address different from item 1? 0 Yes
If YES,enter delivery address below: 0 No
COmbo
Gf0/�AO.t
340 ✓1✓isi4/►r fir 3. Service Type
L ertified Mail 0 Express Mail
0�//41/1(&111 y Q Registered 0 Return Receipt for Merchandise
- JJ cud / 0 Insured Mail 0 C.O.D.
�7 4. Restricted Delivery?(Extra Fee)
2. Article Number ❑Yes
(Transfer from service label) 7008 01,50 0003 8569 91,77
PS Form 3811, February 2004 Domestic Return Receipt
102595-02- /