50216D - Stallings

�CAMA/ ❑DREDGE & FILL
GENERAL PERMIT Previous permit#
g'New El Modification ❑Complete Reissue III 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 2/4/- //0 G
yr�
1 / Lg'ftiIes attached.h
/?It Name .,/4l j{ `/ -5 / L Lf,,r5 S Project Location: County ,,,! c✓ !/c CI
92 35. l-ic%ds LX/) G n✓. Street Address/State Road/Lot#(s) 2(p/ 6 c
ei,9a tGaf/ e State/Y C ZIP Z F2 2 2 /`v L1 yle(i, Z ,
0(7 7y2 -044,Fax# ( ) Subdivision
zed Agent GLoyr/ /1)/ ✓1Z City /50L11/ii7 ZIP 29,,
j EtCI CW DEW-- PTA DES ❑PTS Phone# ( ) River Basin Z---4/,7
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body 62 I !.-3, A✓ rat
❑ PWS: ❑FC: A /
yes 1_no PNA yes no Crit.Hab. yes / no Closest Maj.Wtr. Body
if Project/Activity C/? ,9 c e L x ,f f /i✓ev do..' ]', lie/e"dc/
(Scale:/
ock)length P'' ` 5
rf
pier(s)
ength -
umber
ad/Riprap length . ", / >j 71 S
ig distance offshore l
iax distance offshore _ - _ I
i
:hannel I i
yards � �
ibic t. —j - -
imp
use/Boatlift vi��h e I
p
3ulldozing ..--- --- l� � 7 , .
' Y 4cit' V 4_ _.. tfr . 48,. tt• :4‘./.....-rimmg4+.6....
1 .
5 p
j
ne Length
i
—
not sure yes (ho
gs: not sure yes ono I - 7\l ems✓ dog GiC.'�
;rium: n/a yes L V L '
�fi yes o I 1 I • -
Attached: yes �o,.
ling permit may be requireded by: U a c/^'$w/e.�/ Cc H,� H See note on back regarding River Basin 1
- - I2_ / //I _ .. , /f, . ., � 7J ,— .f) _ _ / , / . _, C-/J ..n r r_ 1 1

PATRICIA H MINTZ
BRYANT MINTZ �2 t%v
2490 WHITEVILLE RD NW 910-754-89271/
6
ASH,NC 28420 Date
Pay to the
Order f - $ 400,-
r^C "�---�te / )
�—��.—Dollars
WACCAMAW
`_,BANKsrxy Lw66 GP#Soatco
Shollott.,NC 28470
rowu.moccnminubaJ. r--
For
1:053L12L521:80005278L0100L020
' - - - INTOUC-$ C

i1'
REVI,0(I 4_ AP-Fil) LA-6 i?ljj
SC
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`' TA ,.. l !" QS

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
lame of Individual Applying For Permit: , (f ti4 `I / /,
It
a s
.ddress of Property: I. o c w e O d v // ,' RcL S
(Lot or Street #, Street or Road)
(Ja VC! A ,,( C ?It
(City and County)
hereby certify that I own property adjacent to the above-referenced_.propertz•. The individ
,plying for this permit has described to me as shown on the attached drawing the development tl
e 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 Coas
anagement,. 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-39
thin 10 days of receipt of this notice. No response is considered the same as no objectior
u have been notified by Certified Mail.
WAIVER SECTION
nderstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
bck a minimum distance of 15' from my area of riparian access - unless waived by me.
i 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 the 15' setback requirement.
e
Date
Ate-'.

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 �❑Agent
n
• Print your name and address on the reverse ' ❑Addressee
so that we can return the card to you. B. eceivpd by(P inted_Name C.ge of elivery
• Attach this card to the back of the mailpiece, i(,
or on the front if space permits. _
D. Is deliv different from itt�(n ? es
1. Article Addressed to: If YES, ter delivery address beld4 `, 0 No
L a1-7/4,,i;t7;c'encil .... APR 0 7 REC'D/3a g P (1
/1 \ \\....._
.t...r! ,.A
__
c a�7ca 6 3. Service Type .., ,...-/
(' (lij GYCertified Mail 0 Express Mail
0 Registered 0 Return Receipt for Merchandise
•
0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7008 0150 0002 9188 4186
(Transfer from service label)
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
"ES r rr.rnl'TF,., -——
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.
■ //,
Print your name and address on the reverse X
/ 0 Agent
so that we can return the card to you. ❑Addressee
• Attach this card to the back of the mailpiece, i '1.Fr`l ed Name) C. '
qe=of Delivery
or on the front if space permits. .[/�
1. Article Addressed to: D. Is delivery add.. different from item 1? • es
Rc,-*/
If YES,enter delivery address below: ❑No
,zfr Fes- /�
/ 0 s7c -
D /�A T J/ ,!/tL C�/1 rho 3. Service Type
rJ ,L gd'Certifled Mail 0 Express Mail
0 Registered 0 Return Receipt for Merchandise
0 Insured Mail 0 C.O.D.