50321D - Wood

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❑LAMA/ ❑DREDGE & FILL 1
GENERAL PERMIT Previous permit#
i New ❑Modification El 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/J 1•/ Z G U
I pilules attached.
tnt Name-_ 9,'2 aI iv o Cy Project Location: County 49,-•.S'i.✓i c, e'
s2 '7/ 1 S C ' ! ., /t , Street Address/State Road/Lot#(s)7e zi.),L.,
/6 4 P StateSC ZIP2 ,15'/ -
#(r tf -zYG53 Fax#( ) Subdivision
ized Agent City'C Al?,.'1 S< < U�l//7t_ h ZIP-2 7 c/z
d ❑CW ❑EW 4❑PTA ©ES ❑PTS Phone# ( ) River Basin L-u.9,
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body 0-,,,/,4 L ✓- / f'/i'✓w (r(
• ❑ PWS: ❑FC:
yes d no.- �PNA yP — Crit.Hab. yes / no Closest Maj.Wtr. Body ,/41141
Df Project/Activity /90 J Al'.c:,,i 17409- /L, %/ 7/G e,X i S?' , 'f ( ?z #- /t Pn
i
GC r L o c/ 't / S (Scale• —
lock)length[,(,5/ Jb' 3 ' 17 y AI), J
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pier(s) I -�-� /A' J -
length �. C it,
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lumber r -
:ad/Riprap lengtIllh j
ivg distance offshore �I ,', IV
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nax distance offshore
channel
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w_ d 21/4
ubic yards t
7 i.
amp Z1 ' , *4¢/l - f ( 1 I
>us Boatl ,,t '
V
Bulldozing • •,i I r W j _
tO‘,. of ( �' I
ine Length . 4-1 ,z I I L 'Jf 1$ �jla Ii V I �\
not sure yes A a - , ,
igs: not sure yes ga_. i 1 iv
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>rium: n/at 2 i
yes }
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Z Yes La 0. 1�-- thL-Al/y Gr s L
Attached. no L
ling permit may be required by: �pP _ 75 t P gal?:C 4 {/ See note on back regarding River Basin
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WESTERN! !MONEY INTEGRATED PAYMENT SYSTEMS,INC.•ISSUER
UNION ORDER Greenwood Village,Colorado
08- 904407343
82-40/1021
PAY EXACTLY ///���
PAY TO THE A/COE�// r A}LM r Fs•/..f �),, ,.
ORDER Or
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v, .2 ZIV811 la,610NFA Pon d AST!
!rt/ • MASER!Y NOaMa YW AOaE!TO TX!1laYS 0a THE REVERSE&aF.
Western Union Money Order and Design is a service mark of Western Union Holdings,Inc/Payable at Wells Fargo Ban •Junction•Downtown,N.A.,Grand Junction,Colorado
I: .0 2 /00400i: 400890440734320
4(11.0 563.17

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11-25B9721 B JConstruction 4101146.3360» 8436655410
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path Carollra Department of Environment and Natural 17.es)urc;es
Division of Coastal Management
.3,i'P1 (,e' tttlt James H Giessen.Director wAan,; f:i3E
Authorized Agent Consent Agreement
2
_ 1
/; r l �ll� - '> �f'`I C c it rs nereby autnonted to act on my behat`
.in1e4 Pwm.or AgOrl
order to obtain any CAMA oermit(s)required for the property %Steil below The authorization is bolded to the
soecific activities desc►beo tr1 the attached sketch
LOCATION OF PROJECT!
70 '
sekiatA 1' 6,
PROPERTY OWNER MAILING ADDRESS:
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Wo-2sigeo_, ct
PHONE NO
AUTHORIZED AGENT MAILING ADDRESS:
r' •r �'/11 "'.r 1� (I ex 1 _.
.1.))( /t A' •e •� `��> _�_
µ .__._. PHONE NO 74 ` ! l f`'/ %l._.�....
Signature of Property Owner _w _
Signature of Authorized Agent �z��?►e'L r
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nr CLEUZC _OF COASTA + ]4ACYEMEIQT
ApOACZNT R'_'PARIAW P.QPERTX 4Wa NOTIPICATIONLTOA{Ytii FORK
XJaME Of Individual Applying For Permit: , ti(1 +,�
Address Of Property: (� Q/LL1 a.4atnrc_. j)
No • ? ,� ,2 c
(Lot or Street Street or Roe. City Fe County)
I 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 are roposing. A description or drawing, with dimensions,
should b rovided with this letter.o proposal.
�, I have n objections to this
f w e'nc a write_che
Division of Coastal Maaaaement- 127 Cardinal Drive
wilvIngton. ttion4 Carolina- 2 @ or ca 83 `
days of receipt of this notice No response i1 roneider thy. slm
as na of ectjoa ;f 1'ou have beep _notified by Certified Mail
_r.
VAMP. SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
house, lift or sandbags must be set back a m:.uy.-ruir distance of 15'
from my area of riparian access unless waived by .me. (If you wish
to waive the setback, you ;must irrtria1 the appropriate blank
below. )
44 01
I do wish to waive the 15'aetback requirement_.
I do mot wish to waive the 15'setback -requirement.
1 "ure 2./,/- T _ A t o

B IVY s ION ADALVEmiumulampp E COASTAL _WANK/ :7%7
Name Of Individual Applying For Permit: _/�� , l U�1!I
Address Of Property: 11(, M,1 j
ak
(Lot or Street # , Street or Rom C r
y & County)
I hereby certify that I own property adjacent to the above-
referenced property. The individual applying for this pezini-t has
described to me as shown on the attached drawing the development
they are proposing. A cescription or drawing, with dimensions,
should a provided with this letter.
I have no objections to this proposal.
If von have nbiee o to what, is beinc i.pleaae write the
Division of Coastal MatfigereptCardi nay nr g ve tt nss jon
Wilaii.n9ten, Wort)} Carolina. 2e425 or call 53Q 395- 92D mitt n p
days of receipt of i s aoti ce. 'e cone Wider the sew
#.@ no ordecta.e . if you have been notified bby ertifttd. Mail
►rv,PR .ECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
house, lift or sandbags must be set back a mir. -zun 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. )
a
I do wish to waive the 1.5'setback requirement-
I do mot wish to waive the 1E7 setback -requirement.
6)06. 4 -fl;C.__S÷0 PAi‘ 14-L- s--1(1-•.?
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