47559D - Collins

CAMA/ Li DREDGE & FILL 4'
iENERAL PERMIT Previous permit# 4S99I
New Modification RComplete Reissue Partial Reissue Date previous permit issued !f1/o
ized by the State of North Carolina, Department of Environment and Natural Resources
oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 71+ /ZC.-
1 Rules attached.
Name _A-WI .1 ,j/{-1V I - ( 2L L-1 l- Project Location: County P(;.1'.JO K
OS R • Ft-"j(.-j t& _V F F DIL . Street Address/State Road/ Lot #(s) ,C, IG
'lyb1 f7sn70 _State M L ZIP 2M1-j-4
(I) ) 2-lb- ;RI(.Fax# ( ) Subdivision FL—LAC A-7,./ r<=L--L"- F
Kd Agent City vyTST�7� ZIP Z 4 L
❑CW ❑EW [ +TA ❑ES ❑PTS Phone # ( ) River Basin C/-y'1�C%
❑oEA H HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body 1/I IZGI N I A- C K e->✓vc.- ( at)/n
❑ PWS: ❑FC:
fes / C:� PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body A I wVV
Project/Activity r"F 1 V lire VI 1N/ I. --k"r a, V(\TL ) i 1 Xr , LA.-Tit_ (—+A .
-?,
(Scale: 1.
k)length 2-24' %y
:s) Ib "t D' Fisccv 15 >Ert'nriz V ii2_ NIA L42-E::tkk— /*`--
sr(s) 1 j , / ram'igth
iber w '4M4 -- ic' i0� 1 1
it,o I yt
I/Riprap length / In \ .
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um: n/a yes no - --
yes no fr 1- ✓r< �` f(/`'m
attached: yes no I—.—
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ig permit may be required by: 71V...._ I See note on back regarding River Basin ri

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03/01/2907 11:04 9102700735 EBCOLTD PAGE 01/01
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mosiHr PLAT EMEAFTENT$AN ASS SURLEY INAt ME£TS OR NI7H SL
rHr 17£DWREIlE7YT5 OF A MASS a_l/It14'Y IN ACCORDANCE Nf7N TH£ � �1�,,fy C..�
BiMrbARCS OF PRACTICE OR LAM SURYEYINC IN NOR1M CAROLINA.
JONATHAN L. WA RLS 1-3391
COpyrlght 0 Honorer DeSjArn Serv;Ce9, PA,, Ail rights reserved
reproduction or us! of the content* of this document, or additions 711S MAP 15 NOT FOR ACCORDARON
or deletions to this document, In whole or port, without the written 50' 25'carmen! of the fanio eurrayo, is prohibited. .}gyp---- ----�.50'
Only copies from the original *f this document, marked with ar '
a'fglnoi signature anal original seal of the surveyor shall be . SCALE AV FEET
considered to he valid end hire ',Alec _ ¢n

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----- VLLIlnL VI'RI«JL lI`IW f"�iV` �,
DIVISION OF COASTAL MAN G
ADJA_caNT RIPARIAN PROPERTY OWNER,NO I1r1CATIONI FORM
Name of Individual Applying For Permit J N E 14 A� CO L I AF S
Address of Property__ I cE ei4 S B L IF
(Lot or Street#, Street or Road)
NA/ri?TEA D, N• C • (PE1ll DEe Caulk i)
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The inndlvi
applying for this permit has described to me as shown on the attached drawirra the development
are proposing. A description or drawing,with dimensions,should be provided with this lette
I have no objections to this proposal. _
If you have objections to what is being proposed, please write the Division of Coe
Management, 127 Cardinal Drive Extension, Wilmington, NC 23405 or rail 910.395-3
within 10 days of receipt of this notice. No response is considered the same as IIo objectic
you have been notified by Certified MaiL
WAIVER SECTION
I understand that a pier,dock,mooring pilbzp,breakwater,boat house or boat lift must b€
bck a minimum distance of 15'from my area of riparian access-unless waived by me. (If:
wish to waive the setback,you must initial the appropriate blank below.)
I do wish to waive the 15'setback requimnent
•
I do not wish to waive the 15' setback re:q ire-new_
. Siffi Name Date
Prim name
Telephone • AditkaL.AA
l- ��j�Nuzabe wfth Area codeNCDENR
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13/2007 09:27 9103291864 PRUDENTIAL CAROLINA PAGE 01/
-13-2007 08:12 From: To:93291864 P.21E
ATA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F Easley,Governor Chance S.Jonas,Director William 3 Ross Jr,Secretor:
Authorized Agent Consent Agreement
Is hereby authorized to act on my behalf
tforirned Name al Agvnq
n order to obtain any CAMA permits) required for the property listed below The authorization le limited to the
pec,fic aetvities described in the attached sketch
.00ATION OF PROJECT:
/05 EAs r L 4 FC DR
PROPERTY OWNER MAILING ADDRESS:
10,5- EAR I n14 804 f:-.F
tf-A,A P r EA D, 1V a?i,L..q3
PHONE NO 9/0 — "' 3P/t
AUTHORIZED AGENT MAILING ADDRESS;
PHONE NO.
— - c � J
Signature of Property Owns•/f�//�J�//�ilk o A e (iQ2,Q
V J rJ
of A A.......�