43355D - Davis

1CAMA / ''}DREDGE & FILL / ,.
IENERAL PERMIT _ Previous permit#
.New Modification Complete Reissue Partial Reissue Date previous permit issued
-ized by the State of North Carolina,Department of Environment and Natural Resources ,/
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC /�j/'7 .// 0
E R1E-attached.
t Name Project Location: County igq,r,stii cA
3 t"ps_ prCDtT IA.'? Street Address/State Road/Lot#(s)/,,3 6 DaZ,
4 !# M,/f1 TMR7 StateSC ZIP 275-yy
(7y?)6(z. /2 GJ Fax#( ) Subdivision
ed Agent 5/7/r)/r) y V/9/rA/Aei City/-10Ldo,.' ea.9 c' ZIP .2TYh
❑CW D-EW ❑ 'A --Es- ❑PTS Phone# ( ) - River Basin L y" ,
❑OEA E HHF ElIH C UBA C7 N/A Adj.Wtr. Body C/,,.,A L d 71/4/9/14 4"(nat/I
❑ PWS: ❑FC:
yes / PNA yes / rrt5� Crit.Hab. yes / no
Closest Maj.Wtr. Body Ai W'✓
'Project/Activity /Y e ) _R0,t A-42'/'J,
(Scale: /
:k)length
(s)
ier(s)
ngth /
.nber () f 11 L ----.� 1
I/Ripraplength Sa ,,ag)i Y
distance offshore 14311.
x distance offshore -49'
cannel �.
l I
.. ,)
)ic yards 4 ;
'p r }f 't s
47.7 ,�,
se/Boatlift ...s.
ati t/l, A91
ulldozing 5 t.4 t.k k Md I
; i..
Length , t
not sure yes ,,n;
s: not sure yesfL%
ium: n/a yes (_-�}�,
yes I
\ttached: yes _t6 -)
g permit may be required by: / ,_ /rig . v/;) -^7) r. 4 . _1 See note on back regarding River Basin ri

VARNAMS DOCKS & BULKHEADS INC
1574 MONSTER BUCK ESTATES 4786
SUPPLY,NC 28462
910-755-6861 66 ttvsst
(ti
BR4NCM 62101
DATE a - /5-` O�
x; PAY / i"
TO THE / �C��N�
r ORDER OF ( $
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lI' BRANCH BANKING AND TRUST COMPANY it 0-1 U�- i"
t-S0a&WK BHT BBT.cnm \\ � �� �:
S5_ J1A(�+�s0.00-c u
i, FOR fer(Th 3�S6 �r, /6:/ /40.Ail — —
II60000478611' 1:05310 L 1 2 11:0005 2 1579 287 20
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Arirlf
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
:hael F. Easley, Governor Charles S.Jones,Director William G. Ross Jr., Si
Authorized Agent Consent Agreement
ili) Va C?��/1 is herebyauthorized to act on mybeh
y (Printed Name of Agent)
der to obtain anyCAMA permit(s) required for the property listed below. The authorization is limited tc
p ( ) q p p Y
:ific activities described in the attached sketch.
:ATION OF PROJECT:
O fD 1p i i\0.5 )U)-- //
1c)e✓1 ( e ch
1PERTY OWNER MAILING ADDRESS:
(os 3 PO )ht ou 4--I/I
1 Iva►i r-erry C a9s1-N
PHONE NO. /03 — ao,A l0203
HORIZED AGENT MAILING ADDRESS:
ern►vr Ua,r(Ia m
Y
-7 y Mc 064-er- 13,., s--.
'P/k'-( NC %(-/(02,
PHONE NO. 2/41 - /702, 7S
ature of Property Owner. ei

c)1 6,)1eIV)04
---------------------
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13g I31 Dolphin 134 '�-

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: k Davl
Address of Property: I O
KAPPLIAk-
(Lot or Street#, Street or Road)
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individk
applying for this permit has described to me as shown on the attached drawing the development th
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coast
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-391
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be s
bck a minimum distance of 15' from my area of riparian access- unless waived by me. (If yc
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.
ao.otc,. d_
Sign Name Date
p ukts E. Use Aw W WA

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: V -(.,I'. k C) LLLLV
Address of Property: ( 3
(Lot or Street #, Street or Road)
°
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individt
applying for this permit has described to me as shown on the attached drawing the development th
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coast
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-391
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be s
bck a minimum distance of 15' from my area of riparian access- unless waived by me. (If y(
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.
L0(QU U AolAu) l - - O7 44,a)
Sign Nam Date
�n/� `� l
Llt�r/Qla_c d � )(i es (/31IA AMA