HomeMy WebLinkAbout51918D - Falby 1-
ZCAMA/ ❑DREDGE & FILL
GENERAL PERMIT Previous permit#
INew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
Prized 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 / hi • 12-cs'(..)
JdRules attached.
nt Name kit C I A 420 IA 1-4.j' Project Location: County (\1.N SL L)I ( K
s 1 0 i k=- : i..; ►.1 6`J D OR. Street Address/State Road/Lot#(s)
a L l LItiV ;) State Ni (, ZIP L. l,d J i t'_.) J C j ,-)i; j T
Q) Z 1`(-ti5 Fax#( ) Subdivision
zed Agent City A (C 4 5U-N3 -1,) ZIP Yid(s
j ❑CW ❑ i EW PTA ❑ES ElPTS Phone# ( ) River Basin l Afi
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body DA V' i I ( I}tv A I—. (natJ
❑ PWS: ❑FC:
yes /ono PNA /ye / no Crit.Hab. yes / no Closest Maj.Wtr. Body i 01 4N
if Project/Activity Vi<1\i'VA f 1,. 'L IC
(Scale: i I/'
ock)length
m(s) I X1C4(TLoP r) i I I 1
i
pier(s) I ! 1
ength
:ember t 1
ad/Riprap length i
rg distance offshore _ _ (--)A AI. ^- —
lax distance offshore 1 7 l/
:hannel i '
r
lbic yards ;....... �+O ! 3 N
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mp I ` I
f ,
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use/Boatlift i • i 10
3ulldozing �x luw ITl(.Y.D _ 4.1 1 (442iirp17WO Wdi096C A1 s
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ie Length ‘,-1 ` 1 714_
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not sure yes (no V ttc V :1
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gs: not sure yes (no
rium: n/a yes no _ I
yes no - .4 1, S i S- 43(11 51
Attached: yes ne 1 ( i 1 1 ,
ing permit may be required by: jam } j( j,SL 14-1\J ) I I See note on back regarding River Basin
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1/01/2005 00:02 9102783778 PAGE 02
DIVISI N 0 OAS MANAGEME T
ADJACENT'RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: C , r -D ,g4-05v
Address of Property: tt.S i•�", l3
(Lot or Street#, Street or Road)
(City and 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 ors the attached drawing the development they
are proposing. A descri ' 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 Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
within 10 days of receipt of this notice. No response is considered the same as no objection if
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
set bck 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 the 15' setback requirement.
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SENDER: COMPLETE THIS SECTION COMPLETE TLIIS SECTION' ucLIVERY
• Complete items 1,2,and 3.Also complete A. SigWOW'
item 4 if Restricted Delivery is desired. X s !Pgent
• Print your name and address on the reverse i� ddressee
so that we can return the card to you. )Prreceive. , Printed Name) C. Date of Delivery
■ Attach this card to the back of the mailpiece, / • )I-1 5..()
or on the front if space permits.
D. I-delivery a.dress different from item 1? ❑Yes
1. Article Addressed to: pp If YES,enter delivery address below: 0 No
1d,E� in,tz g l vi.rrl.,j
r] 3 � Q.t-per.+ rs 6-0 v e
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L t„h, ` a.I �u. Q Q.
a�D�j C 3. Service Type
Q I ❑Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
Cl• Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number
(Transfer from service la, 7005 3110 0000 0581 0643
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540