49215D - Poteat

AMA/ ❑DREDGE & FILL
3ENERAL PERMIT Previous permit#
flew '❑Modification El Complete Reissue El 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 15A NCAC ,#, f Z 1Q
IleeR4(es attached.
t Name ,O 11,Q - Project Location: County Bi ( eifciii C,
/9/9 X A , 4 A cJ, 5i4, /t 32 i0 Street Address/State Road/Lot#(s) /9 6Qq v P
5A .e L r L C State Ai C ZIP .2 757
7
•(7y) 97L- /717 Fax#( ) Subdivision
ed Agent ,53Y/7j M>, I492Nh'M CityO(O/f.i f 2 ' 43evc 4 ZIP 2 Ty'
❑CW USW B.PTA EMS- ❑PTS Phone# ( ) River Basin Lyr./06
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body 0 l Pi 1.1 eV
❑PWS: ❑FC: d .011
es yes / PNA no Crit.Hab. yes / no Closest Maj.Wtr. Body �! �
'Project/Activity Pa.. v 9 4 c v, -t 4.,/ GC 1 e het:J B T L i T llf
(Scale:
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ier(s) 1.— e
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cum: n/a yes no � - —
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Attached: yes no 9_j' �R/�✓PA.'� i / ra 19 ae !...� 1 (IL 1 5/ -ediftves
ng permit may be required by: ©C P, A/ .Z t 4 t,A9,A n See note on back regarding River Basin r

DOCKS & BULKHEADS INC 5135
4 MONSTER BUCK ESTATES
SUPPLY,NC 28462 66-112/531
910-755-6861
BRANCH 82101
L 07 ,
DATE (/S/
Af � I
/2 U/'/£�Q1 / ti' i( ?c/ DOLLARS L?J i,�k o'
y
ST COMPANY
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OOOSL3511° 1:053LOLL2Li:00052L- 7928 "

a'x 15 each
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Jl GVV 7 1J.Vi) raA U1V G!V VVVL rV1L.t11 117JVllA ', . *gut.)5/07 09:33 FAX [phone] HIG FRST GB & 1dUK gout
POTEAT INSURANCE 1�Ot.i
f/E007 3 8:33 FAX [phone]� 938� 1 TO 19102Tsos ,��:
tou7 111@ 1:VAR n:a�a •/7 CO-K1
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North Carolina Department of environment and Natural RE sauces
Division of Coastal Management wpm Roe,;�r, S ac
00 F.Easley,Governor Marino S.Jana,D{roet0t
Authorized Agent Consent Agreere'►ent
1 Dt r+nQ lfiri Is hereby autheized to act on ITC'b4*
ipthvad nb d Awl
order to obtain any CAMA pi:mitts)required for the property isled balm The authorization is iimi.edito the
xicifihi activities deeGribed in the attached akstch,
QCATION OF PROJIaCTI
q C raii4 _
1ROPE Y OWNOR MAILING ADDRRSS:
�.+ ,.. • 4 ?za cap_ ssi--,
44-JetsALvinol
lApet ; • C !_,, 17 PPIONO NO. -9 fi -47/ 7_,.+�..
tUTHORIZED AGENT MAILING ADDRESS:
:5afinnti VACPCI
1a9s+er
PHONE NO. �: Q ��{
ta-1
'�` _ .I `�'.14rl
3tIgnatureoPAOPorryawxe'
----
Signaturn of Authorized Agent -
Date. g�����

DIVISION_._OE.cOASTAL MANAGEMENT
ADJACENT.RIPARIAN_PROPERT_YOWNER NOTIFI -ATLON/WAIVER FORM
Name Of Individual Applying For Permit: ee3
fa4QQ-1—
Address Of Property: L/ Crave() Q.6
(Lot or Street #, Street or Road, City & County)
1 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 proposing. A description or drawing, with dimensions, should be provided with this
letter.
X. I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management,_ 127 North Cardinal Drive.,Wilmington, North Carolina,78405 orsall 910 395-
3400 within 10 ay&of receipt of this notice_ No response is considered the sane as no objeciion
if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back 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.)
6 ge
,�.4.4\ X I do wish to waive the 15' setback requirement.
c
I do not wish to waive the 15' setback requirement.
A , A An

m
To:SammyVarnam, Varnam's Docks
Debbie Wilson, NC Division Coastal Management ^�
w m
As previously noted,I do not wish to waive any setbacks.
I do not have any objections to the proposed dock(as depicted in this i-
a,
Lo
Draws rovidect%An
that
it is installed in compliance with all other regulations.
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Dr. Garry N on
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