49143D - Rollins

4'CAMA / DREDGE & FILL
3EN ERAL PERMIT Previous permit#
;New Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 2AI, /2 '
� I lames attached.
R Name _ 7-/j,✓ ,Q pL L, ,,' Project Location: County /l y...,f cd' Cie
yU r T CEBLCiz, cis .e C 7-, Street Address/State Road/Lot#(s) 4/3 fc e7
rt 00n/sZ.040 State_'/C ZIP #27yJ}_s
`00 6 oL'" 1//y�, Fax# ( ) Subdivision
Y 1
:ed Agent
iA i //90 fiu/n _ City dC 404,, -7:f I-c e/9c Li ZIP 1 YYe
❑CW G.GW r DO C}ES-- ❑PTS Phone# ( ) / River Basin �jM
❑❑OEA ❑HHF IH ❑UBA ❑N/A Adj.Wtr. Body (_/t I9 J 9 L cl(46i wAl a'',
❑ PWS: ❑FC:
yes / PNA ye no Crit.Hab. yes / no Closest Maj.Wtr. Body_ �� 't 1
f Project/Activity U n-/* / - y4. Doc/C
(Scale:/ ."-
�ck)length 5 '?( y ' 0 61/'1t F ( f�/
i(s)
iier(s)
ngth
mber -
d/Riprap length
g distance offshore
ix distance offshore C /�pi 4 L —�.��-�
cannel /'
bic yards
np
16 `
ise/Boatlift
i
ulldozing r Fi!G 4f
;/4-'10A/ // 'X7i
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e Length ...C.'not sure yes LC , ,S
r
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s: not sure yes o �
cum: n/a yes 9
yes �_
4ttached: yes 9_ L S 5 3 GCJ21 j+� -_
ng permit may be required by: 4/C fit"),./ .17:f 2 e ,ep qc A H See note on back regarding River Basin ri

OHN A VARNUM NCDL 76907
RACY D VARNUM NCDL 8695114 4548
!95 STONE CHIMNEY RD SW //
JPPLY,NC 28462 Date M �j v 7 66-I215/531
0 846 7710 840
'ay to the ,�/
hder of �� C /Y 2 I $
Dollars 121
W WACCAMAW
fiy NC 28462
m.m bankcom •
Dr 6PC(`1 j/3 -4d l���` .
0 5 3 L 2 L 5 21:8000 24848 311'04 548

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AT Ate,
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
!ichaol F Easley,Governor Charles S.Jones,Director William G Ross Jr, Sec
Authorized Agent Consent Agreement
t/\N V o q-s is hereby authorized to act on my behal
(Printoa Nutno of Agora)
rder to obtain any CAMA permit(s) required for the property listed below The authorization is limited to t
cific activities described in the attached sketch,
:ATION OF PROJECT: — T
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)PERTY OWNER MAILING ADDRESS:
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(� ,c i y Sc PHONE NO. ( 9 I O ) � o � - O I
HORIZED AGENT MAILING ADDRESS:
D h A.) L rfL ✓�-�
5-ko ,J e C(,►; ►�-.►�? - 2, Q.
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PHONE NO�Q ((:)) C1 4b-'7 7 10
?lure of Property Own r
tturo of Authorizad ac, nt A n1 0 • 11n A . . w

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONiWAIVER FORM
Name of Individual Applying For Permit: JD h r`1 1, A-2ti.) Yv
Address of Property: u GA [ 4 r..1
(Lot or Street #, Street or Road)
Sle c eilcvN '. ct a%'4 (9
(City and County)
I hereby certify that I own property adjacent to the above-referenced.property. The indivi
applying for this permit has described to me as shown on the attached drawing 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 Coo
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3
within 10 days of receipt of this notice. No response is considered the same as no objectic
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mus
set bck a minimum distance of 15' from my area of riparian access - unless waived by me.
you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
l!/l/IL I do not wish to waive the 15' setback requirement.
(�-�jA{A �� CC, DCM W�IRECEIVED
S1 n Name / 4/19.
AA�NGTnN, N
� Date
I ' in A . p 9 g 2007

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LIDS Pec 1e 2_.‘0ve Li Nab � �� Sv� e c ,
C (Lee 590('n 'L ECEIVED
nC WILMINGTON, NC L S $Cc \�N'3 D
3S E P 2 6 2007

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. 0r:t e �//
item 4 if Restricted Delivery is desired. / ''^ /� ❑Agent
II Print your name and address on the reverse X , ' v-L / 0 Addressee
so that we can return the card to you. g, Received by( ted Na`m/e S C. Delivery
• Attach this card to the back of the mailpiece, C)-L till , ��lr 5? yO7
or on the front if space permits. 1 � E.
D. Is deliv ress different from item 1?L-T Ye
1. Article Addressed to: If YE �er delivery address below: 0 No
u3\a-\\ C' �C�\'E 11\��L ���t!\1 . llllllO vC' lu
C� ���j``��f_` ��, 3. Service Type
��.r0�U' i. 0 Certified Mail 0 Express Mail
❑ Registered ❑ Retum Receipt for Merchandise
❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) 0 yes
2. Art
7007 0710 0005 2991 1179
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
SENDER: COMPLETE THIS SECTION COMPLETE I,-iS SSCTION ON SELNE.V
■ Complete items 1,2,and'3..Als.Scompfete . ... .,. k'-Signat ,-. ---.'" -- ""/
item 4 if Restricted Delivery is desired. y I .,, „r^""
■ Print your name at Od n t apt;�{eversc-w u ! �N1k.3 ", � ,_ t �� Addressee
so that we can return the card to you. B. Receivarftijr Printed lgin ,,.r°""L""9 ty o 9eery
• Attach this card to the back of the mailpiece, .% 4,)t V C t fl. l` • C r e0 ,..liv
or on the front if space permits.
D. Is delivery address different from item 1 0 Yes
1. Article Addressed to: If YES,enter delivery address below: o
�fLC(\6rn.c1LL�
l"1 )GIo 1 _\8h-1-OraV P -L_(
A\v,(\-\e kr- U \1`+C.I ' c aq 0 3. Service Type
❑Certified Mail 0 Express Mail
❑ Registered 0 Return Receipt for Merchandise
0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes