51968D - West

-1CAMA/ ❑DREDGE & FILL
GENERAL PERMIT Previous permit#
New El 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 3 y . /1G-
®Rules attached.
It Name Fivi we, r Project Location: County A ei„,... /`fru tiw,—
i `. 31/ I4.4 S/r14//'L' ,.�!'/.,,,,/ ,P— Street Address/State Road/Lot#(s)
Ail i' ,j74'1 State ,4 ZIP 2g 9. 9 S/i«/r'
(g/t) inp.Z.2`l f- Fax#( ) '- Subdivision
zed Agent KY(,./ (4,,��r"! City S/, L 4.... ZIP -5-€1-4-1
i C -CW QtW O'PTA ❑ES PTS Phone# ( ) 2v 1 I-fv/ River Basin r� A
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body /97/4.W nat 1
❑ PWS: III FC: .0 ��w ,
es;/ no PNA / no Crit.Hab. yes / no Closest Maj.Wtr. Body
of Project/Activity (*.'a."S f`i,- fie:';'A' n ,2/,'),%7.i j2,;- - �-94-7 ��/�
.,o t /l'l /`,
f , �'�l,L r ��y hr,- (Scale:
ock)length 125 'X 4 '
b ,�,/ 1
pier(s) I I ---r-- , .
ength 1{E-L- r iOtiiVirs
umber l j ✓
ad/Riprap length ib«,r4..,
ig distance offshore ; I 1 A T
lax distance offshore /2/064'/Irn Qh { fly:hannelr 1
4 7 i w I ra 'NL N
ibic yards _ 'I / ;
mp
use/Boatlift
3ulldozing ._._.
1 1
/,‘,/,riel) ....--- ' :.-- -... -AU, ! . __al
.sN
ie Length '�-4/0 / `'' aI r V V tJ 1/ I ' , l l •( v I L( y I-• 1
not sure yes
gs: not sure yes
rium: n/a yes 6 i �
yes 6: ► • iL -i-- -- I - i!ir/X f L Attached: yes c Ib � ���IC•
I I I
ing permit may be required by: N H (-''. I.i S,D 7//_%,S I See note on back regarding River Basin r
.A. .1 i --, . . . - - - / hi✓_- . 1 If f

3 SERVICE, INC. 2563
RO LOOP RD.
,NC 28409 66-162/531
144'9 BRANCH 50002
Date Ic-,),]D-0
- , $
00 0 D
Dacus
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53 • 1:0 5 3 10 16 261: 20000 2 2988 4411'
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CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
The purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual or
individuals listed below. The CAMA General Permit application procedures require that applicants provide the Division
Coastal Management confirmation that a written statement has been obtained signed by the adjacent riparian property own
indicating that they have no objection to the proposed work or that the adjacent riparian property owners have been notifie
by certified mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by a mar
contractor or other individuals acting as an authorized agent on behalf of the applicant.
This form was sent to you by the following individual or company designated by the applicant as an
authorized agent:
., , t-� 1d/31O .7
authorized Agent's Signature ( Date
\lame of Individual Applying_ For Permit: I_ d v); liJ QS----
kddress of Property: ' 3 I I M 60('0 SoUyt c�. Rozi,
(Lot or Street #, Street or Road)
n *D,t 1Ne.v) 1---kAm i>-t
. (City and C unty) •
•
hereby certify that I own property adjacent to the above-referenced property. The individual applying for this pern
as described to me as shown on the attached drawing the development they are proposing. A description or drawin
ith dimensions, should be provided with this letter.
I save no objections to this proposal.
you have objections to what is being proposed, please write the Division of Coastal Management. 12
ardinal Drive Extension, Wilmington,NC 28405 or call 910-796-7215 within 10 days of receipt of this notic
o response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set back
ininmum distance of 15' from my area of riparian access - unless waived by me. (If you wish to waive th
tback,you must initial the appropriate blank below.)
1 do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement. AA

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PrdP4,- y Pier 4-n r Eci win West
7301 �3I rn r 1erc� Proper
ASvr)Iry (F}I,�r�}-) '7321
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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. 0 Agent
• Print your name and address on the reverse X � _ ai'- e •d.•-ssee
so that we can return the card to you. B. Rece' -d by(P -•C. Date o Ziyery
• Attach this card to the back of the mailpiece, 0
or on the front if space permits.
D. Is delivery address different from item 1? 0 Y:s
1. Article Addressed to: If YES,enter delivery address below: ❑ No
iy\r. .� mrs. korl O. 43,cec 3. ,
7 3 14- 1 mmo,bira 5a..4 RJ
3. Service Type
`,,f%,A`,,ib rI r N G ❑Certified Mail ❑Express Mail
0 Registered ❑Retum Receipt for Merchandise
J, 0 9 ❑ Insured Mail CIC.O.D.
'l 4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7007 0710 0003 8951 3049
(Transfer from service label) --
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
Postal ServicerM
'TIFIED MAILTM RECEIPT U.S. Postal Service,., I
stic Mail Only;No Insurance Coverage Provided) CERTIFIED M A I L L, RECEIPT
fU (Domestic Mail Only;No Insurance Coverage Provided)
ivery information visit our website at www.usps.com® n-i
,,F.r• . 1; r.,, 1' I3 For delivery information visit our website at www.usps.com„
rn
d.v }
Postage if) IU 41 0401
$2.65 03 a- Postage $
Certified Fee c0 sf2.65 03
Postmark Certified Fee
m Receipt Fee $2.15 Here m $2.15 Postmark
O
nent Required) Retum Receipt FeeHere
d Delive Fee I� (Endorsement Required)
nent Required) t0.00 El Restricted Delivery Fee $0.00
(Endorsement Required)
wage&Fees $ $5.2i 10/03/2007 $5.21 10/03/2007
N Total Postage&Fees $
O
i OW. rj D . 1PlerL 4- )r . N Sent p.F. N LA—�.
of No.; 11
,x No. 'i 3�( M4fo N1,,,sa �V tvd '1.. Street,Apt.No.; (�
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n or PO Box No. ;� �s- £
I:Iv"::Iv": ,N .8- 01 C (fig City,State,ZIP+4 c8 I
3800.August 2006 See Reverse for Instructio�,s o.
s-t C a
PS Form 3800.August 2006 See Reverse for Instructions
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Si.•-ture
Item 4 if Restricted Delivery is desired. ,� ILI ❑Agent
• Print your name and address on the reverse 1 �4C� 0 Addressee
so that we can return the card to you. B. Received by('tinted Name) C. Date of Delivery
• Attach this card to the back of the mailpiece, _
or on the front if space permits. 0 —5 e