43913D - Anderson

'CAMA / DREDGE & FILL
3ENERAL 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 5A NCAC /�, / 0 o
) / L�JiruFes attached.
t Name , Gr(j 6,,/(r i�.f p� Project Location: County l'jz N N_S A "e it
Z/.3 i dip/6a4-o of �i /? d. Street Address/State Road/Lot#(s) 2 0 9 L of
nrl/ State/VC ZIP 27>//
f 0 Fax# ( ) Subdivision
:edAgent C/t ay Nv /o%./ City!IOLdt."/ £34 (4 ZIP 2 lye
❑CW ReVir p'IA �+e5' ❑PTS Phone# ( ),�1 River Basin y
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body /-� I 1✓kl _ 61j
❑ PWS: ❑FC: / ��
yes / PNA 0/ no Crit. Hab. yes / no Closest Maj.Wtr. Body
Project/Activity I " 2 A c CX . c /.�f 1 4. Lich CL
l/ (Scale:
ck)length
1(s)
ier(s) ' /
ngch � �, 1/`�
mber
d/Oprap length a
distance offshore Z
ix distance offshore S '
cannel
sic yards * e 4✓ ��/f�C h P (/ e✓g. 2 h!t#f
np o r 4—x IJ71iA, tfil/(4Ise/Boatlift
_._._
ulidozing
e Length !1
r'+
not sure yes o .L0 �
not sure yes IF
ium: n/a yes U lam-
yes
\ttached: yes
ng permit may be required by: ,y(/L d ,✓ £P 19c 4 L See note on back regarding River Basin ri

HOLDEN DOCK& BULKHEADS
GREGORY A & DOROTHY HOLDEN 2154
PH:910-842-9732
1502 STONE CHIMNEY RD SW 2, - Lt. 66-1215/531
PA*SUPPLY, NC 28462 840
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WACCAMAW
BANK
Suptly,NC 28462
pu.7.:vacriaimaJbank:carn
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1:053LL2L521:8000L57530002L54--

U.1H�_r iv t turAtuAN elcuYEK t Y OWNER NOTIFICATION/WAIVER FORM
ze of Individual Applying For Permit: 0(A Ae/e,,,,,.v,
!ress of Property: () 9 60 , 711/.6
(Lot or Street #, Street or Road)
(City and County)
reby certify that I own property adjacent to the above-referenced_property. The individual
ying for this permit has described to me as shown on th.e attached drawing the development they
)roposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
on have objections to what is being proposed, please write the Division of Coastal
iagement,. 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
tin 10 days of receipt of this notice. No response is considered the same as no objection if
have been notified by Certified Mail.
WAIVER SECTION
derstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
)ck a minimum distance of 15' from my area of riparian access -unless waived by me. (II
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.
t NZV73/0(
Datteo

eb% 13 06 08: 19a Willard Tucker 336-632-0834
•
1urr�t_r tv t rLYA_K1AN YKVY 1 Y (_) NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: c81,�j� y ,sp�
Address of Property:
(Lot or Street #, Street or Road)
(City and County)
I hereby certify that I own ro e p p rty adjacent to the above-referenced-property. The individi
applying for this permit has described to me as shown on h e 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 Management,. 127 Cardinal Drive Extension, Wilmidgton, NC 28405 or call 910 3950391
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 I
set bck a minimum distance of 15' from my area of rip;Irian 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_
I do not wish to waive the 15'setback requirement.
ae ►% A, /i'l nc1 r5a'---�Z�=.�:1.� E•c .S �✓� et
Sign Name �2-1 -"" s ``_
Date � J ,�, �.