45991D - Collins

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2CAMA/ '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 ' 1
—t
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7 t ! i i
1.ules attached.
It Name t5'A r\A ( 0..L 11.1S Project Location: County P�TJ') .-
0') \c j(?1-1 1�j1-k)j OtC . Street Address/State Road/Lot#(s) _SA NA E,
v\A (x,-inc-AD State N L ZIP 25 44?5
E(`lii_') 2,1C'-Mtif, Fax#( ) Subdivision
ted Agent City -\A fv' i 5i E7 -) ZIP 2 c�4 4
ittW DEW B PTA ❑ES ❑PTS Phone# ( ) River Basin CA pe
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❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body \VOA) at /
❑PWS: ❑FC:
yes /( ) PNA es / no Crit.Hab. yes / no Closest Maj.Wtr. Body I W
f Project/Activity F)e--k V ATE.- 4 _
(Scale: I"I" -3
>ck)length 'L 22 k'x 9
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>ier(s) it l&I ,k.
:ngth Aflijtk� f— r
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ember I L50- LINE 3-xle
id/Riprap length ©t -OP" . ' '. ,_� , icsAeit€
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4
g distance offshore
t j • 1 ,
ax distance offshore '
hannel
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ibic yards
Tip 4 i • .
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use/Boatlift i / _ ('
lulldozing �___ _ -
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>e Length ` 1 - _
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(Tfdriure, yes no
s: not sure yes . . I _
rium: n/ayes es n:i . ��:-ti'y�'l'vC• 1,� �,:�i AN-,-,) L fX k=. !'r M/1'-14,_
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Attached: yes �»� ! '_..`t, E, 1.i i c-t-1 -'_1•-\- L ,1._,
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SAMUEL T COLLINS 0395
PH 910-270-3816 /'
105 EAST HIGH BLUFF DR
/3/0 06 67-219/539 Date BRANCH 01411
HAMPSTEAD, NC 28443
Pay to the
$ 2C0
Older ot
ollars
•
• CAROUNA FIRST
HAMPSTEAD.NC 28443
For
74 6_
: 3 9 0 2 L971:8 LOO L379 is Los 0395,,
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D & OF COASL4 _MANA Eman-
ACTT
we ofharesidadApplyhisForPermit 3 A M_ CY5[L[n!_'s . - -
deltas afit opatyr /S E, Hi C f-JL t2 F Di -
- (Lot arStxxt0,StizetarRoad)
(aty ad County)
= cart*that I own property arrpeart to the
Pl pemamtbasdodto�asaatbc d property-
awimrthe
i ar :. ,;aos,Shand be providedwith
letter,-:
Ibaie= . la this pecQoeal. _
pa base ebjecilisais to what is befog pajama, please write Se erceaei*
Drive Eximake,Wiiminies,NC 2 or
i41 days afiecsipteeftbk notice. No response is emaside esssab
Eibjedbiliff
hawing*aatlied b!CertiTted 1,
�ia�s���� ,beat�oci�t�must be
wish d wine the af1S'Arm wry area efr ar1aa access-aide s waived b1 see: (If
setback,you sant Wad the appropriate blaalh below_)
- I dsw ishtewaiver*LT setback
I3w�h�
bap Date

19-2006 WED 02: 30 PM ANCHOR REALESTATE FAX: [phone] P.
'/lyf 1 )b l is 5ti .diudzdiu104 h'kU11tN i 1HL eAkULINA F'A(7E, 02
PIVISION OF COASTAL 4N�GE �NT
ADJALCENT RIPAI iAN PROPERTrR,�1Q7 CATTONIW FO
Name of Individual Applying For Permit t1 f I.�t �A rV l (O �./JIl S
m
Address of Property. /p5 A S7 /f l 6.1 B 144 FT'
(Lot or Street#, Street or Road)
11/1Nt TS TEA t)1 N. C . 6PEA.ipEe Ca c.r J`
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individ
applying for this permit has described to me as shown on the attached drawing the development t
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 of Coal
Management, 127 Cardinal Drive Extension, Wi7miug�tan, NC 23405 or call 910-395-3<
within 10 days of receipt of this notice. No response is considered the same as no objeetioi
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier dock?mooring pili ug ,breakwater,boat house or boat lift must be
bck a minimum distance of 15?from my area of riparian access-unless waived by me. a!y
wish to waive the setback,you must initial the appropriate blank below.)
I do wish to waive the 15'setback require, ent_
I do not wish to waive The 15'setback requlrerneent-
c_
2 /.P 06
. Sign Name Date
Print Name AraWA
410
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