43952D - Fern

CA/VIA/ DREDGE & FILL ,
3ENERAL PERMIT Previous permit#
J/New Modification 'Complete Reissue 7Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources /ZOO
-oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC n -
�^ IQ Idr1 ❑Rules attached.
it Name Fern 8 i Tv 44 C Foil i h Project Location: County NLivy ,v`./�
9 Tr/5 A/'/S fhb' /20/. JStreet Address/State Road/Lot#(s)
4f/i teh, /P4 State //C ZIP 2 P.909 y/5 T //f E•..e/
`(ITO) ZS/. gB?P Fax# ( ) Subdivision die.1.1. '
:ed Agent krinl"y TOf{j City "/'frh ZIP i
EgoW LW E9.11A ❑ES LI PTS Phone # ( ) P River Basin (32.
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CI PWS: ❑FC: Adj.Wtr. Body 1.4 .i nat r
Closest Maj.Wtr. Body "HI'7/ L
yes /d PNA /
/ no Crit.Hab. yes / nor/
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ier(s) ( Cr" /��/
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distance offshore
x distance offshore
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sic yards 1 /0/!/ /�I-,/'
se/Boatlift
t
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e Length / ,! L _'.�-'
not sure yes 6 PPP'
s: not sure yes 1� L
cum: n/a yes V 4 V V g ti
yes eo 9/7 Tr,4 i A '•�/ /7o./t
10
ttached: yes
ng permit may be required by: / I See note on back regarding River B rt
1.7 / %a 1 I /_ 1 ./ JJ _ -J •-, / ,!'

•
• STATE OF NORTH CAROLINA
Department Environmental Quality
127 Cardinal Drive Extension 2 -7-0 6 be-nt-
Wilmington,North Carolina 28405
[phone]
Pt L
FILE ACCESS RECORD I f v,(
DIVISION OF COASTAL MANAGEMENT 4 ) I c
DATE/TIME / c_4_— ' " @ 30 Iw `�/, 4
NAME1 y v'
REPRESENTING /'71 S I y/GG�(° etAez• Corr
PHONE �f V3— 90 S 9 LJ
Guidelines for Access: The staff of Wilmington Regional Office is dedicated to making public records in
our custody readily available to the public for review and copying. We also have the responsibility to the
public to safeguard these records and to carry out our day-to-day program obligations. Please read
carefully the following guidelines before signing the form:
1. CAMA Major Permits are issued out of the Morehead City District Office. The COMPLETE
file is in the Morehead Office and may contain additional information and/or comments which
may not be in the WIRO file.
2. Due to the large public demand for file access,we request that you call at least a day in
advance to schedule an appointment to review the files. Appointments will be scheduled
between 9:00am and 3:00pm. Viewing time ends at 4:45pm. Anyone arriving without an
appointment may view the files to the extent that time and staff supervision is available.
3. You must specify files you want to review by facility name. The number of files that you
may review at one time will be limited to five.
4. You may make copies of a file when the copier is not in use by the staff and if time permits.
Cost per copy is$.05 cents.Payment may be made by check, money order.or cash at the
reception desk.
5. FILES MUST BE KEPT IN ORDER YOU FOUND THEM. Files may not be taken
from the office. To remove,alter,deface,mutilate,or destroy material in one of these files is
a misdemeanor for which you can be fined up to$500.00. No briefcases,large totes,etc.are
permitted in the file review area.
6. In accordance with General Statue 25-3-512,a$25.00 processing fee will be charged and
collected for checks on which payment has been refused.
FACILITY NAME COUNTY
1. 0.2 6,14 2003 ///'
2. ?‘ito//io to 7,7,L/S r ,

PINE ACRE /
DED BOOK 1 190 PAGE 299
RIPARIAN CORRIDOR
,.55'
MHW±
LENGTH APPROXIMATELY 150'
FERN BLUFF O (TO PIERt1EAD LINE OR CHANNEL) $
o
FIXED PIER
RIPARIAN CORRIDOR
1
SLEEPY hOLLOW
HELEN LEE
DED BOOK 1094 PAGE 836

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to h sf.4 1�5 B L1pF L L C_ �s
(Name of Property Owner)
property located at ( ) /(( I 'S �1/1 !�t
`
(Lot,Block, Road, etc.)
on 1 _ Ski�( Crce , AMIN\ c n '�� ,N.C.
(Waterbod{y) (To, n and/or County)
He has described to me, as shown below,the development he is proposing at that location,
and,I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
fr I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
HECEIVED
DCM WILMINGTON, N
FEB 0 3 2006
Signature
//ft FA/
..T.....,AT.,w.o

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/ OATHOUrSE))
I hereby certify that I own property adjacent to —N ��v` 1{"
(Name of Property Owner)
property located at 4)S (,j �i) p.cf) ,
y, (Lot,��,, Block, Road, etc.)
on WA (I,K7fA4 ,in Wti 1) 4Th1J PC ,N.C.
(Waterb dy) (Town and/or county)
He has described to me,as shown below,the development he is proposing at that location,
and,I have no objections to his proposal. I understand that a pier/mooring pilings/boatliftlboathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
G fi --
RECEIVED
DCM WILMINGTON, NC
FEB 0 3 2006
AK4N, &Ss
Signature Tv, Q ,c