45816D - Fortner

•
3'CAMA/ El DREDGE & FILL fv/ '
3ENERAL PERMIT Previous permit#
Jew LModification iiJComplete Reissue liPartial Reissue Date previous permit issued
-ized 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 7- , 12 Ci c
p'1tules attached.
t Name fit( FAA tL!' cnrLT N r% Project Location: County u NSW I( k
f 117 P A Li LA C 1(2-, Street Address/State Road/Lot#(s)
A l4- ISt-/ t Q State NC, ZIP 244 tirS )13 PAU LA CI i2cLE.
( ) 7s -j'r1s4 Fax#( ) Subdivision
ed Agent t A t( S ivfl T City VA - 1 S LP 1J 0 ZIP 2.2 t
CW CHEW GYIPTA QES ❑PTS Phone# ( ) River Basin ( A‘-E
L OEA ❑HHF ❑IH E UBA ❑N/A Adj.
Wtr. BodyD/cV I S
PWS: ❑FC:
( A,JA L— nat)r
yes /(;;;;) PNA es,,/ no Crit.Hab. yes / no Closest Maj.Wtr. Body A1 Ww
_,/
Project/Activity C( )NS/71/L 7 j-)1:)VATE 17IE K W 17 R ATFtDePA
S Iv 00 k J. (Scale: I'. =,
:k)length VI IN'4 (17k jrgWI NHLN)
W
(s) )LP X g 1 r__. I
er(s) V S �
i I — 1 i
igth 1 STt11 ,i
nber 1a 21LYi. ._. t rti >) 1
I/Riprap length —
distance offshore i /' 1 .
x distance offshore —L c'
j
annel --
f I 12S'
4
iic yards r
ip
l i se/Boatlift f —* } ' i ' , ,
illdozing ice— �� ; - ! I
l x Si i) poYvN) 1 1
1
44
a Length
not sure yes o I l T 74 y t
`--pq ITS_ 1
r: not sure yes I/' — -
rt-
um:
"/a yes 1 A...
4- 1 l uH '
atached: yes I i 1

SHORELINE MARINE CONSTRUCTION 67-7235/2532 3186
``" GREG PREVATTE 32sa000en
4 P.O. BOX 10671
SOUTHPORT, NC 28461 DATE 7�.3 -06
3 PAY TO THE E ORDER OF e /n% r�1
A I $ �O T ''
Y s /[ram ��`c".�'-v '� ��i b O _�
DOLLA .. !
Coasta/Federa/
—Bank tt&--E-/7- d3„ .;:;II x�z
iFfnn SOUTHPORT,NC 284¢1
'' MEMO 4A7iP ,/,. .e ie,-Ir/ /71Y-r-ar
425327235Si: 3 2 580008 7 20 186
f

-----
_----—- - ---- I
- -.
i d
AAdTS CAr1i9.i.-
11, ,,,,bee_&
r<ivircroti.4:44
I Ai Il X Irl. 'it IFX 14/
. 4-01
I 4 0 r. i
Io•
V.
1 V 444
1./
, W V 1 ,L)
'
I S' --,)
\)1 \l/
511;eiiteiaNg
k. N1 ,
; die
<
I
( o
-,:fLumkt iek i
Rscdol 1:okr,-4,4,

_
ci-tW - 7r
•
,F •
,r
7v7s7 yyrndd £l1
l etiv J SSi1 YQ

DIVISION OF COASTAL M AN AOEMEN T
ADIACF.N'T RIPARIAN PROPF,RTY OWNER NOTTFICATION/WATVER FORM
•
Name Of Individual Applying For Permit RZZ/41 b `O EM
Address Of Property: //3 PAULq Cz ec,E
Dy,C ZsL,9,4, ,i/c. .285�! ��PNas��zc,C
(Lot or Street#, Street or Road, City &County)
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described toile as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
/1/./ ^I have no objections to this proposal.
If you have objections to what is being propncerl please write the Division of Coastal
Manaj'ment, 177 North Cardinal Drive., Wilmirrnn North Carolina, 7R405 or call 910 395-
9900 within 10 days of receipt of this notice_ No Irsponse is considered the same as nn objection
if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15'from my area of riparian access unless waived by me. (If you
wish to waive the setback, you most initial the appropriate blank below.)
�(1 I do wish to waive the 15' setback requirement..
c 1 da_not wish to waive the 15' setback requirement.
re-71k4/1e . plc"FA
Signature ASA

tL I * 1
•I -- /
aj
giTf f
l0 /
cc l rLULLIJJ f!
4.t, 11:oi
I if T�! lrlf 1111—L1l I
l y
� V /
•
O ! o
A' li, 'V , r'V t I' {' 8 3f �
1 T rt. 1
'1 1
1.t. l,/
1
1�' '1' , f
1 to
i ... • I1 BLUE WATEF
/` f I 1 5710 WEST
II i BRUNSWI
r -1 �f LONG E
BASED Ot`
MCHENRY
h JANUAI
ww
WEST 001.11 IN DRIVE • •r
4011.W>s
JIM
i:�`as i lNG FLAN IV VI
B Mu97 DQ'
per.
9Cx? 5) '0 100 200 i ,. t,6
t
CAI—E PM FIST �►-„s• ,