44086D - Hayleywood

4AMA/ DREDGE & FILL
3ENERAL PERMIT Previous permit#
Nw 1Modification _Complete Reissue Partial Reissue Date previous permit issued
rized by the State of North Carolina,Department of Environment and Natural Resources /�
2oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ?/1. Jae
[ J-Rotes attached.
it,Npame hift yle t.✓p4 1,. ,r1C, - Project Location: County34 44., 'IcIC
Y . 0, €dx T 6 Z Street Address/State Road/Lot#(s)
,i I 0.4♦/b 7y./i4/ State/VC ZIP 2 y1 2
( ) � l G
,�^�z Fax/# ( ) Subdivision
:ed Agent
�1(� r^-- City/90 Ld 01J 6PeC4 ZIP 2 7y�i
❑CW C.!W DeiaTA i tas." ❑PTS Phone# ( ) River Basin 4 y-ry6,
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body Ct9^4,9/ pler,/iv 41 (nat Q
❑PWS: ❑FC: ,/ \
yes i. PNA yes o Crit.Hab. yes / no Closest Maj.Wtr. Body_ /w^'
f Project/Activity i?rIAC e Cx 'sr, ice L,e/hEAD
(Scale:f
•ck)length �._
i I
ngth - L -- -- _r - _
r
mber
d/'tiprap length 5-y
distance offshore .2 a
ix distance offshore 3-` �t 1.'1
f%ti
cannel — ( t
1 l
bic yards -+ + - . ....
. .-..np
. .__.
L
se/t3oaclih ---± ic it , -41J--; 41#;,, Pail'r) ;
Cr- f r ea $t� , f/fici a4a l
ulldozin - ` . _ '._ -r�
SQL XN[An } , t
e Length a.. i
not sure yes r t,__,_
... I
s: not sure yes 1 72 1 v'
.cum: n/a yes I l
yes
4ttached: yes _, 1
ng permit may be required by: t/OL p#n/ (8///C 4 See note on back regarding River Basin r

•r
GRIZZLY BEAR
HOLDEN DOCK&BULKHEADS 2192
GREGORY A& DOROTHY HOLDEN
PH:910-842-9732 A g 1 �j
1502 STONE CHIMNEY RD SW 66-12I5/531
Dalr� 840
SUPPLY 28462-V"-' .A
'' PAY TO THE I . atoORDER OF ` `
LISbVNQj` L, C7U\c"- J Yij � 8 =7—
WACCAMAW •
W -
BANK i •
Supfly,NC 28462
unuw.m
1:053LL2L521:8000J6cf 7530�i02 /9
6 /� � WILDLIFE GORTRRITSe WP
°ear.Amerrcan l// �

r.tN i IUr tuAiv YKUYFK 1 Y O WNER NOTIFICATION/WAIVER FORM
ae of Individual Applying For Permit: 41 e Woo L
.ress of Property: 13 Z vvc-‘ n
(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 tie 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 it
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 rip:Irian 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.
1
zeoOVLif2_
i Name Date
l

.-11JJHl_r.IN 1 KJ.r!11 IA.N rKUI-' 1 Y U W NER NOTIFICATION/WAIVER FORM
ae of Individual Applying For Permit: 7 4 e /,,/a ;h t
1'
'ress of Property: /3 2- /(-h i ,2,-,
(Lot or Street#, Street or Road)
i-70/c/e., 2ear; /7, 6
( ity 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 the 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
lagement,.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 i1
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 rip:Irian-access -unless waived by me. (Ii
wish to waive the setback,you must initial the appropriate blank below.)
J'� I do wish to waive the 15' setback requirement.
I do not wish to waive the IS' setback requirement.
111C ;eurn So � dw.,.,.�� o�i'3 4 Oh7/4I v, a,
rw. ; ,i ID r( )4t-4- -th:c,- ,4 0`45 e C 2 /ata C f //c are, Piilea $(0 fYo 6,/,
C e ti- J A 4 ,?J ,2-7-06.
1 Name Date