43902D - Old

?LAMA/ DREDGE & FILL tir-
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 , / 201#
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC Yj
/��� ❑Rules attached./'
it Name /ly�hte rig# / Z//L . Project Location: County �« /7,.s7,04✓40
22 y �t/4 lr ,�a Street Address/�Sttate Road/Lot#(s)
'�/�!�/ �S N State/VI/ $ZIP .2y hi S 0/p "71lid, Gi'1 •
(9/Q) ✓ 2 Fax#( ) _ Subdivision O" �g;i17' y
:ed Agent /'% /1e&ate ' City a///.4 i .J ZIP 2g .2
❑Cw Le6LI PfA E ES _I PTS Phone# ( ) .cif River Basin C-l+0i
❑OEA ❑HHF ❑IH ❑UBA N/A
Adj.Wtr. Body ,4//V11,.� (nat/ /
❑ PWS: ❑FC:
0/ no PNA yes / no Crit.Hab. yes / no
Closest Maj.Wtr. Body P7'# �/4.4
f Project/Activity/� /12e -gam•/- /yif,, 7 nj /'!7l'r//,A �� !y/' ,
X/S f//�G/ Td#//&/%n t . (Scale: /V/
)ck)length
n(s) �J/�,J. ` p/I'/P771 ,,)ier(s) / " "�J / // 4�*er)ieS r' -C.s//% *9°1"
amber ,�c Q r /
Ld/Riprap length S'l1/Y!/ '//` AP/, t C144( `/40-C ,G'7//,0,h0•Qh
g distance offshore _
ax distance offshore ,f
hannel s ,V d e '//i14-7' 464 ' 5./Pc el.-,
ibis yards /- / / / r
mp 3• frd'✓14 'h,li // All Erie 71!-" el/ 6� p ('li4/
ise/Boatlift
Si
lulldozing _ /�
II, (0147111,(71A Tti/f O rlt ,<1�r
��^^
.
/h �'f/047 / /A- CGS ",n i- ) -3
re Length >1'1 d T if,0,A- "VG G. "32 a/c*
not sure yes
:s: not sure yes
rium: n/a yes
yes 66
Attached: yes g �
ing permit may be required by: N# ev5 . 1 I See note on back regarding River Basin r

•
OLD CHIMNEY HOMEOWNERS'ASSOCIATION, INC Bank of America
4024 OLEANDER DR. SUITE 2 Wilmington, NC 28401 2131
WILMINGTON, NC 28403 66-2/531
PH. 910-791-4872
PAY ****ONE HUNDRED &0/100 DOLLARS 8
DATE AMOUNT
fO THE
DRDER OF 12/05/05 $ **100.00
CAMA
066:1/act,'-zz4cL,
,JSgO 4,
mipid
li'000 2 L 3 111' 1:0 5 3000 L 9 61: 000 L8 L L 3 20690

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 1)L l) (f/f'}i w'r 's
(Name of l'roperty Owner)
property located at C ff i ,r, L." L , l n,
(Lot, Block,Road,etc.)
on / I) 77 c'• cot, /cr 6(;,:6'/04„ ,in 1'1 ,L c 6,101. of ` !J . ,N.C.
(Waterbody) I (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/boatlift/boathouse
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)
&Alt.()feL /turn,ca_rLe ay-n m mid 6/ociel
S gnatur
Print or Type Name
%%Le) i,q-[c ' v

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
•
I hereby certify that I own property adjacent to 0/c/ CA t ry, n y 's
(Name of Property Owner)
property located at Ct h rm r, ). e
(Lot,Block,Road,etc.)
on /,14-r4 Ccastmf h.'u ru,aa,in W<< m ,tiriah /V i)NaricJer Co„N.C.
(Waterbody) I (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/boatlift/boathouse
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 de wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
------------------------------------------------------- /
eSignature 2
Try e w. b
Print or Type Name 0