40480D - Wallen

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.....,kr CAMA/ ?DREDGE & FILL I' `•. 4
NERAL PERMIT Previous permit#
New Modification Complete Reissue _Partial 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 ' 1 00�
Rules attached.
t Name 13 I L L- tiV A L-1.. .t,..1 Project Location: County pt N Qtie'
12-5 f,f\A L.L A4Z L) 6,4>/ CZD . Street Add ress/State Road/Lot#(s) 5'A q
iAtAr�TE:A State NC ZIP L-,, L-11-1 I) -. 111.E (1/1ALL.A20 6_,ky
@l0) 170 - la(Fax#( ) Subdivision )V1 A L t/ 2,0 6A �/
ed Agent 1-Ctv VVA--fl City f STE73J c /ZIP .1
L6❑CW eEW TA ES PTS Phone# [phone]`el b a I River Basin C-A-
❑OEA ❑HHF ❑IH 7 UBA N/A Adj.Wtr. Body C A NA L- CIF A t W IN (nat
❑ PWS: ❑FC:
yes (7 PNA / no Crit. Hab. yes / no Closest Maj.Wtr. Body i LAW
Project!Activity OA )TE- JANc-E DV-t - J( ' (c. (cc W V tc y1- 5(MAY)
(Scale: I -3
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er(s) r`� / L A 1.r 4 NI - - - - -,�, - - -
igth bxC AYE MP-) ' -1 ' ,
nber EXIT i J �yVV
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i/Riprap length i'ts �/ CelateElE k C i.5'r.►,v f
distance offshore I (' `�
x distance offshore h t (N� �--iq
wind 75'x i C'x—3 ExcA `� E7Ct�,tl►,Xe
15'x j L�'x - f\M'Y lift Mtn l► n 13c�k���(
sic yards tc-'o(MAA) �� � Aj2E A -it .
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not sure yes
not sure yes iSO V
'um: n/a yes ,n�o-� )�"
0 yes tic, I 1 ?L•
ktached: yes ("% 9 I l (T
lg permit may be required by: pV(:K See note on back regarding River Basin ri

COASTAL EARTH WORKS INC. 3203
910-686-7555
1955 MIDDLE SOUND LOOP RD 66-7172/2531
WILMINGTON,NC 28411
11-30-b6
DATE
F. PA) TO THE $ zoo,
ORDER OF
Cis Li (A- re-G\ DOLLARS 8 Fe
COOPERATIVE
BANK
WILMINGTON,NC
FOR Pe( 4";+ — ��fItri 6) Yo‘le17 �J _
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DIVISION OF COASTAL,MANAGEMENT
' ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit k f L L r 4 m 1,t) i L L€.IV
Address Of Property: ( a 3 M 4 L L et 1-(\ (t % ABC)
Ocii -) l-iC( /11, 5q €_4 () . /t1� � 8'/ 3
(Lot or Street#, Street or goad, City & County)
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described to rtie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
(,�/�C/
( I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 North Cardinal Drive, Wilminvon, North Carolina,28405 or call 910 395-
'3900 within 10 days of receipt of this notice. No respo se is considered the same as no 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 must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
do not wish to waive the 15' setback requirement.
)')// // /0 RIE I A

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete ;may-ture '
item 4 if Restricted Delivery is desired. lo (5_4nt
• Print your name and address on the reverse 0 Addressee
so that we can return the card to you. :, Receiv:• by(PrIted Name) C. Date of Delivery
■ Attach this card to the back of the mailpiece,
or on the front if space permits. C fl) CSC 6 L 2l.{ *'
D. Isw�ery address different from item 1? ❑Yes
1. Article Addressed to:
Ai / -TO NLL S �, If YES,enter delivery address below: ❑ No
/ C!1
S/,9icf_woridJ Rat
0 tt+11 v ?r 6Ar-1 Lk. 3..Service Type
,Certified Mail ❑ Express Mail
N. l')A/A/ r / -7 4- 0 Registered ❑ Return Receipt for Merchandise
V ( f 0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7006 0810 0001 0856 0460
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540:
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. �j / - Agent
• Print your name and address on the reverse "I�/E,/P.c22/X Addressee
so that we can return the card to you. B. R eived by(Printed Name) to f ive
■ Attach this card to the back of the mailpiece,or on the front if space permits. D. Is delivery address different from item 1? Yes
1. Article Addressed to: If YES,enter delivery address below: ❑ No
/)7eco., Lem e 71-44.
s 1 I4y. /I,a II J ,
/ 3, Service Type
/ja FS e S I 0 mil_ /AI .C, , XCertified Mail 0 Express Mail
/ 0 Registered 0 Return Receipt for Merchandise
pZ O�jV 74 a ❑ Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number 7006 0810 0001 0856 1061
(Transfer from service label')
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540