38500D - Black

CAMA/ DREDGE do FILL 'y
3ENERAL PERMIT Previous permit#
INew ❑.Modification IA Complete Reissue III Partial Reissu Date previous permit issued
prized by the State of North Carolina,Department of Environment and Natural Resources Zoastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC -/-7
7. /2c)o
0 Rules attached.
it Name 64)i C 13 L g C k Project Location: County ` (1 v,v s c 'c 4
/3C9 TAppQ. f elk) D'j / Street Address/State Road/Lot#(s)
4(0� PCK State kIC ZIP 2$%7, /5 6 7 4 4- i0k)
t( 0,o)O(-%nit Fax# ( ) Subdivision
:ed Agent S4 V AJl +1- Cg,,,47"ec: City 10 0/22-rl 3c-f ZIP__21(__�
❑Cw IN A El ES ❑PTS Phone# ( ) 30/- 03k River Basin Lopt.gb
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body C1I11/C t S y S (nat
❑ PWS: ❑FC:
yes / no PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body V -
f Project/Activity 0 i 0S�b ()Or(A, 7 7 P ; E o - /_(c 14, IA cifer--- i o xis
( M(-'`-. NoC k (Scale: /s
)ck)length £y,5••-..7
n(s) C y, —L --_.. .— i _ ! +------
1 I
?.ngth / — I
imber /
id/Riprap length f,,,„,5 '�+.�.—.l /`"t
Rill 1-
g distance offshore 1L� EllffiriminiI
ax distance offshore
hannel o-- ... ......... Q7 i * i I
t .
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ibic yards
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a �` i f ,
ill I
lulldozing £lc S f� �1
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le Length 80 t
not sure yes 1 l O h
s: not sure yes r "All .
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rium: n/a !� ,4.IN __I
no Illi.
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Attached: { es no .111.1-4 1 EMI
ing permit may be required by: /11( 2 217 4 0 See note on back regarding River Basin I

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DIVISION.OE C:OASTA.L.MANALEMENT
ADJACENI.RLPARIAN.PROPERTY O.W'NER..lY.oxCATtfl.(tWALY.E.B.a
Name Of individual Applying For Permit: DILUtrYt e -C -
Address Of Property: 1. .iz_' c;. - .Dr..
katika,Suck , NC. avc.t-l(at ck
(Lot or Street a, 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 to?tie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter. /
y 1 have no objections to this proposal.
If_..yotL..have__ohjectinni Jo what is being proposed,_please writr thr,_r)ivlsinn of natal
Management, 127 North CardinaLQci_ve,,.Wtlmin etb:- tolina, 28405 or tall 910 39 :
3900.within lib:Jaysof. pti f this ...No..testtonseis.ffittitidsreslth•sa tritat:AR,
if you have.l enJtotifsPd by ('jrtified_M iI
WATER cEf lON
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 mast initial appropriate blank below.)
414'
t *do wish to waive the 15' setback requirement.
I dnot wish to waive the 15' setback requirement.
I
Snatttre. atr4/. r J. a4vinn i

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