43217D - Carl

PFN
'CAMA/ 1 DREDGE & FILL L 2
3ENERAL 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 7/7E, /ZUC)
/ C-i-Riyes attach .
t Name a,.wtc Ca✓( Project Location: County rei "6- O,
NG ,5 „d ea 65 41., Street Address/State Road/Lot#(s)
it/1/95 h ae./ State he ZIP 40/3 $G.--rl e
( ) SZ 0 `731,l Fax#( ) Subdivision
ed Agent City ZIP
❑CW rP -'PTA Etti ❑PTS Phone# ( ) River Basin ey e
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body al ibyist�)
ll C.✓e-gok (nat /i
❑ PWS: ❑FC:
no PNA V/ no Crit. Hab. es)/ no Closest Maj.Wtr. Body gi��
Project/Activity `/YECc t`/i c a e `A- da i.J,' do 44 L72/
ck)length
(Scale: , - -
i(s) 6/X/U` ,P ,y ,,l-
ier(s) k
b t ...... .........________.----'"-------------.....__________
ngth
•
tuber / ir
J/Riprap length *7
distance offshore �rt* •
x distance offshore f r
cannel if"
4 x 4
)ic yards
tk 5(4J 4V I,,
ir, ---...„......\\\
s :oath Oat U i 4 M
ulldozing J/
y
)e ....._,..................---,„_
, I
e Length i Q � ,,,,�� /Yt
not sure yes ,ffo, `sue1
s: not sure yes
ium: n/a yes
yes
\ttached: yes 6 f /
ng permit may be required by Z44/C e/ [_/'/d 1 _ : See note on back regarding River Basin r

i'v 18 05 03: 1Op Jeff Smith Homes, LLC 9102540925 p. 1
11/17/2005 17:18 9102708882 EXIT HOMEPLACE REALT PAGE 02
r r 1 c./ CAf(&t PI f rJ J..U- ct.:,> ha.,
' L,IY1S]ON OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROP RTY OWNER CATION/WAIVER FORM
zz_ataeL__
Name of Individual Applying:For Permit:
....cam i •
Address of Property: /.46, <t
(Lot or Meet#, Stre r Road) -
gir _ke
(City and oun
I hereby certify that I own property adjacent to the above-referenced.property. The individual
applying for this permit has described to me as shown on the attached drawing the development they
. are proposing. A descript or drawing, with dimensions,should be provided with this letter.
• I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 9I0-395-3900
within 10 days of receipt of this notice. No response is considered the same as no objection if
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, doi:k, mooring pilings,breakwater,boat house or boat lift must be set
bck a minimum distance of:15' from my area of riparian access-unless waived by me. (Ifyou
wish to waive the setback,you must initial the appropriate blank below.)
/ I do wish to waive the 15'setback requirement.
v I do not w" w " 'tsh to give the l5 setback requirement. .
•
• `% r,,G�.�, 2 /� Ag Ova
• Sign me Date
d
Print Name AVA
04 Z7q Cep •

ri'444*\t
4, DELTA DOCK AND BOAT LIFT .
vi INCTON.NC OR AaVitrWs Phone: [phone]
1MLMINGTON, N.C. 28411 Fax: CM 6864700
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HAMPSTEAD VILLAGE, LLC
11 8319 VINTAGE CLUB CIRCLE
WILMINGTON,NC 28411 1302
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I O 66-1247/531
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PAY TO THE
$ 1 a C)L.1 !
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CAPITAL BANK /A /�
'.I MILITARY CUT F RD.,WILMINKTON,NC 28403 `,-6.'LC.�
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2501S3 tie 1302
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