41415D - Clark

rCAMA/ Ii DREDGE & FILLNZ- NO 4
EeN E RAL PERMIT Previous permit#
w !Modification iComplete Reissue -Partial Reissue Date previous permit issued
•ized by the State of North Carolina,Department of Environment and Natural Resources l/ '/�OG
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
/�
SV`Y` C, V ` Rules attached.
:Name Project Location: County 0�'y' 44-0,G/7
' 3 �‘G,�rh// /`7 /e5 t V Street Address/State Road/Lot#(s)
Plle'J 4 *h State/€ ZIP 22 gal et7�i'
(J/O) 2SL . age)Fax#( ) Subdivision
ed Agent e ,-41 „ •.ehT City 11/71,,//7 fist ZIP 711
pcw .EW TYPTA ` i ❑PTS Phone# ( ) ..1.014?/ River Basin e--;,04.
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body /q/ fr* (nat /n
❑ PWS: ❑FC:
des /� PNA yes / � Crit. Hab. yes / no Closest Maj.Wtr. Body r�/�`///� . '
project/Activity 4 '4fll Pik �/S /%,' 4j y 37 '/ f-''‘.0"P ' ,WS
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igth
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c distance offshore f 1
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Ildozing 4 32 / 1185.1
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not sure yes ps'i y ,f
im: n/a yes f G/Ark �LPt-
yes atr
peel,ttached: � no i
g permit may be required by: /* / / L/d . U See note on back regardingRiver Basin ru
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.11\I I,3��INNE,A1 `I iLS'tz'OD 30 NOISIAIa :f N�J�r

ADJACENT DIVISION OF COASTAL MANAGE '
RIPAR=AN PROPERTY OWNER NOTIFICATION WA
IVER FORm
me Of ;_ DUNCAN
Individual Ap 1 �/N� 910-765-6178
P ying For Permit:
CONTRACTORS, NO
�• _> >C,,-� 123 Chadwick Ave • Wilmington. NC 284C
dress Of Propert
J
(Lot or Street #, Street or R �.d, Cit
Y & County)
hereby certify that I .
=e-'enced property_ own Property adjacent to
Y- The individual aPplyina f the above-
3cribed. to me as shown on, the a or this
y are r drawingevelop
proposing. A descriptiont or attached
the development
�u1d be--'provided with this letter_ g' with dimensions,
I have nc objections to this_s
proposal .
youeau have oblectioas tow
of Coastal M- pat is beima proposed
�naaement _ 127 please write the
minQton North Carolina. Car'dina�. Drive
s of receipt of this28aC5 or call 910 30 Extension
s f -receipt
_ notice. No res 5'3900 within 10
�tion if v aonse is considered
you have been notified by Certified
same
Ce_�-ified Mail
WAIVER SECTION
3derstand that lift Or a pier, dock, moorjnC iTir
sandb-cs F- -cgs breater,
;e, area -f must be set back a Lit'n " boat
riparian accessunless m Qi stancewishs"
waive waivedof
e setback, you by me. (If
�w_ } must i m;tial the anpropria you
blank
=—"A_— doI do wishto waive the 15" sett a'1
cC!C reSLiirelT'le'...L_ �P/
I a XIp'� wish to �,
waive the l5'setback realirement.

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14' 14' 6' + 26'
II Q 0- m li E �— fo 4 f1•
W C9 �� Q Li� _ 1 I
0 Q X BOAT :13 BOAT to 3 1
g W UFT SUP N i-m _
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7777 E A
�;t�fa 6'x60' FLOATING DOCK a z z O 0n
ii �if I Wa
BOAT BOAT o o
1.7
UFT J
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J.J LWL U.I 111IL 111J LUJ LLLI JL IJ.LJ 1.11 1111 11/42,JJ11
f PROPERTY LINE EXTENCED
° 1 0 tr
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III
0
0
PLAN
DREDGING
30
REPLACEMENT OF GAZEBO
AND FLOATING DOCK

bi
PH.910-256-6620 DATE yl1
PAY �J�
TO THE
ORDER OF v/�� � $
0
���� DOLLARS
Bank of America
�'
ACH R/T 053000108
�, l/
FOR CAw},4 ?> L ! ([,/ Tls
11600E005v 1:053000 L961: 000696E1990 2311'
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