39808D - Farnsworth

•'CAMA/ ,DREDGE & FILL
GENERAL PERMIT Previous permit#
New Modification Complete Reissue _Partial Reissue Date previous permit issued
Prized by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 71/- 2/00
[ ales attached.
nt Name C GVO e Rtn k'5&O2 Project Location: County B2awst ,c IL
s 2566' 144L7/4/eAs 14147 Street Address/State Road/Lot#(s) /47r 27
70 uT/. Pot/ State I(,C- ZIP 2 ( Jr6 . /1/42l4,82 S `
GiA4#(q/v ) ZS�-if33� Fax#( ) Subdivision '7 J 4'►ws L,/ ✓7:4
Ized Agent Joet UCLA S 5- ( Jr 24 C'r-01 City •pcJT�Pel--f ZIP Z Cc-
d CW 4w '1VihA C ID ES ❑PTS Phone# ( / ) Z5-3-y3? River Basin `044 i
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body 4 I/4/w (nat
PWS: ❑FC: d
yes / io PNA yes / Crit.Hab. yes / no Closest Maj.Wtr. Body "7 r�W
AProject/Activity pa, 905Fi� t/ 3' a 6A it/ L/IN y L )DAN�LS - 3/ 4.�`4-4c
' $1St4�.t_ — //'o p,4(4'&►5 5/ CAPS I}5 14 C 2 G e,(PS (Scale: � '
lock)length
m(s)
pier(s) ,r-
-- AIMA)
length
lumber
:ad/Riprap length /
ivg distance offshore i
nax distance offshore
channel
Pape°5e9 fitt/6
:ubic yards i �"- / f - i r
amp
i VfNti� grPlT 4av� �
ouse/Boatlift
/ i. /fie ��r
1 Bulldozing P �-
• 13{44 k Ivwtet — tr.--
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r NFL __ !y , ` i',
line Length //3 . I!+ l r Yr t v/
not sure yes n /„1.<1.$' 4 /' `'1 ,' 1 mrift
lags: not sure yes �1 t
Corium: n/a yes ti)-( I Nk
ct Nyw�,-t'FI f Cof> �"
,s: yes no `'t.. 1-i t 7 1
:r Attached: yes � G See note on back regarding(ding permit may be required by: YNSGv r (', g ing River Basir
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
\Tame of Individual Applying For Permit: C f 44 reserAismill.r-4(
Y
Address of Property: Z CI,-layOL✓-v, -3 14 S L1. 2
(Lot or Street#, Street or Road)if N C,
I
(City an County) I
hereby certify that I own property adjacent to the above-referenced property. The individi:
tpplying for this permit has described to me as shown on the attached drawing the development th
ire proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
:f you have objections to what is being proposed, please write the Division of Coast
danagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-391
vithin 10 days of receipt of this notice. No response is considered the same as no objection
rou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must 1
et bck a minimum distance of 15' from my area of riparian access - unless waived by me. (
ou wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
1/7/0
7 S
ign Name Date
RIl Li-Let.nn cfAA .-1--L1

Lam ( L / l
a
' DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
\Tame of Individual Applying For Permit: "-am y/S0/ - 0 �b yPc
kddress of Property: O'1S'6 NA--g/^/CRS 1 iiifei
Se—
(Lot or Street#, Street or Road)
.6z wri-t-POpT /1/- Z l96/ 3A9uovsiilict
(City and County)
hereby certify that I own property adjacent to the above-referenced property. The individu
ipplying for this permit has described to me as shown on the attached drawing the development thi
ire proposing. A description or drawing, with dimensions, should be provided with this letter.
///1- --1 I have no objections to this proposal.
f you have objections to what is being proposed, please write the Division of Coast
►lanagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-39(
vithin 10 days of receipt of this notice. No response is considered the same as no objection
rou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must 1
et bck a minimum distance of 15' from my area of riparian access- unless waived by me. (
on wish to waive the setback, you must initial the appropriate blank below.)
1,17 I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
f / L/ eo
i Name Da

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CLYDE FARNSWORTH 910 253 4338 P. 09
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BB&T
BRANCH BANKING AND TRUST COMPANY
SOUTHPORT,NORTH CAROLINA ,
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