39891D - Falatovich

CAMA/ --DREDGE & FILL /
3ENERAL PERMIT Previouspermit#
-New ',Modification I Complete Reissue ITIPartial Reissue Date previous permit issued
irized by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I5A NCAC —) H. 1 24:3O
,,q Rules attached.
It Name /►i Pa 5‘. ,,p,y� g A Lc r a v r c.t-y Project Location: County c 105 L 0 .✓'
1501 (Q (Ji 44' ST Street Address/State Road/Lot#(s)
u QF GiT •J Stater C. ZIP 28 44 5/ Io O I li (o` N 31
( I ) 32.-)- 31 ) S Fax#( ) Subdivision
zed Agent Sig:Vt- ANITT ty3 Q-'L City.s U R G' 61.71 ZIP Loy 1
I ❑CW !KEW PTA ElES ❑PTS Phone# (9 t 3 )3r)-391 S 1nA River Basin Ali r
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
❑ PWS: ❑FC: Adj.Wtr. Body CA kJA L. (nat 1
yes ' Z+) PNA yes / 0 Grit.Hab. yes / no Closest Maj.Wtr. Body AT W V
If Project/Activity N 51AL L g o c,-k- L j.F r ( ( ( ' X 1 f I )
(Scale: i",i
xk)length
n(s) \
pier(s) 1 - I
ength i N
amber 1
ad/Riprap length
rg distance offshore
lax distance offshore P
:hannel L -+
ibic yards 2
mp 'IS 7
use/Boatlift i Nt✓• 3)
0 111Xlj1 $o•%-r' t= I c-`
Bulldozing 11 1 Y-{/
P `
ne Length__...._ 140I yu
F i
not sure yes (no //,,
gs: not sure yes Go G k. (�Q r f/
rrium: n/a yes (no
yes To
Attached: 'ye no P
ling permit may be required by: S 1n 9...F. G TT y See note on back regarding River Basin I

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T-27-20634 4,2 L 39 PM ',HOC I DRY CHRY5 MRZDR 91 el 54 (654 ( - - P. td:
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00T-28-2004'TUE 11 01 All FAX N0. P, 02
DIVISIQN OF COASTAL MAI AG ;ENT
ADDAcENT RJPAJ N PROPE.RTZOW1v7KNUIVICATIONIWAIVER FOR v
Name of Individual Applying For Permit: 6 ' // Faie, A
Address of Property; GP D/j p 7/"--
(Lot or Street#,Street or Road)
` /�-
(Ctty and County)
I hereby certify that I own property adjacent ta.the above-re'. -,":ed property. The individual
applying forthispermithas described to me-as shown on tile attac drawing the deve1opcnt they. -
are proposing. A description or drawing,with dimenlioi should I:c provided with this letter.
I have no objections to this propgsal.
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 910-393-3900
within 10 days of receipt of this nodce. No response is considered the same as no objection if
you have been notified by Certified Mail.
_. _ witimitSEC'IT9N '
I anderstantrihat a pier, dock,mooring pilings,breakwater,boat house or boat lift roust be
set bck a minimum distance of 15'from my area of ripaciau screw•unless waived by me. (If
you wish to waive the s ck,you must initial the appropriat b lank below.)
. _ Ida wish to waive the 1 5' setback requirmeat.
Igo no wish to waive the 13' setback r ,� t es�unme•at.
•
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Sign None Date
ATI;e4 iv A.
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Print me
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PER Jt l COMPUTER F OR?VI
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NO 11FICATION/WAIVER FOR
Name of Individual Applying For Permit: 1 )4,{ j / /CA 01
Address of Property: Co ' S f 6 O/(,
(Lot or Street#, Street or Road)
r c,-
City and County)/
I hereby certify that I own property adjacent to the above-referenced property. The ins
applying for this permit has described to me as shown on the attached drawing the developm
are proposing.. A description or drawing, with dimensions, should be provided with this 1
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-3S
within 10 days of receipt of this notice. No response is considered the same as no obje
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift n
set bck a minimum distance of 15' from my area of riparian access - unless waived by
you wish to waive the setback, you must initial the appropriate blank below.)
3 I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
I I �. _ —4 . n Cs-r/ . .. , , ! n i;

COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
e items 1,2,and 3.Also complete A. gn: ure /;,7
Restricted Delivery is desired. L{�/,/� ❑Agent
ill UY / Addressee
it name and address on the reverse 4
ve can return the card to you. B.-;.eived .y( rioted Nam C. Date of Delivery
Its card to the back of the mailpiece,front if space permits. . T ` -�^a�_ 1,2 - '- 1
D. Is delivery address different from item ? 0 Yes - O v
dressed to: If YES,enter delivery address below: 0 No 1 o >
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(`J ` N 3. Service Type 1
8 Certified Mail 0 Express Mail
0 Registered 0 Return Receipt for Merchandise N
❑ Insured Mail ❑C.O.D. t v,
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4. Restricted Delivery?(Extra Fee) 0 Yes _DD
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811, February 2004 Domestic Return Receipt 102595-02-M-1540 {
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