42821D - Formy-Duval

CAMA/ DREDGE•& FILL
ii))7‘e3ENERAL PERMIT Previous permit#
-New Modification 'Complete Reissue Partial Reissue Date previous permit issued
rized by the State of North Carolina,Department of Environment and Natural Resources ,/ , ado
Resources Commission in an area of environmental concern pursuant to I 5A NCAC ff
/ / ❑Rules a hed.
it Name a/ f ( limy—7,!j,//,t� �/ Project Location: County �G�y/ / ilk;
c/3 fe hi " fit. /Z • _ Street Address/State Roa Lot#(s
I//I17/, o State/W ZIP y�__ JrS/-3 �GG!'�rl /"f /C01 .
( 7//) ig( Of Fax#( ) Subdivision ..--^'
:ed Agent "-J' _ City 1V/407/`i�, ZIP 2 g'1
Vq,Pr-Cw A ❑ES ❑PTS Phone# ( ) j'Anr.R River Basin Cl►e
OEA ❑HHF ❑IH -UBA ❑N/A Adj.Wtr. Body /4"/`Y (nat
❑PWS: ❑FC: //
y� no PNA / no Crit. Hab. yes / no Closest Maj.Wtr. Body �f (77r��
f Proje7tJ �/y(.e / /" /4 7/ (Scale: /,.
ck)length 6 X N
i(s) /2 'A, /2 ' /S / ���!!
ier(s) PA ' • I Rie
ngth
tuber •
d/Riprap length i°A) ,P
distance offshore ,�,�'>/> r --- I
distance offshore 1 is pepie
cannel _ f _ ' �^'/ ��/'�
)ic yards -f,.1' /�h PA� SC9 I "%'/�t f.._
dift ,
JIldozing
T
Xt t i
1r30 ___I_ _- I
4 C a_
p J
_
s Length ~O O I f
not sure yes
;: not sure yes 9 55-/3 Atico,
�`' X/f /i,t ��ri, c�'/"� ;
cum: n/a yes ® P� Ii . C_ /"/
yes i I i 1/f/W
\ttached: yes +
�g permit may be required by: ��. I See note on back regarding River Basin ri

-01-2005 09:34 FBW 9105092818 P.02
DIVISION QF COASTAL EMEhlf
�JACENT RIP AN PROPERTY OWNER OTIFIC TION!W R FORM
Vance of Individual Applying For Permit:
_ 4-
kddress of Property:
(Lot or Street#, Street or Road)
(City and Co ty)
hereby certify that I own property adjacent to the above-referenced property. The individuw
Lpplying for this permit has described to me as shown on the attached drawing the development the
Ire proposing. A description or drawing, with dimensions, should be provided with this letter.
v �I have no objections to this proposal.
p posal.
f you have objections to what is being proposed, please write the Division of Coasta
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3901
vithin 10 days of receipt of this notice. No response is considered the same as no objection i
ou have been notified by Certified Mail.
WAIVER SE
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must ba
A bck a minimum distance of 15' from my area of riparian access-unless waived by me. (1
ou wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I di,not wish to waive the 15' setback requirement.
gn Name Date

P-01-2005 09:34 FBVJ 910509281E P.03
DIVISION OF COASTAL h1AI�TAGEMENrT
ADJACENT RIP IAN PRQ ERTY O N IC TON RIVE FORM
Name of Individual Applying For Permit;4ycdi. i4;1I ie xr.- A&'ail`'�
Address of Property: ,-s-kr I r .72 A 4/
(Lot or Street#, Street or Road)
4. ,,� daze v
(City and Co ty)
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 description 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 910-395-3900
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 T —'
1 understand that a pier, dock, 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. (If
you 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.
i..- T26r
;ign.Name ' / Date
_____M Ak.le 4.l Al9w
IN'tint
Name

18/01/2005 11: 31 9107993402 EDGEWATER MARINE PAGE
AIWW
12 FT. >� FT.
I_AOOF�C^---b A
w MOORING
° d D WHIPS
V O
-s •
hK BOATLIFT 99'
DECK c�
CC
SILL FORMY-DUVAL
a 513 P6DEN POINT RD.
2WILMINGTON, NC 28409.
LL
X �D
� rY�
DIMENSIONS:
PIER TOTAL: 6 FT. X 116 FT .
DECK AREA: 12 FT. X 12 RT.
OVERALL TOTAL LENGTH: 12S RT.
BOATLIFT: 12 FT. X 12 PT.

( / 7'i
�/� Om
Pay to the I $ �
Order of " �'--`-`_1/]
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BankofAmerica
c �j Bank of America Advantage®
a ACH R!T 053000196 $
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a For L'g� _� -M'
I; 1:0 5 3000 L 9 61: 000 La 33 LI 36 3 Lit 5 68
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O C'Ia.Fe Arne.m an GUAUG AN®SAFETY BLUE WON_