39888D - Fulcher

CCAMA/ X?REDGE & FILL
3 E N E RAL PERMIT 1/ Previous permit#
KNew Modification I Complete Reissue -Partial 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 I 5A NCAC )1-M . I i 0-2 ) N. I S�
Rules attached.
it Name ��M i\�,Z N c c�,.\L�., Z Project Location: County ,0 N1 ✓_3 h/
I 0 PAC-S ` + . Street Address/State Road/Lot#(s)
vcNh% 1-EitZti State+Ji_ ZIP 2-S`Ilo0 10-1 -Pis (--; 51-
(-(C 10 ) VC - 30ie1 Fax# ( ) Subdivision
:ed Agent < T v E A Ni'I (L•/. City Siy>:A[-,S �2JZ y ZIP Z Li (c
Cw KEW ❑PTA NES ❑PTS Phone# CI ID ) ?.2 ) --VDb ) River Basin W` /1a-r i E
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body C.A►3C L (nat
❑ PWS: ❑FC: `
yes (no PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body N E RI✓tt 2
f Project/Activity c.,,. k\..d, 1 b I F i>U- I - Z d< 0 ,,,)0 r 3 X I c' w ra fa .-.v ra r)
\ ?!a C....- 7,i p'3 p -- ,&T ' TS;i-17 KW) a . N . (Scale: I": 1
Ick)length
i(s)
6ii CAAlA CI_A GS Pj1. LKHEA ) 1..):101`)wA7..J GaI1-,A C1p6
Iier(s)
ngth _ L..- r1 N it L
mber
d/Riprap length l BOA (>, D(. E-- P
g distance offshore 40° e- `' -,4----y 3'S" -j,t---- 4 5 9 t j
,x distance offshore 0* I s\
•
cannel 12, X 14 A..- .._._.,
"' Z AL W `, / tt
bic yards ILA 0'
Ise/Boatlift
i
np
/61
ulldozing
4OA\t
P ..L PI--
e Length I O I
not sure yeso
s: not sure yes �io
ium: n/a yes ;Tic
y_ no
\ttached: c:D no _-_
ng permit may be required by: 0 N S 1 -,W G.D .. N'TN 1 See note on back regarding River Basin 11

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: J;P1 1 hA e p
Address of Property: ( c, `kc
(Lot or Street #, Street or Road)
nif4i F RRy , 01JsLvd
(City and County)
I hereby certify that I own property adjacent to the above-referenced_property. The individ
applying for this permit has described to me as shown on the attached drawing the development tl
are proposing. A description or drawing, with dimensions, should be provided with this letter
1N�
y77 I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coas
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3
within 10 days of receipt of this notice. No response is considered the same as no objectio]
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat Iift must
set bck a minimum distance of 15' from my area of riparian access - unless waived by me.
you wish to waive the setback, you must initial the appropriate blank below.)
42C- I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Sian e Date

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: ,3--;'Nl R T i ii R rut_ r h l' R
Address of Property: (a 7 PR y e s
(Lot or Street #, Street or Road)
d 3 (aR y c tip'
(City and County)
I hereby certify that I own property adjacent to the above-referenced_property. The indivic
applying for this permit has described to me as shown on the attached drawing the development t:
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 Coa<.
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3!
within 10 days of receipt of this notice. No response is considered the same as no objectio
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat Iift must
set bek a minimum distance of 15' from my area of riparian access - unless waived by me.
you wish to waive the setback, you must initial the appropriate blank below.)
t . t; - I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Sign ame ate
- -

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SNEADS FERRY, NC 28460 66-19/530 — Q De
[phone] (v7
PAY TO THE //' D/c"/i f7 $ 00 t
ORDER OF
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MEMO rt-t-gele-c_ 12(.7-4-r- -/ a? J erci AUTHORIZED NAT E
00049220 ,:0 5 3000 L96i: 0006 50 5 2 L9900