41513D - Hardwick

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CAMA/ ❑DREDGE & FILL '`\" ° �.
IENERAL PERMIT Previous permit#
New Modification - Complete Reissue -Partial Reissue Date previous permit issued
zed by the State of North Carolina,Department of Environment and Natural Resources (�
Dastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Rules attached.
Name J. N N \,g1.h NnIs C-1 Project Location: County SAD tt 2
Z"1 ZS C., 5 0,--crrt Syi /1- Ort Street Address/State Road/Lot#(s)
I a2. G1.1 y State 13 L ZIP 2,A 4 45' 2"12 3 L So 4-41"N S 4D oc.-c
( ) Fax#( ) Subdivision:d Agent i' iLtiS7 VA IN ILS N.)r, Gz....)Sr— City St (1 F G? i`/ ZIP 2 l N5
❑CW L W TA ❑ES ❑PTS Phone# ( ) River Basin CAP E 1
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body I�A ra V.S C NAw►./t I- 45)l r
❑PWS: ❑FC: l��A1 L S
yes � PNA yes /� Crit.Hab. yes / no
Closest Maj.Wtr. Body o '^
Project/Activity f r" 1 A I-L .a r LS FT Z / 6 xZSTSN G S LZ P—
aa
(Scale: I -3(
:k)length
ier(s)
ngth
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mber •
d/Riprap length
distance offshore
ix distance offshore
cannel es
x • •
bic yards
ripri
rse/Boatliftl I(o' X 2-71 G
lulldozing U
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ie Length g I
not s_yr. yes no ".� -'`'
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gs: not sure yes t=
rium: n/a yes
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Attached: yes (...,...1-1.
ling permit may be required by: S LA P C C/jZ 1 y -I See note on back regarding River Basin 1

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit:�o\_ S. Itt,2‘c,IC,
Address of Property: a-1 a3 �1--- (s- .
(Lot or Street #, Street or Road)
Ckr c_
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individu
applying for this permit has described to me as shown on the attached drawing the development tin
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 Coast:
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-390
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be sE
bck a minimum distance of 15' from my area of riparian access- unless waived by me. (If yo
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.
161-32-04-e,
n Name Date
Jo Xi,' 12 lA St — AMU'E WA

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2723-C S. Shore Dr.
Surf City, N.C.
28445
mobile: [phone]
[e-mail]
May 4, 2005
Jason Loy Sox,Jr.
409 S. West St.,
Cary, N.C. 27511
Dear Mr.Sox,
I am writing to ask you to sign off on the enclosed CAMA form as my adjacent property
owner.Our plans are to construct a boat lift off the north end of our existing floating dock.
The lift is planned to accommodate a 27 foot boat and will require six pilings. Please note
that as you are the property owner to our south,this construction will occur on the side
away from your land.
Please feel free to call me at 910-228-8237 if you have any questions.
Sincerely.

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: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
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tte items 1,2,and 3.Also complete A. Signature
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wr name and address on the reverse X A`'! i71, - J ❑Addressee
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this card to the back of the mailpiece, �Ic-p-� T t 02-v1 _/v
ie front if space permits. rook wl 'GUARDIAN 9 SAFETY ^.°�y°^an^g
D. Is delivery address different from item 1? CI Yes A..,
,ddressed to: If YES,enter del' -,- ..�'•'' •-low: ❑ No
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4. Restricted Delivery?(Extra Fee) 0 Yes O :m Q---d
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3811, February 2004 Domestic .a = ''" —
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