43233D - Paschall

zi CAMA / DREDGE & FILL q
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GENERAL PERMIT Previous permit#
2New _ Modification LComplete Reissue Partial Reissue Date previous permit issued
Drized 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 h. ) 2.3 o
Rules attached.
nt Name VI/ ,..,.i a,.._ Project Location: County Dr. Di_
s , C501 S. ©amp .\--- .ti Street Address/State Road/Lot#(s)
r vA tLG C.Tf`j State *1 L ZI P L 1{ I 5. (- A K 1 •11/4.
#( ) Fax#( ) Subdivisions Si,q1.)It. pAk)
ized Agent City S LN R.c Ga IO I Ty ZIP 28'4I 4
d ❑CW SEW TA ES - i PTS Phone# ( ) River Basin -A p r
• ❑OEA ❑HHF ❑IH E UBA N/A Adj.Wtr. Body�ar'6Ai L 3JL.r+.11 (nal
❑ PWS: ❑FC: �_�
yes / PNAlib: Crit. Nab. yes / no Closest Maj.Wtr. Body
of Project/Activity 1•1.-)S'i L L,
3 x il / (Scale: 1 Ilz.-.
lock)length 3 X
rm(s) 3 x V 1 ''. {)
• ier s
P ❑ kNm ......._......) f i y
•
length _— ) , /
//
lumber
sad/Riprap length _ ;y
ivg distance offshore r
nax distance offshore 1 t
channel .Y d
a: f
:ubic yards
amp 1
wsoatli t� x 1`Z ' +t t <`
\V, ' .,'''
Bulldozing
/
1 • `/
Wit\• e ` a _
ine Length-__ �-— ) "l x
Ny
,..pot sure,:-.) yes no 5
}
igs: not sure yes (.„, j y
glum: n/a yes ' P
i.
yes
•Attached: yes 1
ling permit may be required by: kn Q-A' i t '--f . 1-1 See note on back regarding River Basin
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Na
me of Individual Applying For Permit: W,LL, 1F. /5c sL
Address of Property:_ I'91 S. an k be ve
(Lot or Street#, Street or Road)
5 it f Cif
(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.
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 7 qto
within 10 days of receipt of this notice. No response is considered the same as no objectiot
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier,dock, mooring pilings, breakwater, boat house or boat lift 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
lV t. `: , /v-/3-os—
Sign Name Date

ADJACENT PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to (,v,�/, N. SCG7,9/c_
� J
(Name of Property Owner)
Iperty located at /0 e,nk
(Lot, Block, Road, etc.)
C/7t1hC off %��� � �- , in f" e
(Waterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing at that location
i , I have no objections to his proposal.
DESCRIPTIO D/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing developme
00.
loci S . (Az bt.

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0101111.1.1.14
• - 100.11°111.

WILLIAM H. PASCHALL
CONSTANCE H. PASCHALL 2533
PO BOX 4244 PH 910-328-1724
SURF CITY,NC 28445
J5 66-7704/2531
Pay to the ��Q C Date
Other of /1/C Z)'i/ $ /00 ca
c/tea Dollars el
State Employees'Credit Union
13 Wilmington,North Carolina
For C/5541i?
1: 253 L770491:086 26840 25 LII' 2533