36979D - Blaney

tCAMA/ H DREDGE & FILL
3ENERAL PERMIT Previous permit#
Flew ''' Modification __Complete Reissue —Partial Reissue Date previous permit issued
•ized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7 H - 120+0
Rules attached.
t Name T"" l 4 ''` c Project Location: County O v S I a t
1 Q 3( C,r c I e r Street Address/State Road/Lot#(s)
crS hued State(1) ZIP Z1 784 61058 14 5-4
('410)qSg-6.333 Fax# ( ) Subdivision
edAgent .S-1c e Ah4; /y0i t City surf- G+-) ZIP ZA t /
❑CW W WTA rtS ❑PTS Phone# (CIO ) it(SR-g 3 3 3 River Basin bJ 1 E ('
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body /vleyi rv.4 d t Cr,,,t I (nat //
❑PWS: ❑FC: /�
yes / no PNA yes no Crit.Hab. yes / no Closest Maj.Wtr. Body A J w w
Project/Activity Ne w f;e v
(Scale: I if
:k)length i 1 ' k 1, /
(a) l0 'k (Z' tovc '14
ers Z '3 X 3 t 1''�1 r�✓`M �^i
cCrrtl
igth
nber
1/Riprap length 3Z
distance offshore 3
x distance offshore
annel
iic yards IC
se/Boatlift I
2.
illdozing I I
III' .
r i
a Length
not sure yes no' 15 ' `— " i1.
not sure yes ?L {
um: n/a yes ro+ '74 5 k 5� 1
yes
atached: es) no
1g permit may be required by: Su ✓C 6. �J See note on back regarding River Basin rt

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: J r-vi itlyve
Address of Property: 90 571-
(Lot or Street#, Street or Road)
(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 the
are proposing. A description or drawing, with dimensions, should be provided with this letter.
-79e( 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 910-395-391
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 1
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.
t0 1/-1,7-4 ,3/0/50-2/
S. e
e Date
I —.,,. . , I l , AWA

• • GENERAL, PERMIT COMTUTER FORM
A PPL!CAN i N_rvE: elckevz
ADDITIONAL NAivES: e\re q�! -^6 ;
A.=C DESIG: EL✓/ t?1,, E S DEVELOP QR S: . , PROJ D SC: P _
(Will LILT::6) ———
(V+'7i!only u 1)
WORK: '9' 67, fl Iz 10
•
(wit on}vr.4) TE
TE 3 Z, 3
M.AINT:
(Will only e)
IMP: O w ? d
(will only mk s)
ACTION ). RAT ION
D_ ''' E&FILL 3/ 0 `} 5 1( 0 /0 4
CAM-k MAJOR DEV-7 RE ?/i ) 1
Qv�: ny 57l0 f oy

DIVISION OF COASTAL MANAGEM VT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit:
Address of Property: g0rg q r
(Lot or Street#, Street or Road)
(City and Couaty);-
I hereby certify that I own property adjacent to the above-referenced property. The individt
applying for this permit has described to me as shown on the attached drawing the development th
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 Coasi
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-39+
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 s
bck a minimum distance of 15' from my area of riparian access- unless waived by me. (If y(
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. '
Sign Name Date
474 77 A

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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired.
• Print your name and address on the reverse X --------0 Agent
so that we can return the card to you. Addressee
■ Attach this card to the back of the mailpiece, B. ceived by(Printed Name) C. Date of Delivery
or on the front if space permits.
� 's �� : tk- fw 2- -15 -0q
1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes
44 r If YES,enter delivery address below: El No
aue/ bt// //i l4 pp?l)
i 3 uG fif//a LAi,T 57,
r
C� l/, / C . 3. Se e Type
/ 2 7 ci/ Certified Mail ❑Express Mail
❑Registered ❑Return Receipt for Merchandise
❑Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee)
2. Article Number ID Yes
(Transfer from service label) 7002 2410 0006 5594 4555
PS Form 3811,August 2001 Domestic Return Receipt
102595-02-M-1540