36971D - Cernugel

CAMA/ fI DREDGE & FILL
iEN ERAL PERMIT Previous permit#
New 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//,'2 CO
❑Rules attached.
:Name c%7 Ce 1'445 e I Project Location: County r,
.2010 1 . yK c h t "r, t"C- Street Address/State Road/Lot#(s) .?_OG
kl /'(a Na/ State A/C ZIP .2 E4/6,S C.5,4 V C_
('1l v) 7i't GB 7 to Fax#( ) Subdivision c/
?.d Agent re- , ,� ,fie. City L7(a.2d ZIP ,PS'/L-',.
CW Xlw XPTA ES ❑PTS Phone# ( ) River Basin LLr.>>
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body /`//LC)i) (nat
❑ PWS: ❑FC:
Closest Maj.Wtr. Body /`Y/(LJA)
(es /tc.) PNA yes / o j Crit.Hab. yes / no hh
Project/Activity C c ,,5 t, 7'. /�/e-/Xiti r� 4- 5?f L;:fit r✓•' X , 5/1 n� l"f,
(Scale: / '1ti 2
k)length
(s) c f,:.3
er(s)
igth
nber
/s
I/Riprap length t 1 O L. it /.577/V6
distance offshore
(distance offshore ( + F r` . Z c
annel ® 1# T' r>C GIB
is yards
ip
'2
;e/( oatlifY X/-1 !
illdozing
} I
1
Length 60
not sure yes ��
: not sure yes no,
um no
: n/a yes C U h f/
yes 'rig/
I j ttached: yes (h92
ig permit may be required by: 7 See note on back regarding River Basin rt

GENERAL PERMIT COMPUTER FORM
kPPLICANT NAME: (le-
eedw (
ADDITIONAL NAMES: rC//
SEC DESIG: Lc_) ,>7 DEVELOP AREA: . 61. PROJ DESC: P -
Will only take 6) —— (Will only take I)
VORK: / �., /z
Wil1 only take 4)
4AINT:
Will only take 4)
MP: Ow • iW
vill only take 6)
ACTION EXPIRATION
IREDGE&FILL REQUIRED: c ! 7/OILa., /7 Gcf
AMA MAJOR DEVEL REQUIRED: Feb / 46t.ei !3 U4f

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN'PROPERTY OWNER NOTIFICATION/WAIVER FORM
le of Individual Applying For Permit: Cr 'Jt 1.e.}0..
",
7
ress of Property: Q_Q . _ . c�.40. ,r- ,
(Lot or Street #, S reet or Road)
5 4004
(City and County)
tA;0
____W,.___,--(121—• vOA Al_ I►�`sN.AGEMENT
eby certify that I own property adjacent to the above-referenced property. The individual
ying for this permit has described to me as shown on the attached drawing the development they
Iroposing. A description or drawing, with dimensions, should be provided with this letter.
e I have no objections to this proposal.
Hu have objections to what is being proposed, please write the Division of Coastal
agement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
in 10 days of receipt of this notice. No response is considered the same as no objection if
have been notified by Certified Mail.
WAIVER SECTION
lerstand that a pier,dock,mooring pilings,breakwater, boat house or boat lift must be set
a minimum distance of 15' from my area of riparian access -unless waived by me. (If you
to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
7 z.,,,.#4 I do not wish to waive the 15' setback requirement.
Na71,81944
le G Date
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• DIVISION QF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVR FORM
Name of Individual Applying For Permit: Afi
W
p
Address of Property: 2-0 (e r ,
(Lot or Street Street or Road)
gol- AgS4A--4. CV-C, 22`.i 65 .6 ru..,,..4...,_;4c c_o_
(City and County)
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.
B ✓ 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 SECTION
I 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)1.F 13 V/ I do not wish to waive the 15' setback requirement.
Sign a e Date AllarY7814Ark

•
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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. 3 .2 CI Agent
• Prinf your name and address on the reverse X ���- ri Addressee
so that we can return the card to you. B.•fleceiveid by(Tinted Name) D. e o Delivery
• Attach this card to the back of the mailpiece, J
or on the front if space permits. .1 C r'1 a/fra-
D. Is delivery add diffe-nt from item 1? ❑Y>-
1. Article Addressed to:
If YES,enter de •- address below: ❑ No
c)N 6A n \(‘1"-JejL6_ .:
3. Sere Type " ••••., 276)22
Certified Mail 0 Express ICT
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑ Yes
2. Article Number 7003 1680 0002 5929 1603
(Transfer from service label)
PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540
•
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Signature .
ElAgent
item.4 if Restricted Delivery is desired. X 4A ❑Addressee
• Print your name and address on the reverse
so that we can return the card to you. B. -> eived Pr}tltecf p p) C. g-te .f Delivery
• Attach this card to the back of the mailpiece,
4r �f51'tr(/
or on the front if space permits. ■ Yes
D. Is deliv•Ty address different from item 1?
1. Article Addressed to: If YES,enter delivery address below: 0 No
3. Se ice Type
301 Certified Mail 0 Express Mail
❑ Registered 0 Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7003 1680 0002 5929 1610 .
(Transfer from service label)
PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540

back or detail,• / ` ,
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,, THE AMERI KAREN Z. PERRY
r ; ;` >;`'r CHARLES H. OR , 2
WEST BAY ST.
I /,r'J , . ‘, , e `./' PO BOX 11046 28461 /' .,' l DATE
+,�, /, SOUTHPORT,NCl)'`i,!'`•I` (' i ,
t TPAY O THE
I' ORDER OF /We- 1,/\ 7
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