38506D - Clark

❑CAMA/ ❑DREDGE & FILL
GENERAL PERMIT Previous permit#
INew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
prized 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 711/Z O
/ ❑Rules attached.
nt Name MAyf in (f4✓k Project Location: County Artl f✓
Old Ailiett / Street Address/
State Road/Lot#(s) /51 j ad i
44MpSf•Fesk State/0,o ZIP Zd 4-3 V. 174rniOee#fet / 4Z
(r'j 10)2'7 0 - 18i0 Fax#( ) Subdivision
zed Agent 9Ye1 4✓ir'n City ,96m, ?57i9,/ /Pe ZIP 2
j CICW IZ1 EW .PTA yES ❑PTS Phone# ( ) River Basin CF4
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body C.-n
mif jeXeed nat
❑ PWS: ❑FC:
yes /6io PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body 41k)
if Project!Activity ,4/' i n $1 n j/e bat 7q/4"41
(Scale:
ock)length
1 r
pier(s) f ! I / At' ' 4e "' 1
ength i `�r i< 1 "'�'—""�� - /4 0
umber j l*+.J7 1) A I- - _3% I ; h ��+;t frlir, i
ad/Riprap length -._1 .1-- f f' ! r.... ('r+I F..._"'..)
rg distance offshore r 1 l +....
;
lax distance offshore 4 .__-.__ — ....._._..._ 0 1,171
I I _
:hannel }- 1 ... 4 1
ubic yards }.... } „f j'$ ,vcif vie
imp ...... __ l l +.....�7. ____I_ I ___ ___I_. _....s
)use Boatli /3X /3 3
} I
1 ' T t
Bulldozingbe i104/
I
,
; --1
_
ne Length �GV 1.... I I
not sure yes io i , 1 -
tgs: not sure yes
{
y
)rium: n/a es n ✓mil
yes + + i - -- -- I -
. .__i 1 I ' i
•Attached: yes
ling permit may be required by: .4fl 4, / 6-. . See note on back regarding River Basin

35-
GE 'ERAL PERMIT CONIPTJTER FORM
?pi TCANT':. t124t'7 n Ua k
ADDITIONAl. f� .
ABC DESIG: DEV'.OP -..�..=-1_1L•D PROJ DESC: $) - /Z•
(Val only tak.t 6) (W m only tai:r.1)
WORK_ 61' /3 x /3
(�iI o -)
M fl is
G) /61
(wi'd my=i:=5)
ACIIONT A iON
D_R &FILL R QJ :
CAM.CAMA MAJOR DE r REQUIRED:

(co,
DELTADoc1 ' iOAT L
aac VSAT
Phone: C91� bgb9700
0x,t+cTar.rc � �D� ���io5 b�WILMINGTON, N.C. 2$4 Fax: (910) 6$f�'77�
.t i
fsv . ,Ro4 Z
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DTVISION OF CO44?4L MANAGE'l ,N7
.•DL-A-CENT R e4RIAN PRAPERE TR FORM
•
Name Of Individual Applying For Permit: • . 1'
Address Of Prope-rv: / '-f J 01LPe >ut (
4k
,14,0stecic--)
(Lot or Street#,f, 1eet or toad, City & County)
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described toile as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
x I have no objections to this proposal.
e e
Manarzement• 1/7 Nnrrp Cazdival Wil in nz_ifl
3900 withl� 1��,� e � � �L�'ar lira �_ OS nr rait o7 39S_
Nn re ppnse is rnnsidere� the Ra ?S�c nhteztio it vnuh o Ao 1
_ati n norrfed by Cer7ifiP.ri N,ai],
WAIVER SESTION
I unders=d that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you znrcr initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I tic..not wish to waive the 15' setback requirement.

AD T
• , T ' 1�
Name Of Individual Applying For Permit- G(2fk) a
•
Address Of Property:
= p
per
a. fin x e4_
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above-referenced The
property. Individual
applying for this permit has described to ri a as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
/ I have no objections to this proposal.
er
� � P
'� ,�Qr call 470 ;9i
if vnn haYe Ir n_rintifiPtd by Cenifif.ii Maii `
WAIVER SE.CTI[ ter
I understand that a pier, dock, ring pilinzs break .ate , boat house lift or sandbags must be
set back a minimum distance of lc' from my ea of ripar' arcess es waived by me. (If you
wish to waive the setback, yo initial e aDprop ' to blank- -sow.
do wish aive th 15' s.etb :requiremen
I do nnr wish to waive the 15' setback.requirement.
Ar.cir, A
9`

amingigamel Security renhancedd I.ermrart. a.::h7tf tepr Ji111 r.
DELTA DOCK & BOAT LIFT 5700
402 AQUARIUS DR. 910-886-9700
WILMINGTON,NC 28405
f 88-30/631
SAY DATE ` / v o y 386
10 3R THE -I/P '`)12
J $ 000 o v
CO �'u.�� �" L L
F RST CITIZENS us
BANK ►r.trr.er,r a rr con'a,y
MrnOr�nd,N.C•2tMl
www.flrstcitIzens.com
'OR -C..1-4AA `� /'G(/C a PaAhiS
11'00570011' 1:053 LOO 3001:00 3 5 3 L99 L5041