37838D - Capen

LAMA/ ❑DREDGE & FILL
'ENERAL PERMIT Previous permit#
JNew JModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
sized by the State of North Carolina,Department of Environment and Natural Resources _
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC r I H. j Ler'
❑Rules attached.
t Name D e rlh ' -S (-r,^ e 1---, Project Location: County Pe rid�' �"
`t ' 4 A o f C 1,...,/ It el Street Address/State Road/Lot#(s)
a.1s1ead statet4L ZIP 2P 'rI4-3 r 11 L Fi nr{lel„/s 1,4
(pc,)Z 94 445 Fax#( ) Subdivision
ed Agent -Dc v i e II Ea,'I y City ex (54 e A 01 ZIP Z A II I
4Cw gtw X1 PTA ,rt ES ❑PTS Phone# (e)1(3)Z?0 W 1.5 River Basin C'ye
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body I T L J jAi n6 /r
❑PWS: ❑FC: AsrAf�./
yes / no) no PNA yes Crit.Hab. yes / no Closest Maj.Wtr. Body
Project/Activity M e W ( se, -4 f)O1 1 ) r 1'7
(Scale: N
ck)length •.j ,?5 'X 44.'
,(s) 8 ', 1 (e, i I ..
ier(s) 1 .
' 44-r0e�`1 -*- r • .12'X
ngth - yam+
mber f � o a4 i :11-
-
d/Riprap length 1 y
distance offshore r i _
a distance offshore _ }........ - __ _�._ A- Dye.
i*,,,
cannel i y, 1F �T—, ....._.. t ,_ 1
,icyards ( r Y+._ --1j� �
I /301 t.'f v
rip f .._ . . i J j. F _...! ! - - l —_ . Acs .5 ..
Boatl�// 7- XSi' ii. r I - - r f 'If ----I--- 'li
1 _
ulldozing
1
, 1 E : 1TT -
, , eri4 1-. . ---
e Length /
d
not sure yes 1 /1.l
__ _
T grief ret4r X .
s: not sure yes
n/a yes r 1.._._ C 1 46.-- _"ay?_ I 1
,um:
I �� _— 1
G _ i—
kttached: yes now ! 1 i- i
ng permit may be required by: PAO yic(e✓ G4 U 1114 . . n See note on back regarding River Basin 11

GENERAL PERMIT COMP J TER FORM
PPLIC.A N i
ADDITIONAL NAMES:
_CDEVELOP AEA:_D .O 4' PROJ DESC: ? _ I2
DESIG: (Will
WORK: 131-- 2) i 2_ TC /6, 8
M.T.T:
(;•-III only:al=4) -
: �w 9 9 Z- H /V\ S L 0 L 9 0
(x-EI only-,.-6)
ACTION EXPATION
D_ E &FILL REQUIRED:
CAMA MAJOR DEVIL REQUIRE:- :

V / 1
i-ir74' AnDtget,is v20 :.4w6 Li i_i_rT i{),1E.-
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•
DIVISION OF COASTAL MA NTAGEN.d<'NT
ADJACENT PIPARL4N PROPERTY OWNER NOTIFICATION/WAIVER FORM
di
Name of Individual Applying For Permit �/f/ %/_//5 �/�,/7 726
Address of Property: `7 /i !% i'22 z j 12:k �/
(Lot or Street#, Street or Road) �(
f,// i22, 57�9,P NC E-' - ..5
(City and Cowlty)
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 pro)oosing. A description or drawing; with dimensions,should be providcd with this lcttcr.
//� ] 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 do not wish to waive the 15'setback requirement.
Siel—Nrme `/ ,A">( Date .'`Xi- 6 .
'P'Print Name N /. �
f 6),Ve! .............3............AVIA
Jrn o

---
DIVISION OF COASTAL MANAGFME_NT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Po nxi-•
r
Address of Property: /q,9 1�/�G L;1 C7\
(Lot or Steet#. Street or Road)
f1
(City and C. . )
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.
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 wtuvc the 15'setback requirement.
of` I do not wish to waive the 15'setback requ.iiement.
Si`�'oaff e �—', Date
J1i r tr,Ilt,(44
A s.AIS"
'Print Name /

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