36828D - House

CAMA/ ❑DREDGE & FILL
iENERAL 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 (..1�y �
oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 'i`* 7 N ` ' O 0(1'
C Rules attached.
Name T e c 3 L ' House Project Location: County rJ i ,; ou.
i s q i7 et.k l eli F°4 0i Street Address/State Road/Lot#(s)
.‘/;01+a✓. State NC ZIP b328 9 Hj i i-th :)¢
.?(c' ciga._S116(00i
etlo)59 -I 68q Fax# ( ) Subdivision
tdAgent S-FCvc A 44;,�o✓ i City si,-r C1T ZIP 28/14.
❑CW W $P T TA ES ❑PTS Phone# (9/CI).Se 1 -/6 8 q River Basin Li 4,4
❑OEA ❑HHF '-'IH 7 UBA -N/A
❑ PWS: FC: Adj.Wtr. Body Cc-1"t ° 1 (nat /
es / no PNA yes / no Crit. Flab. yes / no Closest Maj. Wtr. Body AT kity
Project/Activity ;\ vc 1.i'61r t d-r eX,Si .—) ekotK L' r+1.S-i41 ( toQJ fti+.
(Scale: I/L 2.1
k)length
s)
'r(s)
gth
fiber - --y—+
/Riprap length
distance offshore
distance offshore /�
,nnei C o V A __
lc yards e /; '4 r i. s` x its '
s `
oatlift jj.S.Xj1.5) (,n
of C,�1f4 )
Ildozing S n,t
z8. 5
/�- s.0,-1-- &x;9I:..� it,
Length in J S/ is 1 e)C'c k (Z
not sure yes o Iv c•"5 ' G r
yes p1 i_ rill ( re-0/21
not sure1
/
im: n/a yes k S-i PL
:tached: yes ' no r
g permit may be required by: .SOU(4 (.' l'i \/ See note on back regarding River Basin ru

GENERAL L PERAE T COMPUTER FORM
''PLICA T NAME: J
DDIDONALN4MES: • -)-t GVe A't/ i„0,- i
DESIG: G C/ ?T �S DEVE,OP AREA: C. PROJ DESC: P 20
ill only ta::6) ) / ----
(Will only tat::I)
oR_K: ff L 115 1.1.5 •
ill oaiv a;;.4)
:4ll\1:
RI only taiz 4)
LD: O 4M' l �7
I only a;:.6)
ACTION E ?CATION
' DGE& 1 7/(0/0"tl S/(oJ
01)
,MA MAJOR DENELREQL 2- / io/ o S//O/Dl-

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: J4ni.E„5- ,L, s,c
Address of Property: 2/// 2 (5/-
(Lot or Street#, Street or Road)
)--te,6 � �c (a/c /,‘„) _.)
(City and Couiity)-;-
I hereby certify that I own property adjacent to the above-referenced property. The individua
ipplying for this permit has described to me as shown on the attached drawing the development the:
ire proposing. A description or drawing, with dimensions, should be provided with this letter.
� _ I have no objections to this proposal.
:f you have objections to what is being proposed, please write the Division of Coasta
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-390(
vithin 10 days of receipt of this notice. No response is considered the same as no objection i
ion have been notified by Certified Mail.
WAIVER SECTION
understand that a pier,dock,mooring pilings,breakwater, boat house or boat lift must be set
Ick a minimum distance of 15' from my area of riparian access- unless waived by me. (If you
rish to waive the setback, you must initial the appropriate blank below.)
--J01..) I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
'�j�_SC �..s� `� g� //Z'1-/ !�`}'
i on Nama \ T1„F,. -��

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit:
_. 4 n1 S Z . 4 asp
Address of Property: 9/// 2 sS c7I:
(Lot or Street#, Street or Road)
,5-4,,P 6- WC_ 0/)/ Z.0 6J)
(City and Coup --t
I hereby certify that I own property adjacent to the above-referenced property. The individuz
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.
0/
.41 I have no objections to this proposal.
[f you h:v�b'ections to what is proposed, plea
se being y p p se write the Division of Coasts
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3901
within 10 days of receipt of this notice. No response is considered the same as no objection i
(ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier,dock,mooring pilings,breakwater,boat house or boat lift must be se
)ck a minimum distance of 15' from my area of riparian access-unless waived by me. (If yot
vish to ive 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.
. - Gil
4/
/ zdv AAA
'on Name r� �.

•
BANK OF AMERICA
ANTINORI CONSTRUCTION
896 HWY. 210 66 19/530 -/ C,' G
HOLLY RIDGE, NC 28445
[phone]
TO THE
ORDER OF I
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34 V ( 36
AUTHORIZED S GNAT RE
MEMO � /q��
v / 000E1059iI' I:053000 L96i: 0006505 2 L99011'