38503D - Hosack

+CAMA / DREDGE & FILL'1V
ENERAL PERMIT Previous permit#
F'New -Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
.rized by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC '7H.4 2- CO
❑Rules attached.
nt Name He. --/-7105aC,4 Project Location: County bi-tr; :vt % ��.
s '?Z iie .ids icf>// ,E.,c/ Street Address/State Road/Lot#(s) /6/0
/ems v; //e State n/GZIP ,2-83/;-- L;74,-. .
# ( ) 9''`/--757/ Fax#( ) Subdivision
ized Agent_ _ City0 /den /3each ZIP ,2F4-4
d CW II EW rTA ❑ES ❑PTS Phone# ( ) River Basin Li c r;
• OEA ❑HHF ❑IH ❑UBA ❑N/A
I: Adj.Wtr. Body Cc +'7a-t (nat
PWS: ❑FC: /mow
yes / no PNA yes Ls//9 Crit.Hab. yes / no Closest Maj.Wtr. Body
of Project/Activity 7 574 11 25Ulc74 Li,
(Scale: /
dock)() � c9 .G.,o -S
s /6 X length 7 X� Gvs� i._ ,.. i r r ,._ ........_._— 'r.... r- ---.._.. ---------
:length j j
number i /� I
1 I I I C I
lead/Riprap length I I 1 ' i I
avg distance offshore I 1
max distance offshore —. 1- _ } I
,channel 1 I I if i i j
cubic yards 1 j._. — .. 1 b. 13i.._ '
ramp --- _ +— 1 •-._._-£XI N4 - - —�
iouse%Soatlih. 13 X/3 i ! -- 11
a V
1 Bulldozing ! ' t •
i
r I 4--- 1, i
t , lif , , c.,,I -‘: . ,
r � ir,-��- � mr � __
I
dine Length O I r ir
) 0 t 6 /,�{tr_'0,ie d ; --
not sure yes no i l =
P j t Le c.
>ags: not sure yes no ! t � I
torium: n/a yes no r ..-_
is: yes
:r Attached: es no ' ; 1
!ding permit may be required by: e .-7 FOC.G c-% Li See note on back regarding River Basir

GENERAL PERMIT COMPUTER FORM
.APPLICANT NAME: KCJ1 SQC -
ADDITIONAL NAMES:
AEC DESIG: DEVELOP AREA: . PROJ DESC: I -)-
• (Will only take 6) (Will only take 1)
•
• WORK: L f 5, 13
(Will only take 4)
MAINT:
•
(Will only take 4)
IMP:
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: _ 24 /0(7i 7/2-q l4t-i)
CAMA MAJOR DEVEL REQUIRED: 21(04C- -7/29/0c!

JUM.1.3.6J101, ,y10bHM NLULNK W1KO NO.628 P.5
•
•
DIVI_STON of COASTAL MANAGEMENT .
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER. FDRM
/
11
Name Of Individual Applying For Permit: \rk Sic I�
Address Of Property:
1-\OLb V Lc\c/t
(Lot or Street ', Street or Road, City & 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.
I have no objections to this proposal.
If you have objections to what is being proposed , please write the
pivision of Coastal Manaoement1 127 Cardinal Drive Extension,
Wilmington_, North Carolina . 28A05 or 910 395-3900 within 10,
days of receipt of this notice. No response is considered the same
as no ob-iection if You have been notified by Certified Mail
•
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
house, lift must be sat back 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.
•
tur � k 1.lc,p/�.Q. 3/2/
� DO to l
0 an -p_ _ii i K,pfr�r vv�u igfiu✓ fir

_ N0,828 P,S
•
JUN.19.2001 9:06AM NCDENR WIRO
DIVIETON OF COAL NA.NAOEMENT •
AD,TACENT RIPARIAN PROPERTY OWNER NOTIFICATION_/WAIVER. FORM
Name Of Individual Applying For Permit:
Address Of Property: —
(Lot or Street #, Street or Road, City & 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.
I have no objections to this proposal.
If you have objections to what is being proposed . Please write the
piv .sion of Coastal Management) 127 cardinal Drive Extension,
Wilminaton, North Carolina . 28405 or cam, 910 395-3900 within 10
days of receint of this notice. No response is considered the same
as no objection if You have been notified by Certified Mail
WAIVER SEGTION
I understand that a pier, dock, mooring pilings, breakwater, boat
house, lift must be sat back 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.
1 do not wish to waive the 15'setback requirement.
- 3 117:71
Signature
Date

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HE HUMANE SOCIE
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53000 / 961: 0006902 . 02 : IN 3356v : i ,, €
The Humane Society of the United States