39724D - Kjellberg

DAMA/ -i DREDGE & FILL g �'�� �
ENERAL PERMIT
Previous permit#
New i'Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
orized 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 7//. /Zoz.
❑Rules attached.
nt Name Bo6//cidc,-jjood 5cvc.-7 c/l1,ei'-.J Project Location: County 5,La�,sw/G�
s 1 6o(c%S 6&-D 5/7-ce f Street Address/State Road/Lot#(s) O?
YG- ->--' r5Lc s c State A/C ZIP ,?g9& 9 6o/d56o, o S4- e
#(LQ)?VS /33- Fax#( ) Subdivision
ized Agent City c7Ce r-t /v 4G $eacA ZIP .'84,
d ❑cw IOTA El ES ❑PTS Phone# ( ) River Basin L. rr
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
• ❑PWS: ❑FC: Adj.Wtr. Body C'G/c2e (nai
Ali
yes /0 PNA yes Crit.Hab. yes / no Closest Maj.Wtr. BodyWw
of Project/Activity C 5 -c /' f 'K r/c, 4,y Ael cy �=`* ;Nr!)
ft
(Scale: //
(dock)length Age/Go }(
)rm(s) X,2,6 f 1 _ ...
{ I I 1
tr pier(s) Ii It
f j C I i i
1 length I I f
number I
lead/Riprap length 1 I I /I C-.-/'�N 4 / 1 -
avg distance offshore _ _
max distance offshore —� '—� {-----}.'_ " .�._. ,
_.--
,channel I i i1 i
—.-_,.-1--— # __ .- ---^—
cubic yards ---I —
;
ramp i— — - --;
louse/Boatlift ( I
t fI t - 1 -I--4-7� ''
h Bulldozing i i i I - _T—_. i
r t
I 1 ' . : :., I , pr,, 1
A.-J.,.--., .. .-_-_- ... _._+ .. +— _._
dine Length J`-d , - - 9I — It-, a _ _� . Iel - -' _ ..,. i.y� - -I
l -�
not sure yes 1 t CLe��'-#-ram A J/) y ,
4- i.. 4 �__ i I
gags: not sure yes no T 4 I 1 _.— ....... 4 ._. . ..._
torium: n/a yes J I
1— — i , : : 1- I T
Br Attached: (yes i
ilding permit may be required by: QGG�-r /3/Gsr Ga_c-Gi See note on back regarding River Basil

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: (5:kves--7 �G//beiy
ADDITIONAL NAMES: Nao andci ,S
AEC DESIG: k'Zc) DEVELOP AREA:_ �l PROJ DESC: f-
(Will only take 6) (Will only take 1)
WORK: PZ S',/G
(Will only take 4)
MAINT:
(Will only take 4)
IMP: 6,to Z7
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: sfr/o9 8W Y
CAMA MAJOR DEVEL REQUIRED: 57sloy- 8/5/61e-

DIVISION OF COASTAL MA1 AG i 'N'T
AnTArFNT RTPARIAN_RV OnERTY OWNER NOTIFICATION./WAIVER FORM
Name Of Individual Applying For PeL nit : J I�✓�-'1 c /120e
0
Address Of Property: v O I kqo c).
ee),-, e_e_r_...ct As) 6, Rron_s 643
-- -- {hotor-Street # street or Roit, 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 .
Tf von have objections to what is baing _nronosed , please write the
Division of Coastal Management , 122 Cardinal Driv.a Extension,
Wilmington, North Carolina, 2B4_05 or call 910 395-3900 within 10
days of receipt of this notice Na r,.spons.- is considered tha, same
as no objection if von havia bean notified by C=0-tifilad mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
house or boat lift 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 must initial the appropriate blank below. )
I do wish to waive the 15 ' setback requirement .
t✓ I do not wish to waive the l5 ' setback requirement .
31Z( oI�

DIVISION OF COASTAL mANAGF'mEN
ADJACENT RIPARIAN PRO ER Y O1 ER NOTIFICATION/WAIVER FORM
Q o L, i a--ye -e,- C
•
Name Of Individual Applying For Permit : Ste Ue, ) ,
0
Address Of Property: �� v,�
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 provi with this letter.
I have no objections to this proposal .
Tf von have obj erti ors to wlat i s being nrop-QaPd_, n1 fasA write the
nivision of Coastal ManagemPnl- , 127 Cardinal IlrivP Extension,
Wilmington, North Carolina, 28405 or call 910 -9 5-aszs) within 10
days of rereint of this notire No response is considered the RAMP
as no objerti o. if you have been no1-ifipd by CArtifi Pd Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
house or boat lift must be set back a minimum distance of 15 ' from
my area of riparian access - unless waived by (If me. you wish to
waive the setba , 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 .
- E
Sign Name G`�

3 ' Q ¢ 3724 Duxford Dr
Raleigh, NC 271
Office-Fax [phone]:
Cow on, Inc, Mobile[phone]
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