39724D - Kalinar

' 'CAMA/ ❑DREDGE & FILL
GENERAL PERMIT Previous permit#
` New _Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
iorized by the State of North Carolina,Department of Environment and Natural Resources
a Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ////143U
Ngules attached.
int Name Cita i/e,- /e(G/ rt 4 v- Project Location: County Pe•1 K'-
ss `/ )1 Cote Wv, Street Address/State Road/Lot#(s)
116,npdiei.4 state VI ZIP 2$g1143 -�iirl
#( I ) 2GZ-tv(1IS Fax#( ) Subdivision
ized Agent Tim �Ori a City ZIP
d ❑CW $1 EW PTA Q9ES ❑PTS Phone# ( ) Old
JRiver Basin
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Al Ol y/KO�
I: Adj.Wtr. Body (nat
❑PWS: ❑FC: ea h 6 r
yes / no PNA yes p/ no Crit.Hab. yes / no Closest Maj.Wtr. Body ��
of Project/Activity / tv/)oo PA
i7/o t Ile- ,/�.',,,7 frec iJi 7"�°`Odr/f • /
l it
/ (Scale: -
dock)length /G0 X G' /
rm(s) /i A /Z •
Ty/id, id.l?F r
pier(s) ... I j — I
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length — I
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number { i'1' ! D
cad/Riprap length kjpgr
avg distance offshore i it
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max distance offshore a....
channel t (i>� N
_ubic yards
.amp --.7-r-'-.,_.-- J— - --
ous oat' 124 i?i I
a 1 i - i
Bulldozing
• - o nLet/ 8X Zv‘+i4t I � '
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line Length —t-
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not sure yes o ,V SO
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ags: not sure yes no { —I ---
:orium: n/a yes no �./e ri.. .. �...-....._......._
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s: yes no _ I T__ _�
r Attached: yes
ding permit may be required by: ` . , ///❑See note on back regarding River Basin
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• DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit:
•
Address of Property: ,t'n L (j
(Lot or Street#, Street or Road)
9--e44,01 c2ir-Ncitn(
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individ
applying for this permit has described to me as shown on the attached drawing the development tr
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 Coas
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3S
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
set bck a minimum distance of 15' from my area of riparian access - unless waived by me.
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.
Si Name Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: L- K� (L 4 C-1 h `�
Address of Property: L Cc( C a 611-2-kV(Lot or Street #, Street or Road)
\CrAlWIA-- 2971
C
(City and County) 7 u
I hereby certify that I own property adjacent to the above-referenced property. The individ
applying,for this permit has described to me as shown on the attached drawing the development ti
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 Coas
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3c
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
set bck a minimum distance of 15' from my area of riparian access-unless waived by me.
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.
' ////7/04/
Sim Name DatP

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