39734D - King

CAMA / i DREDGE A FILL
ENERAL PERMIT Previous permit#
'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 I 5A NCAC
❑Rules attached.
nt Name C t ice`f 1<:i
W v ' ,, Project Location: County
• Lj /i /r r c r;/rr, : fi Sf r 11.r` Street Address/State Road/Lot#(s)
/rC State ZIP f Lr, ,rrc , if,
( ) Fax# ( ) Subdivision
ized Agent City ' r;FG, ; 11/e- 06(..(- ZIP
d ❑CW n EW -PTA H ES ❑PTS Phone# ( ) River Basin
li OEA 7 HHF ❑IH il UBA ❑N/A Adj.Wtr. Body (nat
PWS: ❑FC:
yes / no PNA yes / no, Grit. Hab. yes I no
Closest Maj.Wtr. Body /+iu:�.-)
of Project/Activity
(Scale: /'%
dock)length
I
I I j
r pier(s) I 1 { I1
I4 A L
I length ' '
number I I , `4
I I
lead/Riprap length ,/ i I i L 1 I
�L + _.I �._ —, fig.— ____+ -- —.— —
avgdistance offshore + --i i_.._ -t —I i-
max distance offshore —
t i j I ` I
channel I 1 . �7Cf Tl n1( ]� �?k
t' ±-; i 1—. _... f K-T cry —
cubic yards T i (
! 'ramp .
f
j
louse/Boatlift I L- i y'T
__
I f Dct, I I
I i i
i Bulldozing I I
r
�//4/I/�✓/.✓/e/i/i///yy 7(✓// //i/i✓4. ✓//,/�/✓f/%�//rig/✓✓/✓/r////%////;
C,... _ '/c G �(j ICJ i .,�.1
)74`, '
:line Length j f
not sure yes no i I j i 140 tIle j f'T1416<<ll: ,Z.io'..-�.• 1
tags: not sure yes no y... --.I I I r - r..., � --� ---
i — -
torium: n/a yes no ; 1
yes es no I_ i
;r Attached: yes no ----` i -- I
(ding permit may be required by: .5/C 5f f,i 6 . I See note on back regarding River Basir

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: gee k j Kt:n j
ADDITIONAL NAMES:
AEC DESIG: i 5 DEVELOP AREA:__.02 PROJ DESC: P - t
(Will only take 6) (Will only take 1)
WORK: 114 50
(Will only take 4)
MAINT:
(Will only take 4) •
IMP: E-I J`OO
(will only take 6)
ACTION EXPIRATION
DREDGE & FILL REQUIRED: //Pi /G 4 C Z/v /°Y
CAMA MAJOR DEVEL REQUIRED: /// /6;4 oZ/o 9/o S

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FOR]
Name of Individual Applying For Permit: t ' II//
Address of Property: 9 L�-1_.i2-i lv 10U 2 S i a+
(Lot or Street#, Street or Road)
c ap, 1—, / L &ACt, N C a g:Li L 9
(City and County)
I hereby certify that I own property
applying for this permit has described to me as shown on the atcent to the tached
property. The ind
ttached drawing the developme
are proposing. A descri tion or drawing, with dimensions, should be provided with this le
_izp
I have no objections to this proposal.
If you have objections to what is being
Management, 127 Cardinal Drive Extension, lmington,eNC 2840 write 5e or
Divisl ion - C
39within 10 days of receipt of this notice. No response is considered the same as no objec
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater,-boat house or boat lift
mt
set bck a minimum distance of 15' from my area of riparian access- unless waived b m
you wish to waive the setback, you must initial the appropriate blank below.) y
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15'setback requirement.
Jk _ i alr 4 ,// a Ar
Seal Name p / v
/ Date
Print Name �i •

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FOR'
Name of Individual Applying For Permit: IL l'Qe
Address of Property: OLLULt s
iacia-
(Lot or Street#, Street or Road) 1
(City and County)
I hereby certify that I own roeoe ��►CSC CD,
applying for this permit has described to me as shown on the a above-referenced property. The indi
are proposing. attached drawing the developmei
A description or drawing, with dimensions, should be provided with this let
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of
Cc
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395.
within 10 days of receipt of this notice. No response is considered the same as no ob'e 5
you have been notified by Certified Mail. ct
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house set bck a minimum distance of 15?from my area of riparian access- unless waivedlft b me
you wish to waive the setback, you must initial the appropriate blank below.) y
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15'setback requirement.
47-61‘ed 4/2 71
Sign Name
Date
(ter ,,Jr- • -
Print Name ic'',

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': COMPLETE THIS SECTION COMPLETE THIS SECTION ON pELIVERY
A. Si nature
lete items 1,2,and 3.Also complete \ R)•1.6.65-k.
` ❑Agent
if Restricted Delivery is desired. X, _. r (� ❑Addressee,our name and address on the reverse a �X�'
t we can return the card to you. B.received by(Printed Name) Date of Delivery
i this card to the back of the mailpiece, �11 �P fie{ r
the front if space permits.
delivery address different from item 1 t 0 Yes
Addressed to: 4• _ If YES,enter delivery address below: ElNo
ii1 it Ble-Vejtk3
V( ; I� 3. Service Type
DoCertified Mail 0 Express Mail Si = W a
�O� (09 0 Registered 0 Return Receipt for Merchandise ❑ �
0 Insured Mail 0 C.O.D. ❑ o
LJ+ u
4. Restricted Delivery?(Extra Fee) 0 Yes
_ 0 ✓-4 a C
Number
fer from service label 7004 1160 0002 8823 1151 II5 . MI-. ``� c--,,
102595-02-M-1540 ,•fJ
13811,August 2001 Domestic Return Receipt V
W �• (0...
0re b., 4 .... .'
i
❑
.1 (Tj
R: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ry
ui
plete items 1,2,and 3.Also complete A.
Si ure �� Ui
your name and address on the reverse ❑Addressee
4 if Restricted Delivery is desired. 0 Agent
at we can return the card to you. • ceived by(Printed Name) / c •=te of Delivery ❑
:h this card to the back of the mailpiece, ��i c� �� �� u'
i the front if space permits. ,A 1-1�-D. Is delivery address different from ite 1? ❑Yes • 1
3 Addressed to: t r—
If YES,enter delivery address below: 0 No I
ti I I
1 J Oil kL- �� ru 1
La1"LiftS.\— ❑
1 • Q:2_ ,
u o L, U I\J C 3. Service Type
`may " / ❑9ertified Mail 0 Express Mail c-1
L
cD-6 95 CA
egistered 0 Return Receipt for Merchandise
1 ❑Insured Mail 0 C.O.D. o
4. Restricted Delivery?(Extra Fee) 0 Yes
14
le Number r 7004 1160 0002 8823 1168
sfer from service label) _ I
m 3811,August 2001 Domestic Return Receipt
102595-02-M-1540 I O
I1 Ili