36809D - King

CAMA/ DREDGE & FILL 3
IENERAL PERMIT Previous permit#
New --Modification ;Complete Reissue - Partial Reissue Date previous permit issued
zed by the State of North Carolina,Department of Environment and Natural Resources
costal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7/74, /2461
! ❑ attach
Name TAB V' to e Project Location: County 4,1jRules
4 S c✓f
2 O2 E. Kt u‘f. 2�2// ', Street Address/State Road/Lot#(s)
/S__ Statehe ZIP lyC- '56 of e._
(70) WI-- 681 Fax#( ) Subdivision
ed Agent City ZIP
❑CW W j$PTA gES ❑PTS Phone# ( ) River Basin 4/ea,
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body Cad)
Oat /e
PWS: ❑FC: ,i/Cad
es / no PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body
Project/Activity dW141 / (/15eIf kid" ( 74 71-a -Pr"r 5 f% /? � ie/.
c)length (Scale:
_) //IC
r(s)
th w n' j
ber 0r Jf -,-
CI
Riprap length i?/ /
fistance offshore 131 2 f
distance offshore
nnel O ,
yards _ r
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/Boatlift /3X /3' besT+.
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dozing 1 4-
_ength
not sure yes4152 2.go G £ c- U U ki Jjli`ii
not sure yes 11
Ti: n/a yes O
Yes s*
ached: yes i' :
permit may be required by: �i y kg ©�i i€ . See note on back regarding River Basin rule

•
• GENERA.' PERMIT CONIPUTER FORS
APPLICANT MA.NE: 4-10/11• CONlie
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AEC DESIG: DEN'w-OP=.- i:_�.Q 2 PROJ DESC: p - 1Z
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ACTION D?IR.4TION
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29-2004 10:25A FROM: T0:17047861419 P:1
)VI I • A11 MAN AQ MENT
AD.I NT Rl:'
WA1 VFR FORM
Narne of individual Applying For Permit: 047 r C 0i/4 /) I h
dt ress of
Property:r; C�!c7�'� (� Y<Le `jIOr
(Lot or Street is, Street or Road)
0-4A
/(
(City and County)
hart y certify that 1 own property adjacent to the above-referenced property. The indiv,riuzl
1pplying for this permit has described to me as shown on the attached drawing the development the
arc proposing. A description or drawing, with dimensions, should be provided with this letter
t-<1 I have no objections to this proposal,
if you have objections to what is being proposed, please write the Division of Coastni
Mwnagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
within 10 duys of receipt of this notice. No response Is considered the same ns no objection '1
1ou trove been notified by Certified Mall,
ANIFFACSFIZIC
•
WAIVER SECTION
1 uudersrand that a pier, dock, mooring pilings,breakwater,boat house or boat lift must be set
be k a minimum distance of I5'from my area of riparian access-unless waived by rue. (If you
with to waive the setback, you must initial the appropriate blank below)
•I do wish,to:waive the 15' setback requirement.
I do not wish t6 waive the 15' setback requirement.
a®
6e,fi, l.S Zov
3in Name f Date Ar9r:AA
lac i(VE it D c vS 1 D i•r, Pu 11 L W o,r
Print Nerve r nw n of ou k :s(knd . NCDENR
Soc..._ou_ Cha.wi.__ o.
ea 1/1 _ �1 f _ i . [Ilw�p..on

29-2004 10:25A FROM: T0:170471361419 P:1
NI
AQIACENT RIPJ RI Op ny OWNER NOTIFICATION/WA1 VFR FORM
Ndme of individual Applying For Permit: . /Oki 9 y, K,
�, it
Adcress of Property: qb / GtG r
(Lot or Street it, Street or Road)
/.( 4 „ 2 )
(City and County)
I hcrel,y certify that I own property adjacent to the above-referenced property. The individual
applying for ibis permit has described tome as shown on the attached drawing the development the-'
arc proposing. A description or drawing,with dimension.s, should be provided with this letter
jhave no objections to this proposal.
if you have objections to what to being proposed, please write the Division of Coasun1
M,►na gem ent, 127 Cardinal ririve Extension, Wilmington, NC 28405 or call 910-395-3900
wirhin 10 days of receipt of this notice. No response IS considered the same us no objection if
you hove been notified by Certified Matt. •
.1
•
WAIVER SECTION
1 understand that a pier,dock,mooring pilings,breakwater,boat house or boat hit must be set
be k a minimum distance of 15'from my area of riparian access-unless waived by rue. (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.
—-
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