35081D - Montgomery

LAMA/ DREDGE & FILLS ' N3t
iENERAL PERMIT Previous permit#
dew Modification _Complete Reissue -Partial Reissue Date previous permit issued -
Eed by the State of North Carolina,Department of Environment and Natural Resources /Z oO
oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
4les attached.
Name ilir f-f l..,v'- /M blu(hO/s4 - f Project Location: County - k •
-VD ''C, /0 0 Street Address/State Road/Lot#(s)
f2 1 c)1( L L 6 ff— State VC' ZIP rxq' O l(G 05 J4C.'AJ. /�,
)1+45- lit( Fax#( ) Subdivision P P ' f r
:Agent S/ifl%/ X-IC 1( - 77 City W it M 1A/4 TLC ZIP 7k L/0
❑CW / ?EW I-XPTA ❑ES ❑PTS Phone# ( ) ----- River Basin L'T/fid—
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body -6k( --/ CTv (na m;
ElPWS: ❑FC: `
s PNA ye / no Crit.Hab. yes / no Closest Maj.Wtr. Body c t A -
'roject/Activity OP` U(t 1 C i,„. (1t&v , r/a1cO//t f- - a1Da. "4,_.5 de
/ U ( (Scale: '1/3 i
)length X 1
) 1oxIt;
.(s)
th
)er
Riprap length
istance offshore
distance offshore
reel
yards 14/`A17 -ki CF--E'6-)•-.r_ .r. `"
Boatlift 4 .__..- r —1 ._ _ i c/ /j,/ /
lozing
1 ©i ��Z to' 6
D
ength /Z
( a11
not sure yes no 141111114111411„
Inot sure yes a v/ \► , \r/ "� {
n: n/a yes if-0 kgAO � . }
I
no
ached: yes (CS) _.— �Qfti \ �,,.._ V/
�t /�,, Vl
permit may be required by: r / 1 W • I i See note on back regarding River Basin rule

GENERAL PERMIT COMPUTER FORM
?PLICANT NAME:MOrr f 5011- f1/1-r?a from
)DITIONAL NAMES: 5".`z n 7-4( I
:C DESIG: lA- i {7T DEVELOP AREA:0 D Z'PROJ DESC: P - 2—
ill only take 6) ————
(Will only take 1)
ORK: t (/' ) -/p S _ g/ (6
ill only take 4)---, -
( � - rO � ��
Z7/o
kINT:
11 only take 4)
EP:
1 only take 6)
ACTION EXPIRATION
:EDGE&FILL REQUIRED: Z ° Y: 3 `(.9�
,MA MAJOR DEVEL REQUIRED: Z f 3 ° S - /7- p t

/17/2003 15: 19 9107993402 EDGEWATER rn::RIrJE PAGE 03
DIV ISIOJSI OF_cCZASTA I.,hi4N14L MF_N t
RIPARIAN PROPF zt Q tQ O r.i- -• - -
Name Of individual Applying For Permit: ►t _ s o+n Mon 0 AAr f
Address Of Property_ 11,03 ke{r;
IA1I , 1,, f ,0 , NC 2$9o3
(Lot or Su-eet A', Street or Road, City & County)
1 hereby certify that I own property adjacent to the above-referenced r t:
P aP r't')'• The individual
applying for this permit has described to ime as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions. should be provided with this
letter.
Z I have no objections to this proposal.
)f yott.
12Z elina 284QS nr cait_salusffL
if you have-berm notified by Certified Dail
invisor
WANF.R SFf7.1710.N
1 understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of
riparian unless wish to waive the setback, you mutt initial the appr i te b access be ow.)waived by me. (If you
op
ZW-A-C-10 wish to waive the 15' setback requirement.
I da-nnr wish to waive the 15' setback requirement.
- -
Nmeennionimmommimumemonw
1 - ZOC>7
iture _ nn,. ATIPIA!

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igned By: Edgewater Marine Construction, LLC
ress: P.O. Box 365 =
Wilmington, NC 28402 M
ne: 910 443-1106 V
910 799 3402 �� /
scale : tin . = 10ft . 0 V
x V
Dimensions :
Pier : Eft . x 40ft . V
I-head : 10ft . x 16ft .
Floating Dock : 8ft . x 16ft .
Shoreline : 120ft .
< >
6 ' 0 "
-- - - -

f
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Signature , 1 ORD
item 4 if Restricted Delivery is desired. X /l� l• 0 °Agent
• Print your name and address on the reverse Addressee
so that we can return the card to you. d
• Attach this card to the back of the mailpiece, ecerve b' (�rinted Name) � C. Da of Delivery
or on the front if space permits. ��► ' . (ILA l, t 4
D. Is delivery address different from item 1? Yes
1. Article Addressed to:
II If YES,enter eliv ddress b % No
fly_ Kehne V• P,I4,Ck,le-(tif✓v spsJ
35SLI3 5 ReL Olf\\
PPJ1,,
C0hCOtAI v 3. Se ceType
��(1 1S Q Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number
(Transfer from service label) 7003 1680 0006 5575 9073
PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540

.
REMITTANCE ADV
ICE 66-112/531
TER MARINE CONSTRUCTION, L.L.C. LAMA `
P.O.BOX 365 (T ,'1lC 6'rnel' I b 6 5 8 3
WILMINGTON,NC 28402 LDS ���>//i y L!!.
PHONE:[phone]
CHECK
Ur DOLLARS AMOUNT
rY10 .�tliYl A F(I R/Yl� I O (y
TO THE ORDER OF DESCRIPTION CHECK NO.
IJ;� 1 Mon1onl 1AMA�r/rv1if l6SR1 $ 100 •p�
� DE � Y
Maar G� 350'
Brae!Basin/and Trust Company 5 C `"""
11'0065831i' I:053LOLL20: 52LL86479811'
'1 URITV FEATUR(-5 MI)Hi)PRINT BORDERS-COLOR!))BRICK PATTERN-WATERMARK ON REVERSE SIDE-MISSING FEATURE INDICATES
4,114
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