38578D - Moose

il LAMA/ ❑DREDGE & FILL
3ENERAL 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
2oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC /h ; . ,
❑Rules attached.
t Name .T' Tbt, v i d Mays e, Project Location: County El pa).SccJiG .
(g 30 On e ro k ce Road Street Address/State Road/Lot#(s) 61
(DV 61 cf.., State SC, ZIP 2,q so I //.-,-)I,iCj fl'i -
E( ) Fax#( ) Subdivision {/
:ed Agent 57-cvc Cern u}a cam(. City a'P.z2i'I.LkeG c'aA ZIP 2K'b
❑CW [4W kOTA ❑ES ❑PTS Phone# ( ) River Basin Lie m i
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body Ci cis (nat /1
❑PWS: ❑FC:
Closest Maj.Wtr. Body /V CO&cJ
yes /0 PNA yes / no Crit.Hab. yes / no
F Project/Activity C0-71 37 C-f / /ew T o6 ii,,cf. _66.=c-k ( /-e jy(ace,'
(Scale: ///-I-
sZ
ck)length ,X Q?' 14417
!
i(s) 6 X Zv r,lact -_.- `_ ._.- l
QIIG
1 i
t
iier(s) I 1
t t [ i
ngth } j i {
i AO 1
tuber
. � i j I I
d/Riprap length - 1 l� t
g distance offshore .. ,._ . ; ........ ._... - .... -
1
ix distance offshore -f ,- _._-_ _- -,------
1
hannel 1 i I
1
bic yards i i
n {
ise/Boatlift I4 41 / ' W V! v
4/ I '�' 0`y
Bulldozing 0rI I
— p
e Length �<). — .
.
_i___
ictt l kilt(
t f
not sure yes 3
; I ! I
not sure yes ® i + ' F^`Ole -1 f
1
lum: n/a yes 1...... i
1 ,
4ttached: yes ("no i I 1
ng permit may be required by: Or1-o+-7 /6i . 'ac_% . n See note on back regarding River Basin r
, r. — . _

GENERAL FERMI I ( Uiv1Y U 1 LK r UKM
APP) 1CANT NAME: ✓'d /6705:_-'
ADDITIONAL NAMES:
AEC DESIG: ea) DEVELOP AREA:_ .Q/ PROJ DESC:
(win only take 6) (Will only take 1)
WORK: 1k U
(Will only take 4)
MAINT:
(\,ill only take 4)
IMP: O /L 0
(will only take 6)
ACTION EXPIRATION
DREDGE &FILL REQUIRED: - /1b�V- 3/2O/C)17/
•
CAMA MAJOR DEVEL REQUIRED: 570&./o y /2(Vali

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: 1)44 4 (Yl oo')t—
Address of Property: l09 l.J,IN1 To
or Street#, Street or Road)
L. z ,4 40
(City and County)
hereby certify that I own property adjacent to the above-referenced_property. The individt
ipplying for this permit has described to me as shown on the attached drawing the development th
ire proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
f you have objections to what is being proposed, please write the Division of Coast
✓Ianagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-391
vithin 10 days of receipt of this notice. No response is considered the same as no objection
'ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must 1
et bck a minimum distance of 15' from my area of riparian access -unless waived by me. (
ou 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.
1 �
y/;Y/ /
ign Name Date

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Received by(Please Print Clearly) B. Dab of 3ti -ry
item 4 if Restricted Delivery is desired.
• Print your name and address on the reverse
so that we can return the card to you. C. Sig j e ■ A ent
• Attach this card to the back of the mailpiece, g
or on the front if space permits. ����r� ❑Addressee
D. Is delivery address different from item 1? ■ Yes
1 •rticle Addressed to: If YES,enter delivery address below: 0 No
T len1 Ov,1 r.1 t..,J1 I)
log 51-,0_11,4cl D,,►�..
3. SSer ice Type
LvM g 1Da , I‘)L 2.13? c 2 0 Rertiie Mail 0 E ss Mail
Registered eturn Receipt for Merchandise
0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) []Yes
2. Article Number(Copy from service label)
'S Form 3811,July 1999 Domestic Return Receipt 102595-99-M-1789
a
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY -
• Complete items 1,2,and 3.Also complete A. Received by(Please Print Clea • rB c to of Deli
item 4 if Restricted Delivery is desired. .i5 Af� / try Z.
• Print your name and address on the reverse
so that we can return the card to you. C. Signatu = ,'•. c c.
• Attach this card to the back of the mailpiece, X i " �'iz, ❑ ' CD
or on the front if space permits. ::,,•,1y;,--_ee
D. Is delivery address. erent from item 1?!-
1. Article Addressed to: If YES,enter delivery address below: 0 No
ZtL.5 T a+ Nia► 41 R4)
3. Service���� Type
�,1, rtified Mail 0 Express Mail
co , 1r I^ Lr'J ���`Mi5istered Return Receipt for Merchandise
4 . - ❑ ured Mail 0 C.O.D.
1).,\• �► A 0, r 4. Restr ted Delivery?(Extra Fee) 0 Yes
_2. dili `NI(CoP).J nice abel) N
PS Form 3811,July 1999 r Domestic RL°v ec 102595-99-M-1789
J.David Moose
Vice President
Certified Mortgage Originator

66-85S. B. CONWAY CONSTRUCTION CO. 027217426
27217a 3 56 2 4 9 5
6
P.O. BOX 7383 910-790-9737
WILMIINGTON, NC 28403 nA re_s ' Z�—�
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