38997D - Matkins

'CANIA/ -1 DREDGE & FILL
IENERAL PERMIT Previous permit#
+New JModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
sized by the State of North Carolina,Department of Environment and Natural Resources n H nG I-i 5--Co
:oastal Resources Commission in an area of environmental concern pursuant to I5A NCAC /
❑Rules attached.
t Name f-^,e 6"P,C �`1 ci 4 k ►r15 Project Location: County �G.e1!( c e-
/7C1 IS 6 \ .?erg Street Address/
/� t
Staate Road/Lot#(s)
r ,3a t;1 Qea(!., StateMC zip 28TUU gS _( !C' (/ftie Ave✓IvC
0 0) 3213 - 3 4 H 1 Fax#( ) Subdivision 6, V ec ')► G ra ✓+ )
ed Agent VAle Met";I) City ))1 p ce : ) eeeAL k ZIP 2_04'
❑CW .SEW XPTA ❑ES ❑PTS Phone# ( ) River Basin C q/e
❑OEA ❑HHF ❑IH E UBA ❑N/A Adj.Wtr. Body Ca ha ) (nat /I
yes / no PNA yes no Crit.Nab. yes / no Closest Maj.Wtr. Body /
'Project/Activity N e ke p IA re✓) ,..n - 1 Oa 4 ;•�vi O(G c k) t e,„ -- 1,'. / 4'
rn a ce9A/ d5 , S J
�+1 ✓1A h e ✓� )(Scale: / e
:k)length 4' k I '' ----
iers 3 X Z.S ' ay. 'A11 o io _ A
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ngth
) d: re I ()see` oCk '
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nber 13 I._. 1
i/Riprap length 1ierr-
, —
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distance offshore ft. • _ 1 i _
x distance offshore ► -- j
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x Z o�, et v� PC E , 7---
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8 i '�/I` Z -CAI WA LK-_- ...-__1_ _--
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ulldozing may' t
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e Length ._.
not sure yes I I ) I...._ i i I
s: not sure es
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ium: n/a yes ! I 1 � -Y _1
yes - �_+_ !. I 1-..-
\ttached: ( 1 no n_' . i
ng permit may be required by: -GrS^ j Ix)Q t j'` . ❑See note on back regarding River Basin n
t' , I 1 1 1 i /) _ ) , ). _ - 1 1

GENERAL PERMIT COWL-TER FORM
ADDITIONAL ONA T NAMES: P I 6 rierr
17 - J 2
A C DESIG: Cal / PT DEVELOP A-R k:_Q-O 2 PROJ DISC: 1= - , S.
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WORK: 1 R4 ;I F S 8j f3
(Will =) sM(_ 13 q G —3 Z r 3 7_ — -t
1ST �
only tai:=INT -) -
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ACTION PIRATION
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A MAJOR DEv�L RE trIJZ`"D: r1 161 d y /0/00(1
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Form to be used if not sending by US Postal Certified Mailing
ADJACENT RIPARL&N PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to( ,f `r/IA'rxiA?5, 3-Zs
Fame of property owner.)
property, located at / 7L) G Alt A LIE
(Legal description and/or street address.)
on GA-le / 1/ CJ4 A.Jh L , in Topsail Beach, N.C.
(Affected waterbody.)
I have reviewed the site plan/survey and/or descriptive drawing(s) for the project
being proposed, at the above noted location, and have no objections to this proposal.
(Signature) (Mailing Address)
t_ F ie ( 1 PDLP0i1-) 27° 30TC
(Print or Type Name) (Address) (Telephone Number)
Sworn to and subscribed before me this the day of , 200_
My Commission Expires:
Notary Public
Attachments; Current site plan/survey or drawing of proposed project &copy of permit.
tiVo 1 /j "7",b WRi vE 7-fig i reekk gEya/kli

Form to be used if not sending by US Postal Certified Mailing
ADJACENT RIPARL&N PROPERTY OWNER STATEMENT
n
I hereby certify that I own property adjacent to c—"ie5'6 /. ,9�/�/A. 5 9s
(Name of property owner.)
property, located at 976 G-T4Ytr /9 lie,
(Legal description and/or street address.)
on Gty1 / [/L, Cf9,vA A in Topsail Beach, N.C.
(Affected waterbody.)
I have reviewed the site plan/survey and/or descriptive drawing(s) for the project
being proposed, at the above noted4ocation, and have no objections to this proposal.
oeens c'.a-ti-1-. i' -e74
e.
.� fir 4).
A, tF,pite_C, 3 - --,
(Signature) F (Mailing Address)
5f.i'0261.,1)7 /3/*Scht) jgg(g.z42fudidj,,,f4j ..34/- 0.r//
(Print or Tpe Name) Address) (Telephone Number)
Sworn to and subscribed before me this the day of , 200•
My Commission Expires:
Notary Public
Attachments; Current site plan/survey or drawing of proposed project& copy of permit.
/fir' � '/jam% /e t///1,E/��/J
17.E Wi5/71 ,7v Wi')/ -� �

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