38930D - MDB

1CAMA/ ❑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 15A NCAC y(tr. ) L CO
piltules attached.
t Name WI Q 9 Nnl d;.-,s , LJ.C. Project Location: County e kl el e"-
407514'. P. 6. Drat we.P 3a"7
Street Address/State Road/Lot#(s)
(-4/:i rvt>r,1)4o^ State /U C ZIP /f(') k;,„„ /,S Lpi al of,'it.) /eel
(10) ,2n' ` 44 Fax#( ) Subdivision t
:edAgent (4,rel fl4 ?' , ,, City Ha rgeet01 ZIP ZA
CW ❑EW XPTA is SD' LIFTS Phone# ( ) River Basin cele
LI OEA ❑HHF ❑IH k.UBA ❑N/A A jjl,//�/ at Adj.Wtr. Body
❑ PWS: ❑FC:
yes / no PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body �L✓
F Project/Activity AM L./ c/"A 4-, , do r k -A bee) 4 ( i-It 1 45 i ex i s 1 f,1. er C✓'
(Scale. /.2'
rck)length it.,'
n(s) ''Y/E' 7l ee _ — .._..i r .f Z
>ier(s) . I 1 i ® IN I' t
;ngth
imber i
d/Riprap length ;._ . . .. � ~�
g distance offshore i }_-. !
ax distance offshore 1 i , -- / L l� _ ❑�
hannel
i f
ibic yardsI:4- - ---1,-
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mp
Jse/ oa6 tlift; /3 X 1 3 III 1
a i _ --f
lulldozin
Mill !g _ r s t r-
inialitillittliMil ill J
C
ie Length . / > i I
..� _
not sure yes o
;s: not sure yes o , _, .-
,,
rium: n/a yes no : , ;
` II ' I
yes E I -1 i �7.� 1 !
4 k il reedepal DOI, ! AV / 3.6
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Attached: ye ) no 1 l,
ing permit may be required by: lam-e rtp(eV- •�'^l l Ilk . I l See note on back regarding River Basin

P ' ' GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: Y"` /5 0 (+61(l `9S, L1
-"ADDITION_L NAMES:
AEC DESIG: DEVELOP AREA: o jZ.(Z1.7 PROS DESC: P - IZ
. (Iva'oaly Ilk:6) (u i]D only tak`1)
WORK: c5 , I (,
(A ill only tale 4)
t3/_ 13, 13
MAINT:
iti Doti tk:4)
LW: 0V1/ . 1
(will only take 6)
ACTION EXPIRATION
DREDGE&r IT.I REQUIRED:
CAM-k MAJOR DEAD,REQ aED:

ADJACENT RIPARIAN PROPERTY OWNER STATEMErIT
(FOR A PIER/MOORING PILINGS/BOATLIFTIBOATHOC'SE)
(37 6 - 19414?
I hereby certify that I own property adjacent to la 1-1-01()LtAi s
(Name of Property O'cner)
property located at //
(Lot. Block, Road, etc.)
on S.v7. t,ems-nu- Lt5d7 cu,41 , in ---k, vn , N.C.
(Waterbodv) (Town and/or County)
He has described to me, as shown bellow, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatliti/boathouse must be set back a minimum distance of fifteen feet(if ) from my area
of riparian access unless waived by me.
I do dot wish to waive the setback requirement.
I dri wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature

ADJACENT RIPARIAN PROPERTY OWNER STAT NIT
(FOR A PIER/MOORING PJUNGS/BOAIZJFT/BOATHOUSE)
# 1///14,/,1 / LZ C
I hereby certify that I own property adjacent to 's
(Name of Property • n
props located at f/ 7 l . i'!!
(Lot i3ioc�ad, et)
on f2Ziiiite in ��� �/ N.C.
(Waterbody) (Town and/or County)
He has described to me, as show,* below, the development he is proposing a:that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatiift/boathouse must be se:back a minimum distance of fifteen feet(15 ) from my area
of riparian access unless waived by me.
do not wish to waive the setback requirement.
: I dQ wish to wai,ve that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP\IEYI:
(To be filled in by individual proposing development)
•
i- leY1/S7
•
•
• Sienature

O°c1( AND Bo
9r
DELTA DOCK AND BOAT LIFT CO.
'''' . '• P.O. BOX 10429 Phone: [phone]
-INCTON, WILMINGTON, N.C. 28405-3756 Fax: [phone]
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MBD HOLDINGS, LLC PORT CITY CAPITAL BANK
P.O.DRAWER 3007 66-1247/531
WILMINGTON, NC 28406
[phone]
k(1-te/
OF:
HE
1✓ 7 E P $ / 1C
,j7„,
Y M LDINGS, LLC
Gi6b' 38q 3O AUTHORIZED SIGNATURE
000 LO5411' 1:053 L L 2L791: 2 50 366 211'
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