39059D - Malyevac

gri AMA/ '�'DREDGE & FILL
E'N E RAL PERMIT Previous permit#
t 1New -JModification Complete Reissue Partial Reissue Date previous permit issued
orized by the State of North Carolina,Department of Environment and Natural Resources /� /,
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC -7 r/, /I DV
O Rules attached
:nt Name �}�J t of/ 11 G 1/e (/4 G Project Location: County /3,714 s4'ic 4-
s 2 005i i G 4 r, Street Address/State Road/Lot#(s)
4k 71,14nie State ZIP 2-f5f(0- z--
#( ) Fax#( ) Subdivision
'zed Agent 7mrrt y Pe'fry City ZIP
d E CW 4EW [PTA [ES ❑PTS Phone# ( ) , River Basin
�: ❑OEA ❑HHF El IH El UBA ❑N/A Adj.Wtr. Body 1�J
(nat
❑ PWS: ❑FC:
yes / (io PNA yes /� Crit.Hab. yes / no Closest Maj.Wtr. Body
of Project/Activity 4e /4 d Ci 4, 6-vis-lift? /4Ae. (
r (Scale: .r
dock)length I
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r pier(s) ! I i 1 M T I
length j I i
number ' 1 I 1
ead/ 'praplength - � --
vg distance offshore i }
max distance offshore __._ _
channel
cubic yards
amp — ---!-1,. f ki-k __
t
ouse/Boatlift I t i ' �/Lt�✓ V�~ F .
r 1 1
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i Bulldozing 1 j ' �/� bs
r - 4.... ,, ...- �. fin -; __ , ,•_...._..._
1
line Length i66 �.. +.. 4
not sure yes no j _1 1 1
.
ags: not sure yes no — 1 — .. j.—... .�..... —__.—
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:orium: n/a yes no ._....._ F �_.-.. I L.......1 _..... -—,}....,.
�. .__ _� ,.. ....t ..--_—
s: yes no ; I I 1
:r Attached: yes no I I I : , ,
(ding permit may be required by: tk /4H/LQ . I See note on back regarding River Basin

GENERAL L PERMIT CO_-N'IPUTER EE ORM 3170
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CA MA MAJOR DE v.E QL�^?:

American - Fish Company
P,O, Box 11046 i910, .4.5 •• •
�l Southport, North Carolina 28461
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DIVAI ? oy Q0A0'41,, MANAOEIviaNT
ADJACENT RIPAr '} tc1 PRQneRTY Q NOT IC QN/WA v� �L I ER FORM
Name o1Thdividual Applyiag For Permit; , l C1(•
Adcress of Property: aOO$ "� . . A;„ ¶¶ G11 D ,
(Lot or Street #, Street or Road)
, v1/4.1\S(A.)st C__1(Cv(6))
(City and County)
i hereby certify that I own property.adjacent to the above-referenced property. The individual
applying for this permit has described to me as shOWn on the attached.drawing the development thc•r
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this ro osal,
P P
11 you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal D'Hve Extension, Wilmington, NC 28405 or call 910-395-3900
within 10 days of receipt of this notice, No response is considered the same as no,.objection if
rou have been notified by Certified Mail,
• WAIVER SECTION
1 understand tbata pier, dock, mooring'.piliugs,breakwater, boat house or boat lift must be set
bck a minimum distance.of 15' from my area oDriparlan access - unless waived by me. (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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03/1y
341 Name 'Date AA
' "n

4)
DIVISI9N OF COASTAL MANAGEMENT .
ADJACENT RIPARr*Wl5RQpERry OWNER NOTIFICATION/WAIVER FORM
ame of Individual Applying For Permit: i e
dcress of Property: JT}d `
(Lot or Street #, Str et or Road)
tc-k-Sk • C C- (76r g\ ti)
(City and County)
lereby certify that I own property .adjacent to the above-referenced property. The individual
plying for this permit has described to me as shown on the attached drawing the development they
e proposing. A description or drawing, with dimensions, should be provided with this letter.
ON I have no objections to this proposal,
you have objections to what is being proposed, please write the Division of Coastal
anagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
thin 10 days of receipt of this notice, No response is considered the same as no objection if
u have been notified by Certified Mail.
•
WAIVER SECTION
uderstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set
k a minimum distance of 15' from my area ofriparian access - unless waived by me. (If you
sh 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.
CAA
Name Date

SOUTHPORT, NC 28461
DATE
; PAY
j TO THE
E ORDER OF n•Cla ct,
4LNe9 V•iLm4:txsi/ AJJrL `4-- NZ'CSAI2C DOLLARS 121
FIRST CITIZENS 4"
BAN K c-P-Y
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FOR 4e.310.51b 3905o 3960-7--A 5 '1 Ila 0 39 2 To 1:0 3 LOO 3001:004 5 3 L 2099 2 211' Li41juu
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