78321C Hamilton 153 Jennifer Dr. (1.2 file)

AMA/ DREDGE&FILL W 7W A B �i D
NEFIAL PERMIT Date previou
pour per
Date previous permit issued
C' ew LiModifcation ('Complete Reissue '--Partial Reissue P %
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an ea of envir n rental concern pursuant to I SA NCAC
es attached.'
I_ L ^ �.
Applicant Name G� - (. ��M I U project Location: County. - — -
/ Street Address/ State Roadf Lot #(s) ///� ----
Address
CC--t--- —W 1 SubdivisionPhone # E-Mall / .�T' �f nPI , + A
Y✓ ZIP
City. - �C✓JC-e •
Authorized Agent ------- ------ - # Phone Ri
( __) _.. verBasin
_ —
�j>CW ���'"r �A LIES ❑PTS �j / , ( —unk—n)
Affected tHHF IH LIUBA ❑NA Adj. WtrBody
AEC(s): 00EA
a Pws: Closest Mal. Wtr. Body.
ORW. yes n�o PNA yes�no� .:..
Type of Project/ Activity
Pier (dock) feagth­
Fixed Platform(s) _
Floating Platfonn(s)
Fingerpier(s) i
Groin length
number
Bulkhead/ Rprap length
„e dfaanre offshore
maxdistance offshore
Bash, channel
cubic yards
Boat ramp _
Beathousel wtil 13 KL' -_
i
Beach Bulldozing.-----..- —
Other.
Shoreline Length
SAV: notsure yes o .
Moratorium: n/a yes no
Photos: yes
Waiver Anached: yes n
4 building permit may be required by: _
( Note Local Planning jurisdiction)
Votes/ Special Conditions
c
(Scale:^ /'r% )
I
[ i See note on back regarding River Basin rues.
:atement on backof permit Signatur
l - ) 0, — -
Check# Issuing Date
Ex IratiodDate

I hereby certify that I own property adjacent too MArl k 14wt �w 's
Prope'rty1' located at J 3 j e IV N 11 c 2 6eame of Property Owner)
on w t'S FMo�1f(� (Address, Lot, Blook, Road eta.)
in I ac /c rsfs/" N.C.
(WamrbodY) (City/Town andlor County)
The applicant has described to me, as shown below, the development proposed at the above
I have no objection to this proposal.
1 have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOOMENT
Ondlvldual propos/ng development must flit In descrfpdon below areftach a ahe drawing) I
lie" 41b,129
t x 1 1 1 1 1 1 Er;t'7 faa I t t l ly
WAIVER SECTION t-I--
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by 9
me. (If you wish to waive the setback, you must Initial the appropriate blank below.)
(:�ze I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(property er Into") (Adjacent Prop" Owner Information)
/ St nhrre
G11.4MY»r ✓
Pent orb Name / tt or d fV/l K
pia, 0-3-1, AL
t4,
R,
(Revised Auo. 2014)

I hereby certify that I own property adjacent to
property located at
on
(Waterbody)
The applicant has described to me, as shown below, the development proposed at the above
loca n.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Indavtdual proposing development must fill In descriptfon below o►affach a alte drawing)
1s '/( fir" z4f p laRy �is7`; �y lbook
('fi&A /
P,ecd
64t4k+- /
3to '
t
fr ;4,x, Bulk t��ad i ya r I �a l
WAIVER SECTIONf F---�
1 understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If you wish to waive the setback, you must Initial the appropriate blank below.) ?��U
I do wish to waive the 15' setback requirement. Zl` ^
(Property
U
I do not wish to waive the 15' setback requirement.
Ownerl
e Name
'A,-/.,x Ywd Rd
•l%%n.4 A'A o27 G�
Ip5og4 6M//99®G,�1,a/
Vumber/email eddress
d- 1I0;Ro
m)
50
!Revised Auo. 2014)