28289D - Williams

CAMA and DREDGE AND FILL (., ps . S I oat// 34-
GPERMIT
E N E R A L 23289-)
as authorized by the State of North Carolina
)1 :,,...-. Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC 7 il. 2/h"J ) / p(
i)Ay, q1 6.°"
Applicant Name 4 if Pry kJ, II, Ain S -+-�Pti. o/' S� Phone Number (c)' t' J cle.ti • g-i6 3
Address 60 .3 li 0-4 5/
City S I&4 C i`'11-`/ State (1/ ( Zip J S ti 7.5
Project Location (County, State Road, Water Body, etc.) A v 3 t/ 4.71 57` y S N A'j C ; r 1
%
4 r_) —4`PA 'iv)N- /44 ' (4/1 , / ,'t-$/ll `-v e)
r
Type of Project Activity r‘dc?i i4 tP P/4 i 3 1/`14e-11-) Rt~Pk-Ein r'ti-1-
PROJECT DESCRIPTION SKETCH t (SCALE: / . GC) )
Pier(dock)Length _f X JS , .
Groin Length �,',.,�,,,,__.,,,.....
number
i i /— •
Bulkhead Length ---)-/ NM .
4:...
max.distance offshore
' AV C 1111 111111 __. __._ • __ _._
Basin,channel dimensions II 11
cubic yards 1
Boat ramp dimensions
—
Other ? i OX ......__.
_
1� ... --. - - l ,
11111111,1111 1all
II
, ,_, __.e .__ _____.,.....„
This permit is subject to compliance with this application, site drawing x 9A?.-.-44,.....,,,,,,,,,,,,.<,--
and attached general and specific conditions.Any violation of these terms I applicant's signature
may subject the permittee to a fine, imprisonment or civil action; and I
may cause the permit to become null and void. r �SL&�
This permit must be on the project site and accessible to the permit of-
( permit officer's signature
ficer when the project is inspected for compliance. The applicant certi- /Q - 0(I—0) 0 /- 0`/ - 0 .:Z
fies by signing this permit that 1)this project is consistent with the local issuing date expiration date
land use plan and all local ordinances, and 2) a written statement has
been obtained from adjacent riparian landowners certifying that they 7/I . //UU 7.//_./0 C'(..,
have no objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that this project .�4r 0(), `)v ( 1 •4,. 30 o s_
is consistent with the North Carolina Coastal Management Program. �1 application fee

• CODES FOR AEC DESIG_ ATIO_''S
"On' - Ocean Hazard "PT" - Public Trust
"fir' - Estuarine Waters "CW"- Coastal Wetlands
"ES" - Estuarine Shoreline "FC" - P,
-agile Coastal Natural/Cultural
"PW"- Public Water Supply "OR" - Outstanding Resource Water
CODES FOR PROJECT
- Private-usually an individual "F" - Federal
"C"- Commercial "L" - Local Government
""LT"- Utility "IT- Housing Development
S - State "0" - Other
r CODES FOR PROJ DESCRIPTION
"11"- BulartR:.g,Riprap "16" - Utility Lines
"12" - Piece, Docks Boathouses "17" - Emergency Repairs
"13"- Boat Ramps "18"- Beach Bulldo ng
"14"- Wooden Groins "19"- Temporary Structures
- _ "15"- Maintenance of Basins, Channels,Ditches - - --- - _- -
GENERAL PERMIT COMPUTER FOR
APPLICANT NAME: A l 1 Pti ti
ADDITION AL NAhES: DAL) t-(eN�
4E AREA:EuJ pT , S DEVELOP RE :—6.O �' PROJ DESC:
( oniyuko o) i --
CwZ;oni �
WORK: eR ,5 5 y v
(Wril only 116=4)
a 55
. .Ivi AINl: au
(Fili only take-.4)
11\e: DV/ 3 3 v
(will only laicc 6)
ACTION DIMATION
DREThi L P7T.L R.QUIR_. -0q V 1-0 to-0)-
CAM A MAJOR DEVa,,REQUIR 77): L 0 - O'4 1)i 0 t-0 y-o

Ia
4
•
n ICION OF CO4CT 4N4GF.N NT
4D14CENT RIP 4RI4N_PROPERT: 0 WNTR NOTIFIC4T1ONfW&TVFR FORM
Name Of Individual Applying For Permit ,4//t i �, /1 e a zi
Address Of Property: 663g & f& S
S(Arf Gi1' 1 , a8`ti-5 © isktd co.
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described to lie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
/ I have no objections to this proposal.
If�'ou] hAVP. (7Il1PlTinns to what 1C h inp nrnposP� nl aCP R/ritP the niyi i n of Manaq.ement, 177 North Cardinal Drive, Wilminon North Carolina 28405 or call 910 '395-
'm90() within 10 days of rat of this notice. No response is considered the same as no objection
if von have been notified by Certified Mail
ATVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sa.ndbans must be
set back a minimum distance of 15' ^ ea of riparian access unless waived by me. (i you
wish to waive the setback, y mnst iniral appropriate blank below.)
'7-elk) I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
7- -- 6 /
Signature Date
Co"n ► e wells
Print Name
Sic as9 - 197ff NcDENR
Telephone Number With Area Code ..ARDJNf. DEFARrM=N-or
ENVIRONMENT AND N4UF«FC SOURDS

DIV1cION OFCO4�T4I1���'1DOE?•iE\1
' n • -ER NOTII✓Z('4TION/NV 4IVER FORM
•
Name Of Individual Applying For Permit: f- t t�n t I j q rn5
Address Of Property:
5L1r4 C j� air gq.5-- lens/ow Ca.
(Lot or Street #, Street City & County)
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described to tie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter. •
I have no objections to this proposal.
If von _have objections to what is tieing primed, please write the Division of Coastal
Marra xement 127 North Cardinal Driv WilminD-on, North Carolina, 7R405 or (-all 910 39z
";900 within 10 days of receipt of this nonce No rr_ ssnonse iC consideresfthe same as no objection
if you have been notified by CP,rtified Mail
WAIVER SECTION
I understand that a pier, dock, mooring piiinRs, breakwater, boat house, lift or sandbags 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 riwcr initial the appropriate blank below.)
I db wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
S.45411-' Pugh
signature Date
witfir
Print Dame
..e �
NcDENR
-re e •i..pnone Number 'With Area Code NDF:71- ::AROLJNA DEPARTfraNT OF
` =NVIRONME i AND NQURA: R:S'JUR;^S

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3005 I
D. ALLEN WILLIAMS 66 112l531
NCDL 1744453 WILLIAMS ' y G� 0/531
512 11,11
E 1056500 Date
E.WESTBROOK ST. PH.910 285 4810 O i
WALLACE,NC 28466 �oO ",
Pay to the �f/ �'. I!
Order of •
d —�� Dollars 8 y;
11
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BRANCH BANKING NORTH TRUST COMPANY ji ' I'�
WALLACE, CAROL�A_` _` ___________LT
•
For
• So 3 O5 r.. 4,
...• -J:• ..`:..... 's. v---.�•:.• ��� GUAROtANO SAFETY YELLOW()EYE
t:053LOLL2LI. SLL67843
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