28212D - Johnson

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1 CAMA and DREDGE AND FILL
4 G E N E R A L8212
PERMIT -PS Po61/4t4q
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 `?fi . i_Uv
64 & 3c'I t.I& *N
Applicant Name MAC t. '3-nh(\son Phone Number R I U e y(0 -4-SI 8
Address 112. 5 P 1 1-.1, ,.k r 1 'J &G*
City il,0'cJ .,"r k State JC ) Zip ) a Li (r 2
Project Location (County, State Road, Water Body, etc.) r u_ c- 1 c'L.. C G k,�r,4 -Cce _its,In
�u?.54 t m i r- In.)A-\r L -t f 't J C , "�c;„tk'l• o r i r `r, `J
et`Y c � J` -.'t J e-.-/—
Type of Project Activity Ne.,J i,� . 2- kV\COVC,re a b + ' c (Ao r 2 boAi s)
ik.- r-, r' ''-r. (off r ‘ fi c,r i�t.Pdi 5 }v he_ f c 61, ske CS t-i r t!c-'../1 r
PROJECT DESCRIPTION SKETCH (SCALE:` Kj e T T . )
Pier(dock)Length c;t ()(1 ' r • P. •
t j _
Groin Length m E la Q(J ia+ S OilL
-
numberII
Bulkhead Length il le 02.1
4 .4. ,
max.distance offshore
Basin,channel dimensions -` — s —a
„ ... \ ..._
_ _ - t i i X
cubic yards
—_.. ._.- __..,.m _ �._.
Ltk-
Boat ramp dimensions gel
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..._.,o_._..»-_.-.-...-.,..............,.....,.,.,.�, ....�..._ ..,,, ,y... ...... 11.. .0 .......,........,. - --,..�..,..._.........
Other co, 'n C C 4 c-f �1 �..
r _,.L »_. �. .....a I ...
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IN
a c a+ II r -t S _._..-._._ ........ ...._ ._.._.1, Y • 1IUP! I
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Thispermit is to compliance with this application, site drawing
i �
subjectP PP g / , �-
and attached general and specific conditions.Any violation of these terms appli ant's signature
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void. /, .4,,,tie' �1 A-�
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 cert. _- id !01 112.
/
14 I m
fees by signing this permit that 1)this project is consistent with the local suing date xpiration date
land use plan and all local ordinances, and 2) a written statement has ,
been obtained from adjacent riparian landowners certifying that they I 12�'C)
have no objections to the proposed work. attachments
it In issuing this permit the State of North Carolina certifies that this project l UJ. '�
is consistent with the North Carolina Coastal Management Program. application fee

-c-E. E.R.A.1,7ERMET CONI ?UTERFORM
-�PL1C=ST 1"\tl t
ADDITIONAL N ES:
As.0 DrSIG: P \ E .DEVELOP T_--� PROJ DrSC: - I�_
1 ( O ' ti)
WORT . . aOo x I CD
(Val c:ily=kr-.4i) IL, 0
•
MA DTI: • •
(• 1 crfry Y 4)
aW 800 ow- 2e0
WL 44.0 ,0 w aqo
ACTION IP ATION
FILL P QIJIP. - lI1-lIO1 12 1 14 10
CA MA.I 1 CRDE-M., Qom: q 1 1 I-0 1 121 I I l •

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�TSIn'' (�F 'n4CTdi w1. r.... ��
•
Name Of Individual Applying For Permit 4c/C /
Address Of Property: -- -- s,
S„i‘ ere .vG vPete6a
{I.ot or Street , Strect or Road City & Count ))
I hereby certify that I own property adjacent to the above-referenced applying for this permit has described to tie as shown on the attached drawing the The individual
they are proposing. A description or drawing, drawing development
letter. with dimensions, should be provided with this
I have no objections to this proposal.
- - a
a 7
hay h� A
n nntifiA y (`�rtiriP� Rya � A
HArKERseraiaN
-r k, mowing piiin s;br`,aural 'r;
set�a;:k a:r, , boat house Iii or sandbags must
minimum distance of 15' from my area of riparian access unless waived bym u
wish to waive the setback, you miist initial the appropriate blank below.) (If you
,
• �:r _ ..: . I o wish to waive '_setback re re
the
I da_nar, wish to waive the 15' setback requirement.
lif
llY1:11,
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e / d i
Co a
1
'ame .......----,---„,...YAmissmiummull
6 - . 2g-- .3L (3
NCDEttelfR
Telephone Numb
er With Area Cog,.
_ NET*+ CAROLINA DEPARIr„LN7 0F
ENVIRONMENT AND NATURAL.F{_SOIJR.^_S

•
nvtcION OF COACTALMANAGEMr!NT
ADJAC£'iT.RL ARIAN_.SOPFRTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit: Mq vc) L5O
Address Of Property: (����. Nle� (NJ tc1'i �2
.5v� aQf UcJ G • ovvG /
(Lot or Street If, 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 iiie 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 you have o12 •J11t1S to what ie h�i ig prnifos�� Rleae' writ the I)iyicinn
Mans menl, 127 North Cardinal Drive Wilmington North C'arnlintL_264fl5 or mill 41f1.44tj dl
4911Ci within It]days of reoemt of thin �- `No re inn ce it rncid red the came as nn nhjp,c inn
if you have hen nntifieri by Certified Mail
I understand that a pier, dock, mooring pilings, 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 must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
l do not wish to waive the 15' setback requirement.
pr/
y„ t� ��/°:1- Tip•
/ ate
Sign Lure L D
Print Nam NCDENR
Telephone Number With Area code Emotwp o.waor AND Nouww7 RESCUACa
14ocINe Ownc,it%S AcSOC....,. .
T 'd - 17SOL-LS17-0i6 suowai RajueH dL0 :90 TO EZ InC

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w-5_ec. rll.-enfi 2cee docun2en r. See 6nc.t /or deteilTZ 445
jii .
1•�'� SUSAN H JOHNSON '
66-112/531
NCDL 5568473 �210I
it 6254 INLET WATCH DR G� /p p l
•
i SOUTHPORT,NC 28461 PATE—�-—
is $ /d0
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j! PAY `� ----
TO THE
I 0 ORDER OF LLAFES 8 ',-v ' A'
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i 1 BRANCH RANKING AND TRUST COMPANY j�
I, SUPPLY,NORTH CAROLINA - _ ^ AP
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S`j FORS.. 2 ■
u� �:05 � LOLL2Lo; 5 �956452 II
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