27311D - Myers

CAMA and DREDGE AND FILL -1 27311
G E N E R A L
GPS PC6 iSib P
PERMIT
as authorized by the State of North Carolina
)011 .• Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC '1+4 . 11UU
Applicant Name We S 1ev\ Mv,c;,r- `-, Phone Number y 1i) 51c1 - HOCo Lk
Address OW U iUPa+D L tq`^C.--,
City C0 G Sink kkF.---• State Oka Zip cz,2 1 U U
Projectje Location (County, State Road,�t Water Body, etc.) " Nub c.Lk t c K- (o . r- , 1 2 61
be `c, ...', r^ `-k-re2-E t TOb\ck r ` est\c k M+mil ' 14Adc._) C A-nR
Type of Project Activity UnCc -( d A{ L,I t Co r One ( ` ) toolelt
1'CNAY-- baPr't S .-(� '\'h, s S-'Y U c1u re /
PROJECT DESCRIPTION SKETCH (SCALE: )
Pier(dock)Length 111111 I '
Groin Length m_ ins.. R s EN
number 11111
Bulkhead Length IIIIIIIIIIHhIIIIII
max.distance offshore III 11
EN ■ 01 mmill00
Basin,channel dimensions MI I
11.1. uI1IiHI!i1IIIIIiiI
A , , ,
1 r
Boat ramp dimensions e � 1 III ` !IJIIIbpa III
1�'1111'f\ _
p Fil
I _ 1
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it
P. 4 All
1111 1,
This permit is subject to compliance with this application, site drawing _ 41
and attached general and specific conditions.Any violation of these terms applicant's signature
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit of- \ permit offirr's signature
ficer when the project is inspected for compliance. The applicant certi-- 5 } 15 ! U 1 8 ) J u 1
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 l . 1 -VU
have no objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that this project It I (X) ,
c/
is consistent with the North Carolina Coastal Management Program. application fee

G .IiER,A1_,TERMET COMPUTER FORM
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WORK:. 6. 1._. I l X (4 _
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ACTION aTRATION
DP €P LP3QUIRM: S IS I o I 8 j us/of .
C 1 -�MAJOR_ .P QJIR :

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DIVISION OE COASTAL MANAGEMENT '// C Z
ADJACENT RIPARIAN PROJ'ERrY.OWNER.NOTI LCATION/WAIVER FORM
Na re Of Individual Applying For Permit: _ .; ? :1.
Address Of Property:. „LA Lift. L* .
tL.ot err ;ytr i #, Sueet or Road. City & County) •
I hereby ceriity 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
• they arc proposing. A description or drawing. with dimensions, should be provided with this
lr.tt:�r,
._.. .. I Slave no cxbtet:tiOtts tv :his prolxiS tt.
it you.. have .objecuons t,o .Wbat_ts._beulg prnpnced, pl ase._.wrise:,the .1:aivLsiot) cif Coas:a:
Managr mi nt.. i2.7..No11.11_Cardictat.Drive..Wilmington.-NoM.-C.atoUna_ 2_3405 or ca11.91.0_3 5-
within 10 ciays.of rece& t of this_uo:ict. ._No.t pouse consu ered the same_as_nosibjecrion
iou.-have.1)een,tauii fled..by Certil-lcd Mail
h+kA. VFR SLCT1AN
1 understand that a pier. dock, mooring pilings, breakwater, boat house. lift or sandbags must be
set back a minimum distance of 15' groin my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below,)
A, \ 1 do wish to waive the I3' setback requirement,
1 daJacti, wish to waive the I5 setback requirement_
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l r, Ci`fC Date
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EH..A n[,.�man 14/41!a9SL W. .11,2• u%gP

PAGE 01/01.
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2;tJy lAdjaCellt LO propttr.tv. The individual
,zydr;,Iying for [t.) .riLieao t -41•41-achiA thc
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PH.970-842-6007 HEADS INC CO c ., : .,. .•
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PAY SUPPLY, NC 28462 iA;"�f��TO THE ,'`'��l''mi! ORDE OF__-66,.._./} DATE _� Q .,I�,..).1'!,' 6G-112/531
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BB&T
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BRANCH BANKING AND TRUST COMPANY ��
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