27415D - Ferris

CAMA and DREDGE AND FILL
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R A L -� 27415
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PERMIT 3 (.1A
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC 7-}-1 . I Wu . I =0(-•
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Applicant Name I,3't\\t A t•-• Q . .-e4'r't S Phone Number '1 otL —7 63 2- [c365 (AA—
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Address 1411 1 2- --ivtrvJAi I ( tJ F.J
City Lt?(1( ca r cd State f J 0 Zip a�G 2�1
Project Location (County, State Road, Water Body, etc.) " u ne,uji C L- (ri_)u r%#-i t 1-.J, T d , St c, 2.
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Type of Project Activity N uA) -1- u.l 1c ;a l\k". \.) p te-�.f', c1 t Y 4•:-- t c 1.fA F bor,4 i't'1
J 1 'f , c i-v.vc srV S-k (Ur\ 1 l,-) t 'ti,N (50 t .-t Ioit( cS 4 a-f c h of I
PROJECT DESCRIPTION SKETCH (SCALE: 0071
)
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Pier(dock)Length t�e 1 f u 1l r• 1
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t A — „. . . ,- aulkhead Length
max.distance offshore .2-1I 4a -r' t
t, e ' . c
b _ Q , , ___..�....._ -
Basin,channel dimensionsII
cubic yards 1 i
Boat ramp dimensions ! Il
Other IU Y. i t` �' it t
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u'x 1 l' C 1 v A+ c-- ----- mil —iii_..
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This permit is subject to compliance with this application, site drawing ,Jr L/61/1/M471
and attached general and specific conditions.Any violation of these terms plicant's signature
may subject the permittee to a fine, imprisonment or civil action; and .--...\
may cause the permit to become null and void. i2 . ,(`'1 —
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- 1 t p ( (� 1 I 0j
fies by signing this permit that 1) this project is consistent with the local I 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 ) r' • ( J Uf' ' I:2t.,U
have no objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that this project I DO . 7__-
is consistent with the North Carolina Coastal Management Program. application fee

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DIVISION__OECOASTAI. MANAGEMENT
ADJACENTRIPAR1ANPROPF4RTyONER NOTIFI ATION/WAIVERFQRM
Name Of Individual Applying For Permit: UI'1 ) l)O (CI S5
Address Of Property: Og I (A}6TI7if /011 64.= #VC
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(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'me 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_ltave_ohjections to what is being proposed, please write the Division of Coastal
Management,_12LNorth Cardinal Drive, Wilmingtnn, North Carolina, 28401 orsall 910 395-
39Q1:1within 1f days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail
WAIVER SECTION
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.)
4,�.�` I do wish to waive the 15' setback requirement. V
I do not wish to waive the 15' setback requirement.
41617:11Y1rSignature Datewit�'
Print Name NCDENR
Telephone Number With Area Code NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES

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VARNAMS DOCKS & BULKHEADS INC
PH.910-842-6007 "I
86 VARNAMTOWN RD SW 66 112/531
SUPPLY,NC 28462 3 1 62131
DATE
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PAY ///��� I iuv"0---
TO THE r E N l� _
ORDER OF --
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DOLLARS
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BB&T
BRANCH BANKING AND TRUST COMPANY
! SUPPLY,NORTH CAROLINA
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