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S
_ C'AMA AND DREDGE AND FILL
GENERAL l4, 9291.28 "b
PERMIT
as authorized by the State of North Carolina
0 Department of Environment, Health,and Natural Resources and the astal Resources Co mission
in an area of environmental concern pursuant to 15A NCAC 1714 11 o e- rill , 12 t]-
Ap licant Name PC4-e r (-f'. r 4- Phone Number
p � � S
Address `}�.1-{ DO P-u r.b r- L. N -Q
City kit 11OA 1 n --,r State/ A. C Zip �' V "11/
Pro' ct Locati n (5ount tate Road, Water Body,"etc.)�H 00 4- /`7•r. i-,t.*c az-g st D f"i i A-�,f� �.cp Qa
00jAc C4:4 TJ r I W W it L to c4r �3rr�, k4. /� l 1
Type of Project Activity Con 5Try(."r re -rk p 6v/IAlw(4 q" rCel AP 4.44.4 DF sitokel f" 4/f Wt7/'K if.
`oAstr,,c4 6' X IOD ,pit wrh, /6.XLLr 'T le,S 4 ` 3Jh1'- 44/,h rLa..1E" ea'i4//4--pi
.1- bPg4.C61) 4 wa4erwc -A ekt 4. . Aril es«rtfr re faled f.,,s4,-,,14,,;,, 54 /�/ d' 4i- /ck,i' /c
Fro" 6'4c,it rip,ir,i.r. C.,rr. 'J.,- /,,, e V, A-1 4- -�-.,i, Oec1r5A�re 'f J3, ,D-T A/W V
PROJECT DESCRIPTION SKETCH /9-i L V ‘117 (SCALE:or
Np, 7p c(f )
Li X 3 �..•
t. �'
if
Pier(dock)length j, 1x �a i 1
oy� - i 1 1 1 i
N 0 + l 1
Groin length �� 4-1- r LvJ/'� A 1 D�1 t [ T l.r11
L.. ertic-t J.-4e 17 )• /l oo Nt"
numbe
Bulkheadrlength !pr.(P 1 9/I, IA oO .5 r/ q/p l�,
cl praX iv `Pe il._ r. 1 t_ { r(
/ L 1 /
max.distance offshore t C>�4!�(1 /1 u /►t�t-C c
J
Basin,channel dimensions '1 Y v * t. ( f CJ
Y ' , ,
0,;>•> i► �10 e,A _1 ,
cubic yards !/
.r f _.
Boat ramp dimensions *41 °. * lY -'_;
Other i— ti /fl'x Ta' •l' w n .,•^�if'y
ar
gaq-ktir1 1a 'x2o' Ii• ��. �.
- .. 1,
130' 1
•
This permit is subject to compliance with this application, site �._
drawing and attached general and specific conditions. Any (At/14 —?74 violation of these terms may subject the permittee to a fine,
imprisonment or civil action; and may cause the permit to be applicant's signature
come null and void.
a .(11PcuA ,
This permit must be on the project site and accessible to the pelt
e it officer's signature
permit officer when the project is inspected for compliance. — / /� . 0�
The applicant certifies by signing this permit that 1) this pro- .4i-70
ject is consistent with the local land use plan and all local issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no , / J O i�V �r j a3
objections to the proposed work. attachments
0/ 5ab
In issuing this permit the State of North Carolina certifies that ��1j /1 i) 3 Lea
this project is consistent with the North Carolina Coastal application fee
Management Program.

DIYESTON' OF COASTAT,MANAGF,MF,NT
C: ; AnTA F.N'T RIPARIANPROPERTY (1VY11TFR NC1TTFiC'AT1ON/WA TV ER FORM
•
Name Of Individual Applying For Permit: ' fot-er
Address Of Property: 224620 ber
VI t t l'n i vt }vim LL P-er isle Coc,�
(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 toltie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter. .
XI have no objections to this proposal.
if you have objections to what is being proposed please write the Division of Coastal
• I •V II -nt, 127 North Cardinal Drive Wilmington, North Carolina, 28405 or call 910 325-
- 3900 within 10 days of rreipt of this notire N - leis 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 jm .ct initial the appropriate blank below.)
•
I do wish to waive the 15' setback requirement.
I donor wish to waive the 15' setback requirement.
e.
,ipoye."41,7„) � s
c, A7C51rAii
•
tz„naffie,,, Date
iff
Print Name 49 ? �
NcDENR
Tel ephone Number With Area Code NORni cAROUNa DePnRTI.mNr OF
ENVIRONMENT AND NATURAL RESOURCES

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTTFICATIONIWATVER FORM
' - - - -
Name Of Individual Applying For Permit: -Fc,+e- 6. i4c r
Address Of Property: 21620 -1 -or bt t'•' Lane_
Y Y 1 I'►'� ✓� P-P Y1de Oun
(Lot or Street#, try" eet 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 tome 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 h7e nhjertions to what is being proposed, please write the Division of Coastal
Management, 127 North Cardinal Drive, Wilmin5on North Caroii_na,28405 or call 910 395-
'3900 within 10 days oft of this notice No response is considered the same as no objection
if you have;been notified by Certified Mail
W ATVER 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 arrpss 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.
I do not wish to waive the 15' setback requirement.
()241-e
7
Sim ture Date r
/,4Nry (I1 IJ/14- 444- r��•�
Print Name
(?/r) d'L c zc NCDENRTele hone p Number With Area Code NORTH CAROLIN.4 DEPe1FtT1•LHr OF
ENVIRONMENT AND NATURAL RESOURCES

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