22560D - Williams

•
.� r CAMA AND DREDGE AND FILL P �x �a`f�� o
GENERAL S NR f c ( , , NET. 22560- 0
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health,and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC -7 F • •/d o('
Applicant Name 9,14 LA L✓, lllit y,J Phone Number (9/0 ) ' 0 r - 3 7 7
Address I 5 0/D /71./I 4& I A¢7t_t,
City (f/0,11H -- /*i/ 3'T4C H State A/C Zip 2c?-6/60
Project Location (County, State Road,Water Body,etc.)_ ?—P, 14'6• (-^'4 S 117 r 2 SUH 'G l) , C)t ,14 k'' a) .
Type of Project Activity /'i(/frt /"/ Pf
4- r(),,.-44-E.-1 - i w,_ o C (,,aR7k -N P.s61,/ 3PTAt ii --f» 2 314 i /-I i A PP,e/r,i f 4A f)
N-r• )L.1 ; tire' (Ad u ,rP.\,r, 4-r.
PROJECT DESCRIPTION SKETCH (SCALE: /4-yet )
r -
Pier(dock)length, XI'''.c)
Groin length c \ �J
`,.. ,�P `A♦ '
number 0st \'),`') A'w
Bulkhead length tt`Q`
max.distance offshoreS. P, o0
Basin,channel dimensions \ i•p 1
cubic yards r`�
Boat ramp dimensions ,Ilt-/
Other F/04 t
i-,O.-ri4L) l'/ '1vdd '
This permit is subject to compliance with this application, sit- \/
drawing and attached general and specific conditions. Any X
alb 2?aie.../Le.--L-.
violation of these terms may subject the permittee to a fine, 1/ applicant's signature
imprisonment or civil action; and may cause the permit to be-
come null and void. -
This permit must be on the project site and accessible to the ��XCC��• / permit officer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- 0 OI- Ov j 0 1 —00
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 7 4 /0 00
objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that �1 Lt
this project is consistent with the North Carolina Coastal application fee _if
�v� ��
Management Program.

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit: i4 ilk g. 0_,/,c444,02z,
Address Of Property: /7ij OL0/ v;GLlL5 /A,
/f/. 7 6-.6;2 gc4c (0.vs/a 4y ,fil.
(Lot dr Street #, Stret or Road, City
Y & 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.
t.//' I have no objections to this proposal .
If you have objections to what is being proposed, please write the
Division of Coastal Management, 127 Cardinal Drive Extension,
Wilmington, North Carolina , 28405 or call 910 395-3900 within 10
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. )
I do wish to waive the 15'setback requirement.
r I do not wish to waive the 15'setback requirement.
•
0.). i-hcott--
0
S na ure D to 111117&.
Ao0GCAS id, 140c-KET ' .r
Print Name ..�..`�
( 33`) G711- RZS/3 �I I--INR
elephone Number With Area Code

i '
" DIVISION" 07 COASTAL ;+IANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIATION/WAIVER F J,'
/O�RM 5J/
Name Of Individual Applying For Permit s -.P ,F? /dam!Z6
�• r
Address Of Property: // e, ..e .e C,,e .
p Lot or S et 4 Street ‘elortAreo'
Road City &-Coun y)
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. have objections to what is beihq_prro_n d., p1e4sc write the -
Division of coastal_ 4nagernent.,.- ._1- 7 .Cardinal Drive Extens an
Wilminat$n. North Carolinas 26405 or call 910 395-3900 within 10
4 ys...of receipt of this noCice. ores apse ctisidered_the.same
as no objection" if you have •been notified by CertW,_e.ctJ4ai)
W,-
WAIVER SECTION
"1 understand that a pier, dock, mooring pilings, breakwater,. boat -
house, lift .or sandbags must be set back a, minimum distanOe o .15' '
from my area of riparian access unless waived by re, (xf you wish
to waive the setback, . you mkt initial the appropriate blank "
below. )
1 do wish to waive the 15'setback requirement.
I do hot wish to. waive the l5'setback requirement.
---- ---
, / . 10111101
- ' .
..... _
Signs' ure - _ - Dale ,A,
4
f,
Print Name I +_*_*+r —.
Telephone Number With Area -Code
_ '

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A.
ELF AWILLIAIIMS
E Box 4047 WILLIAMS
P.O. CITY,NC P 5910328 379
Pay to 7w s 1343
Pay t M �47 0 DATE
�f� 66-19/530 NC
)/(" 702
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N �j $ v
onsg k
NationaBank,N.A. 4h
dollars �^;M
For
1.0 5 3000 1961. 00060 00 G
Mer
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So �G�����
1343
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