23846D - Hayward

CAMA and DREDGE AND FILL
G E N E R A L cps F-de Slo(o( SlA.4
N. 23846--t
. PERMIT
as authorized by the State of North Carolina
• Department of Environment and Natural Resources and the Coastal Resourc s Commission
in an area of environmental concern pursuant to 15 NCAC 7f4 . 1.)UD - 1 K . 0-)"Y
Applicant Name W,11.t-0,r^ A N h CI;OA 9S.-�4-1 HI\VOA k) Phone Number
Address 109 Tkokkl- AUE
City ?SA,' WEI3K.A4 State ?JC Zip •)ek/i/s-
Project Location (County, State Road, Water Body, etc.) S11rrt' , tt()' tC t,,-t mA+v- cAvk
P=N Co .
Type of Project Activity PR\L)N19 P, Pt' 4 3 T L t{1 / /47,10-7 tf 1.5,t1 M i)
PROJECT DESCRIPTION SKETCH (SCALE: 1 t= )
Pier(dock)Length/'Y'2o f •
Groin Length , r
3 _ .. ._ _.__ N _ . _____---
number
Bulkhead Length
max.distance offshore mm__ mm
r
Basin,channel dimensions
,a
cubic yards µmm� I
I
t_ i En
•
Boat ramp dimgnsiot `)a► O
iiv,tis rrc ....
110111.....' 1 . tliel
Other ; -r.,A+
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imi A • •
den, J
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This permit is subject to compliance with this application, site drawing r . ��
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 3
may cause the permit to become null and void. _ Cc '�
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- -/0-U v 0/-/O - O 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 2 N, '3 0 J
have no objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that this project ,/da G ('t--- 3; ' 5
is consistent with the North Carolina Coastal Management Program. application fee

.,:. kt,rit,iccAii_J 1-/ERI.V1111' COIVII3UTER FORM
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APPLICANT NAME: v.):l 1 ,,,tvvk 44y (A/A-• gr)
ADDITIONAL NAMES: -= --
.. .
• __ ..._ AEC DESIG: E-.".vJ VE • - • DEVELOP AREA E• •elp_a/- PROS DESC:-P - (3..:• - .. . (Will only take 6)
(Will only take 1)
6, C.' •
WORK ilk .3, ao . . 6i-
,(Will only take 4)
• .c-s alio • EL- e /41
i 2G- tl •
.. .
. •
•MAINT:•
_____(Will only lake 4) ,
_ •
7.1 .;.
.
• . IMP: ow 59-
• ,
(will only lake 6) . •
•
. ACTION EXPIRATION ...
. .
• DREDGE&FILL REQUIRED:
CAMA MAJOR DEVEL,REQUIRED: i 0 - I°-00 0(-./0-0 f . .
..::•;i:..y..-::.-:::::..::::•%: :•-'•-•••-: ...'7••••--'-••• '•-•--- •. ... -.....-. ...... • .•..- ••• • • • • • • • ••••• . •.•.--••-•------•-•••'%-••••:1::-.....:.÷::•.•-::: :.::::::::....J.i:f:.7.::::;.-?.:: ::::_.;1.:•:',..!;.:

•
'se PrE i BeR 20 2 aov , .
A ��j,,Y --,..:.` �+ n t. �r9 may*yr
�TOW ", G.F '/ 'fapSAi�. l gr t 9`Tv�°�s(�"' Sty M
•
BEACH K
N O R ~ :1/4 Post.Office Box 3089
V I ' Topsail Beach. North Carolina 28445-9831
Telephone [phone]
' Fax [phone]
1
DIVISION OF COASTAL MANAGEMENT:
•
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVE FORM
Name of Individual Applying ForPeimit W ILL SAN L. 4 ELlZAt3ETM Fr I-fAWWARO
Address of Property: 109 TROUT AVE .
TOPSAIL BEACH PENDER COUNTY, NC
(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 ine as shown on the attached drawing the development they are proposing.A
description or'drawing,with dimensions,should be provided with this letter.
L SEE BELOW)
I have no objections to this proposal.
rJ0 LONGER
APPLICAaLE
.No response is considered the same as no obection if you have
- been notified by Certified Mail.
(I 0 DAY R 6.5 Pa W S E. Tit-1 E
WAIVER SECTION
I,understand that a pier,dock,mooring pilings,breakwater,boat house,lift'or sandbags must be set back
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. F— r , -a{
I do not wish to waive the 15'setback requirement ~ %~ 'Jew cow
FLOATING 10,
NEW/ -
BOAT I
Signature Date ` kej
® e.EFT 'v 1y
►5'—T 12 •W t {4 ►5'
SETBACK / x NEW sE?L�ACK
22� {, '
Print Name //aa \\ = 2.5'x8.5' S5 0' '
�., ttt„r•t/r,467,/„t„,lt,iiiii r17, ttZ,fr4l tT7tit eel
Telephone Number With Area Code E%i5Ts,. NEW ,Fqi }
wALKwAY iO WALKWAY ui 'I 2 •
"� LAND o LAND o►
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m SENDER: I also wish to receive the
0 .Complete items 1 and/or 2 for additional services. following services(for an
•Complete items 3,4a,and 4b.
$ a P-int your name and address on the reverse of this form so that we can return this extra fee):
card to you
•Attachp this form to the front of the mailpiece,or on the back if space does not 1.0 Addressee's Address •
■Wn ea'Retum Receipt Requested"on the mailpiece below the article number. 2.Cl Restricted Delivery l
g •The Return Receipt will show to whom the article was delivered and the date delivered. Consult postmaster for fee. '
g 3.Article Addressed to: 4a.Article Number
S l
I 7 a
� If4b.Service Type
0O Q7 V e_jen— ly ElRegistered Certified l
v ,/ �p �7 El Express Mail CIInsured
k /l.I C. oC 76o 17 CIReturn Receipt for Merchandise ❑ COD
7. Date of Delivery
5.Received By:(PrinOleme) �ku
6.Addressees Address (Only if requested
nd fee is paid)
tiktB.Signature:(A A l v/1 v '>
I PS Form 3811,December 1994 102595-9e-8-0229 Domestic Return Receipt

UNITED STATES POSTAL SERVICE First-Class Mail
11101 Postage&Fees Paid
USPS
Permit No.G-10
__________.�._.... ._ •;t1'lt'1._.. . -. ...,fie_-4+-`hR— i,;..._115'144
•Print your na e, re§§, an ZIP Cow m this box •
ice. o. / 3a A
73SfJ /L &&14c4 Ne
31 l��l�llitlt�l��i�l��l,1,l�l�l,�l��l�nll�n�llluil�tl,ll�f�ll

•
ai•SENDER: I also wish to receive the
.v_ •Complete items 1 and/or 2 for additional services. following services(for an
w •Complete items 3,4a,and 4b.
w
■Print your name and address on the reverse of this form so that we can return this extra fee):
card to you.
•Attach this form to the front of the mailpiece,or on the back if space does not 1.❑ Addressee's Address •
perms Restricted Delivery• i
4 •The Return Receipt will show to whom the article was delivered and the date Consult postmaster for fee.
.
5 3.Article Addressed to: 4a.Article Number
It f. iDe21-16)2 R 4b.Service Type
3 /6,/6 V/LLAGE 6gIE'N Dt+ 0 Registered eaCertified'
L.
G 1C,N y C -1 7z. 0 Express Mail CIIRS8rACP
ElRetum Receipt for Merchandise ; CICOD 6
7. Date of Delivery 3
5. Received By: (Print Name) 011V 8.Addressee's Address(Only if requested
and fee is paid)
6.Signat . (Addres orA tJ
1 -191�✓
2 PS orm 3811, December 1994 102595-98-B-0229 Domestic Return Receipt

UNITED STATES POSTAL SERVICE /, t7�r L"`� Po.. Post-Class fv a.
� F f stage&Fees
f: PM USPS
Permit No. G-10
1134:f5-.4.t pie_ • 3- t3.....47.;....RTR.-_�T+� 1 SS 4
• Print your name, address, and ZIP Code in this box •
w y D
pa Bd)c 5 7
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it

WILLIAM L. HAYWARD OR 3285
• ELIZABETH F. HAYWARD �'`�75� sa ssrsii
AT RENFREW DR. �j�`-rw`-'Z I V C ATHENS, GA 30606 Date S
•
' Order of
Paytothe N C D E J R $ toe '
•• CRhLvtouebiErna4 '''c collars
SUUST
SunTrust Bank,Northeast Georgia,N.A.
Athens.Georgia
For " lrLk V CO& v ° sA
I:06 L L006641: 5712257733o° 3285