20331D - Davis

CAMA AND DREDGE AND FILL
GENERAL )Ckj
N9 020331--0
, Es.:?____)
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health,and Natural Resources and the 9oastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC 7L - lu
Applicant Name elk t L. II LA S / ck ^'� �1 1 Phone Number ��1/U) 3 a 7 3 y 7�
Address t T ty ow
City - //j s<iclp State ti C Zip ) /VJ`
Project Location (County, State Road, Water Body, etc.) 054 _S 3 L7 Atp -f 4.12 ✓
Type of Project Activity d'i J2 f fe '�CiA7i- Lt
PROJECT DESCRIPTION SKETCH (SCALE: / ,. yv i )
Pier(dock)length y t�y0 1. /1-4,4 k' /`� 1 r !
• , --t 1 A , 1 1, - -— i --
Groin length ) i 7 — --r-- —
4- -( - 1 t r — -- } • _ •-)
number I I ( I
-- 1 t.....— .....7.—t, ...... 1
Bulkhead length- 1 ;
II
max.distance offshore 1 ! i i 1 1 I
- 4'
Basin,channel dimensions ( _� 1 ' I
cubic yards i�—i_ f.__� -1-_
Boat ramp dimensions � � - _ }
.,:
gie
Other De(/fi rI' )' ) } i
1r 'er 31
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Q
1 oiq 3 I>r/S t
/Za ' s ( 4
This permit is subject to compliance with this application, site . 77)
drawing and attached general and specific conditions. AnyK O r/i., C Y'C
41
71---
violation of these terms may subject the permittee to a fine, ,
imprisonment or civil action; and may cause the permit to be- appl' nt s signatu
come null and void. ' �..J`'`
This permit must be on the project site and accessible to the permit officer's s(gnature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- 3-J Y--o° c, .c)y _ .)
ci
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 N •/)d6
objections to the proposed work. attachments
y Bank 0+ A .
In issuing this permit the State of North Carolina certifies that p� C.,) C/� - ! ( /0 `�
this project is consistent with the North Carolina Coastal application fee' 9 • ' `�
Management Program.

•
•
DrV -ON OF
COASTAL MAIJA
ADJACENT RIPARIANPROPERTY OWNER NOTIPIC.ATION WA2pEg FOB
,J •
Name Of Individual Applying For Pe-wit:
Address Of Property. --
-
> • j
' ' -
Stree • , Street or Road, <<,� dun y
(Lot
City & Couty)
I hereby certify that I ow
•
n property adjacent
referebced Po ope y. The individual applying for this the above-
as shown on the attached drawingeve1ot has
they are proposing. A description or drawing, the development
should b- provided with this letter. with dimensions,
4/��/ I have no
objections to this proposal.
IfIf you have obiectio s to what is be 'nQ
on of Coa prop° ed
-a ent i 7 Card - pleas writ h
Wilmington North Carolina. 'v
days of receipt of Ca 28405 or call 920 0 'o
a o f receipt
t ce. No 'r _3 00 with'n 10
_f you have e estianse is consider d h
b _n notified by same
__ '-�'fi d i
WA?V�R SECTION
I understand that a pier,E�'
house, lift , dock, mooria ,
fromu ofsandbacs mist be set Pilings, brE-
or ,
my area riparian � back a a,__�;,,,T..�„i ��ter, boat
accessdistance
to waive-the unlessan.ce of 15'
below. ) setback, you must initial waived by pie (If you wi sh
t_r the appropriate blank
the -
do wish
to waive ,S'setback reauirement
I do not wish to waive the 75 !setback re re ment
•
Signature : //-//- 9 ?
ate
P _
•
i
Telephone Number With Area
Code
c'°ff 3Z7- 37S-

DIVISION OF C
ADJACENT RIPARIAN PROPERTY ASTAL MANAG
OWNER NOTIFICATION
WAIVER FORM
Name Of Individual Applying For Permit:
Address Of Property:
/
(Lot or tr et
,. Street or Road, City & County)
I hereby certify that I own •
referenced propert property adjacent to the described. to me as shown�e on individual
duff attached or this above
-
referenced described.
tproposing. Pelt has
shouldy are A description or �g the development
provided with this letter_ drawing, with dimensions,
11'/ I have no objections to this proposal.
If you have ob 'ections to what is bey
Division of Coastal M.anavemEnt � _nQ proposed Please write
Divisi oton North Carolina. -27 Cardinal Drive the
da s of receipt of this notice.28a0S or call 910 39 Extension
as no objection if ou have been response is -390p within 10
been notified
considered the samQ
_ri ed by Certified Mai1
WAR SECTION
house,I oeTstand that a Pier, dock, r
lift or moorin Pilings, bream
of b_ a breakwater, boat
san ' acs must he
my riparian accessb a mom,,;,,,,,,,, o
to waive- the area unless waived `"� distance you f wish
setback, you must initial D ma- (iF wish
below' tie appropriate }�blan
I do wis)
h t0 waive the ,S'setback reoui reme
I do not wish --nt_
to waive the 151Setback reouirement.
Ni( 4,ige,-(2_ ati,a, Ar-P7-/e).
Si tore
Date
PriamN e S Qvt
Telephone Number With Area Code

7 91O
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1
ANTINORI CONSTRUCTION 1403
896 H WY.210 Z - (� 66 19l530 NC ,.
HOLLY RIDGE,NC 28445 Date soya I.�,
7J�
^I Payto the Ntri n
Order of P.% -
I $ s)
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Dollars 8 "- i;,
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Bao erica��� iii__ _
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IVP
I, For 0 IA-0 0-Oki')') f-.a t,M ik r
:053000 L96e: 00065052L990116 . 0103 CDP.91=1.
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