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t ' CAMA AND DREDGE AND FILL -
GENERAL P. 0 . 3°� g � N9 O 2O318- t>
>�n►l A SL; 1 -e, AV 1
PERMIT 3yi
as authorized by the State of North Carolina
0 Department of Environment, Health,and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC 7 II •1 J O° 7 01/. I Sic'.
Applicant Name ir/i^ /ti �^ 1 ) ' 6 - (/ C
-� Phone Number � �v / 4
Address 9/I) / `/ 5 t
City 5 (A . f (,--1," State Ai C Zip )S
YYl_
Project Location (County, State Road, Water Body,etc.) S -,--e Ali P / 4--'/ /)." C(44A
Q z S/o by e.o .
Type of Project Activity Pof/ '4 t. iq' Pr, .R°4 1 L , 4 4 i,t.to 4,4At,U 1),e67—D6-/it.�/
41 Alt r apt,D 1-><i u t`t d 1' 7#! . /]6 t✓ 7 f-( _ ' v S /�-!' A?P/y J
PROJ ECT DESCRIPTION SKETCH (SCALE: / ''od i )
rL .
Pier(dock) length Y� -4
N ��
AAL
Groin length f ChNr
number Bulkhead length 74.,> 1 1 rA V J
max.distance offshore /
Basin,channel dimensions (
13• I
go/ tier A/-01 'Ai L t�
cubic yards 11 i D t
Boat ramp dimensions
Other �At-j L/r r /- 4 'r
/r ' yI1' 47,1L/ (1
1 y 1 _t_
This permit is subject to compliance with this application, site ' (77)
drawing and attached general and specific conditions. AnyL
violation of these terms may subject the permittee to a fine,
imprisonment or civil action; and may cause the permit to be applica s signature
come null and void.
)44-16.
This permit must be on the project site and accessible to the ;1 permit officer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- 3 `a 1--0Li (o_d )—UO
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
objections to the proposed work. attachments ? I/ • /� G° 7+� . /���'
bank.or
In issuing this permit the State of North Carolina certifies that i.0 oU C 1 3(/4, AMA,this project is consistent with the North Carolina Coastal application fee
Management Program.

•
I3:VISION OF COASTAL MANAGEMENT
ADjTAC ENT RL'ARIAN PrtOPERTy OWNER NOTIF E:ATION/WA R FORM
Name Of Individual Applying For Permit: 7i 44 i
Address. Of Property: q%0 / 9'�-5 t
(I.ot 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 toitie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
have no objections to this proposal.
If you have objections to what is being .proposed, please write the Division of Coastal
Management,' 127 North Cardinal Drive, Wilmington North Carolina '2R405 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.
I clo_not wish to waive the 15' setback requirement. •
"gitel:771- 11///r//iir-e-7 - ,5ign e Date / • �
riot Name
6i/e _If NCDENR
Telephone Number With Area Code NORTH CAROLINA oar_
OF
ENVIRONMENT AND NACIURAL RESOURCES

(77i
1'3
9700 _
iSlsx_ R
a CI
\tial-A
y4

(6); �`" U�r wcsh 7V IS1ON.OF COASTAL MANAGEMENT
G rVi`' 4a 1a('Fh'T RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit: /41 Ceir>/k�1-\
Address Of.Property: 9.'/ C0 / f ,
•
6v r (7c-
t or Street #, Stror Road, City & Coun
.. ty)
I hereby certify that_I own property adjacent to the above-referenced property. The individual
applying for this permit has described toitie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
/' ave no objections to this proposal.
if you have objections to what is •being proposed, please write the Division of Coastal
Management, 127 North Cardinal Drive, Wilmington, North Carolina 28405 or call 910 395-
'3900 within 10 clays_of receipt of this noticel_Nn response i&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 most initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
.I do not wish to waive the 15' setback requirement.
•
,,,Vpoze
AlliC511F4
•
g��: ���� �� , DateCS/ .�..�''��
rm Name
NCDENR
Telephone 'Number With Area Code NORTH CAROIJNA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES

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ANTINORI CONSTRUCTION 1386
896 HWY.210 I
HOLLY RIDGE,NC 28445 3 Z.�- �J00 66-I9/530 NC
D ate 6070
; Pay to the vl
,p Q
Order of D g 4\ $
Two � ��(�Ob Dollars 8 .
Bank ofAmerica��
:i For */-121-#'115 PA'
t 30 0 L961: 0006505 2 L990ii' L 386 Op
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