25125D - Dorman

CAMA and DREDGE AND FILL
G E N E R A L ,, 25125-U
PERMIT
as authorized by the State of North Carolina
> ;,...- Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC 9 /4 /006 .
(/ S m AL5 S�' 306,)(466111r)
Applicant Name nfi"�-' Dnlift Phone Number
Address 3)b j-fa (CCswt\ L '4
City ItI)lA"14(MA
( State .1\4 '- Zip 2tP/b..3 /�
Project Location (County, State Road, Water Body, etc.) J4'4n 1I(V1 Avj1 (Ltlr �D f�1in At'Di
C 4 VW/ NL%lt/ /-/,ov,d✓40)t. L1.4,4 ili 1613e .hiiir, O r g /
Type of Project Activity l2L'P1*Q LI/Fri w6 /314 `iik
wis
UPS 0- i3-t {- ( S41,
PROJECT DESCRIPTION SKETCH (SCALE: t( = 3 U r/ )
Pier(dock)Length . 1 11
Groin Length __ _ =(
__
number ... . � Litirm 7•741— •l , �. 'Trf' mm" _,_ t.
Bulkhead Length ( i 0 LF E ✓
max.distance offshore
a
Basin,channel dimensions € 1
cubic yards
Boat ramp dimensions ... r it _ .. J... __ ,,,„ mii„,,, fii
Other ili , . .111
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This permit is subject to compliance with this application, site drawing (/9--‘2.,
and attached general and specific conditions.Any violation of these terms iJ applicant's signature
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void. -I-10)--- t--2"- r "Y"
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- a • f 4. - ao 3- 1 4 -o4
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 7 1k . t 16
have no objections to the proposed work. C dH0 attachment!
i.. :......:—«t.:,.....rw..:h*L..,C1..1...-.0 A L-...L.!'......I:.... .-.-..a:L:.-.-al..-a al-:_ - r'1 .n it _ t .. 11'el

APPLICANT NAivE: 3 1k .Q- ,
ADDITIONAL NAMES:
AEC DESIG- q�� D�r.....,OP AREA: p
(WM only takes) `l __ ROJ DES C:
(WM only take 1)
WORK l t o
(Val only tare 4)
1C)
MAIlv"T:
(WM only take 4) 43,
•
� GI
IMP: s� 2,2_Q
(will only lake
ACTION PI ATION
DREDGE&FILL REQUIRED: J - -06 li &
CAMA MAJOR DINE,REQUIRED: << l

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
Name of individual applying for permit I -ihna DD2mA rJ
Address of property 0 / 1438 J/'i► rt r, 14)' j lC `I'• 14/ 141'4171) AI
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 of notification.
Please initial below if you have no objections snot iqa).8,,1 ro m
1
71( ' • I have no objections to this proposal. I��R ��/n� �+,oP2���1'
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, N. C. 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 NA,
I understand that a pier, dock, mooring pilings, breakwater,boat house,lift or
sandbags must be set back a minimum 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 DO NOT wish to waive the 15' setback requirement.
Signature & Date
. 47C A J C)`//
J -5 Print Name
y %G' — 3 92 — / 2 3 Telephone Number w/ Area Code
SAE t -- PLEASE SIGN AND RETURN TO; F&S Marine Contractors,Inc.
P.O. Box 868
S 2000 Wrightsville Beach, N.C. 28480
— Phone/Fax [phone]

• h
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
Name of individual applying for permit m AnEl UD2mA
Address of property i"� # J'Lr�,, Ph; f I
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 of notification.
Please initial below if you have no objections. 11 i4E0 vu t m
I have no objections to this proposal. f a LAMA ApA2mowi'
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, N. C. 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 A(/i
I understand that a pier, dock, mooring pilings, breakwater,boat house,lift or
sandbags must be set back a minimum 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.)
‘k I DO wish to waive the 15' setback requirement.
I DO NOT wish to waive the 15' setback requirement.
-0 Signature & Date
yJ
(d110 13 ...„-&_ 11,., Print Name
/71
7f j 7 iv/ C 07/zg Telephone Number w/Area Code
1184, ; PLEASE SIGN AND RETURN TO; F&S Marine Contractors,lnc.
_, tip► __ P.O. Box 868
•6975 200a1!o Wrightsville Beach, N.C. 28480
\tP- Phone/Fax [phone]

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°s2 224.10' 7.50 N 83°10'W-27.03'
•T6 15' •DRAINAGE EASEMENT N76°5 30 • 19 1 _ _
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NNING COMMISSION ,\Ill//,
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ING COMMISSION HEREBY 1
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N POINT SUBDIVISION , N3°20.30'W--8.00' I

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: - ._.- 25590
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5 e� F AND S MARINE CONTRACTORS, f' ss—esrss�
�i 1 F ` y1'' 141 TEL [phone] /D� G �" 0272005809
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'- P.O. BOX 868, 28480 "�
Jar ,,I ` WRIGHTSVILLE BEACH, NC • DATE /�, . -::: L _ i
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