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� • CAMA and DREDGE AND FILL
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GENERAL � 5z � ~ �
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 '"7 (-�
Applicant Name FIm s rr.,d % 11 S m A-rt n.,e Phone Number( i c)) 2 SL 3 O‘c)
Address 5C, 1ik1A7nae.c-‘4 a v s
City ln..)r t 3c-4-S v...
Jl�o 2 a ci State t-.f C Zip "2-S4 S d
O ' . . 4_
Project Location (County, (State Road, Water Body, etc.) SA'�st_ QgQIrP �p��e--
b t4S C Lati N ( 1"-I r GED -
Type of Project Activity
PROJECT DESCRIPTION SKETCH 6 vs C ( t Pm t . (SCALE: I 't = )
Pier(dock)Length i V i i = NI
c'�+/ Y (off I ...__:.�. _. :._`� . _ . -�
Groin Length t W r t
__ ._:. Ill , I
number ,i,m, i , 1 ...,.._ tut . , _.... ___-___ .
Bulkhead Length�0 LF t -- allin 5�
max.distance offshore S £ i
i I Ill ►.
Basin,channel dimensions
cubic yards i , I
I
Boat ramp dimensions
Other / r
� I I i i 3 .... 1
Prak t-q Cam) _.__
.►ti- x t3I---- I — :- 5 t _ _.... ,
This permit is subject to compliance with this application, site drawing
and attached general and specific conditions.Any violation of these terms
applicants signature
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void. CI\
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- 5- i`7 — 6-0 —�2 4-r)
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 1
have no objections to the proposed work. +� attachments

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y /3 I F&S Marine Contractors, inc.
G talikes& AZ • 8 P.O.Box 868
Wrightsville Beach,NC 28480
p-t.��,6j L1 (910)256,3062
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May-01 -00 03: 21P Village Tavern Corp 336 722 9004 P . 02
IW !S!()N OF C()L 511 1 AANArE! EN 1
ADJACENT ! PARIAN1 PROPERTY OWNER NOTtFtCAT!ON l&WGIVFR FORM
Name Lit individual applying for permit J Lin M I 0
Address of property J r b J,c_K 1,�L ui IL1601'95 V
I hereby certify that I own properly adiacent to the above referenced property. I he
Individual applying for this permit has described to me as shown on the attached
drawing the development they are propd-cing. A description or drawing, with
dimensions shoiiko be provided with this letter of notifNation
Aleace 'mi! betc d if yc' hive no obi ctinnS.
0 have no obbject.ui iS io tits proposal.
if you have objections to what is being proposed, please write the Division of C,oasiai
Management, 117 Cardinal Drive Extension, Wilmington, N. C. 26405 or call 9iu-
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,Doat house.tirt 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 no wish to waive the is' setback.requieament.
4&4 110 NOT Vii:h ►v%Vorov the scwu~.V read cm nt•
/1/(ce,2
VVV
5co-if 14- ,c& signature & Date
f �j Print Name
(33 )V / Q`9�r//� TAlephone Number w! Ares Code
RETURN TO; F&S tv elute Conirdciots,bee..
Post-ir Fax Note 78/1 ` (.-".°j ► '►. I
I f'.U- Box 668
'°j r7- (� a»�Rui.iun+ - Cc(' riyruv wrrghtswNe Beach, MU_ 284f3U
L- 014447 W .4°. M. 1t.)412' Phone/Fax [phone]

0 •
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
s�
Name of individual applying for permit Jim in' 0
Address of property S / /,'}ft7N«K "LuD, �i��1�3u�11t & rd WC.
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. 6n. AN9 pkith-49/4161041
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, 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
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.
Of.u13--00
4( Signature & Date
Vaxke NNwr Print Name
s (o - Lic-ck o(c) Telephone Number w/Area Code
PLEASE SIGN AND RETURN TO; F&S Marine Contractors,Inc.
P.O. Box 868
Wrightsville Beach, N.C. 28480
Phone/Fax [phone]

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24712 1
F AND S MARINE CONTRACTORS, INC.
P.O. BOX 868, TEL. [phone]
WRIGHTSVILLE BEACH, NC 28480i/I7��
ir
//i/ (91.5Oc1 66-85/531
DATE 0272005809
11
I) PAY de,LTI/2„,
TO THE AI
ORDER OF nv, � J $ C Z)`v 1
1 DOLLARS 8 .....
Aiii II
Century G Bank® �/n/ ft(
A J�`J�i /rklWilmington,t� NC 28401 �'/
Lf FOR GGGiii 1
M.
i II'000 24 7 1 21I' 1:0 5 3 1008 501:0 2 7 200 5809u
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