25280D - Tipsy

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ttoLCAMA and DREDGE AND FILL
G E N E R A L . ',y 25280 -D
PERMIT
as authorized by the State of North Carolina
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Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concer,�ipurl ant t NCAC .-7 if 2-6 e f.bC� .
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Applicant Name Ti pS y Tftr kJer5 A, ,h,5x.Phone Numbe - 3�
Address I Z GO, A s N V t.x.X._, S
City LAY ( Ul. Qiy2,4c_1-\ State (QC Zip Z84-SV
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Project Location (County, State Road, Water Body, etc.) la �Nc9 ST / �2
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c .:“Pv-ixle.,.c C -N4.i t. K 1.rcit-- Ca .
Type of Project Activity yKS '(T7 6 (?1-uLi
PROJECT DESCRIPTION SKETCH (SCALE: j f( - a! )
Pier(dock)Length I
Groin Length igI11111
number11 __., IL. Mil 1111
Bulkhead Length 11�
max.distance offshore 11 •11�_ ■■iI II.UU U
al eta
ins
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a ism immin
Basin,channel dimensions -111PKR f►r
1- I 111 el ..r.wo in
cubic yards I , IP t E a i1mIIuInhIuIIIn
Boat ramp dimensions II 1i r
11
Other l ii 2 E:eriannimaii
( 1111111111M 11 ma Nirli
-no mom a im maw
awil
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This permit is subject to compliance with this application, site drawing / /3 '
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and attached general and specific conditions.Any violation of these terms � �,��" AIL��
applicant's signature
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void. .,
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- CO — 0 —C,t) Ci--3 Q—
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 14 1 2. . 2.0
have no objections to the proposed work. /�. attachments
In icci lino this narmit tha ctatn of Nnrh r rniin..-ortif;ne th,t this r,..,i,,,t r 1‘ 1 ti./ .�'7

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DIVISION
COASTAL ADJACENT RIPARIANPROPERTY OWNER MANAGEMENT
NO
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TIFICATION WAIVER. FORM
Name Of Individual 7 p ~�4-4es
Applying For Permit: 1�
Address Of Property: 12.
(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 me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions,
should be ovided with this letter.
-104— I' have no objections to this proposal.
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If you have objections to what is being proposed , please write
e
Division of Coastal Management 127 Cardinal Drive Extension
Wilmington North Carolina 28405 or call 910 395-3900 within 10
days of receipt of this notice. No response is considered the same
as no ob.ection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
from my area of riparian maccess unless ust be set cwak i bywaived me.imum distance of wish'
to waive the setback, you must initial the appropriate you nk
below. ) blank
I do wish to waive the 15'setback requirement•
LA— I do not wish to waive the 15'setback requirement.
Sig ure 600AT
Date • •
Print Name '
E�f--�R
Telephone Number With Are
a Code

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER- FORM
Name Of Individual Applying For Permit: ( .0.„,
r
Address Of Property: / Z. LcAl, / s [
(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 me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions,
should be provided with this letter.
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ld10"--` I have no objections to this proposal.
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If you have objections to what is beina proposed , please write the
Division of Coastal Management, 127 Cardinal Drive Extension ,
Wilmington , North Carolina , 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 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 do not wish to waive the 15'setback requirement.
ram.•- Ticir
S gn" u e a 4�r
Print Name A
Tele one Number With Area Code LDEI---HNR
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�`D2 G -l1 37

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ATD CONSTRUCTION CO., INC. CENTURA BANK
910-675-0983 WILMINGTON,NC 18607
I 107 TOM AVE. 66-85/531
CASTLE HAYNE, NC 28429 I '
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PAY TO THE V k'��\Y V 111 $ �l O.. f7-a
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I �' ' DOLLARS I
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ATD CONSTRUCTION CO.,INC.
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J MEMO �
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��` AUTHORIZED SIGNATURE
II'OL860 ?II' 1:053 Orin 501:02 ? 2L34096v
D SECURITY ATURES INCLUDED.DETAILS ON BACKSGP I
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