25292D - Crockers

•�CAMA and DREDGE AND FILL
IDG E N E R A L52�2 _�
PERMIT
as authorized by the State of North Carolina
>C........2j Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC 74. 2 08 v�. .
Applicant Name C .CCV- - Lkt'ADI �(/cE u \JJ -Er hone Numbe�tlo z.SC 3062-
Address I T �- t ��tt
L I &.
City Vv tL&v t s State NJ C Zip ZS:54
e
Project Location (County, State Road, Water Body, etc.) �"�'''�e. A c ri - SU ? ' 2. -FA'SI rJ
i
oFF At w uv ` #.1 ft -t.,',v. Cm •
Type of Project Activity Boa T Lt F1 A- tr (k) V (..1 i)
PROJECT DESCRIPTION SKETCH (SCALE: )
Pier(dock)Length ' al 11111
Groin Length
number r
Bulkhead Length I in
A P _____
max.distance offshore [ r
L, . I •
Basin,channel dimensions i ''''‘...—: ---.-- iNTA
_.
■ � �111111%02111 Mill i- M
cubic yards — .. v
T �i [ i1II1 t _I 1 1__ "Iii! 1
Boat ramp dimensions '
Other r in/�, 1
�t+'1' i i I _. gar
' 31 t_ G. 4 e � !. �. A.
This permit is subject to compliance with this application, site drawing gi 1‘44(11)
and attached general and specific conditions.Any violation of these terms
applicant's signatun
may subject the permittee to a fine, imprisonment or civil action; and C
may cause the permit to become null and void. C�
This permit must be on the project site and accessible to the permit of- permit officer's1siignatun
ficer when the project is inspected for compliance. The applicant certi- ID-( C)" 0 j - I _ �SU
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 71 ( �� O
been obtained from adjacent riparian landowners certifying that they +i
have no objections to the proposed work. ��Y-' l 1 attachment
I. .. .,........♦L.:, .----:r tL--ct.....-L ki...rl.r•-..,. ..- ..I: ...-:(:..-tL..,r r . .,l.:- .. ,. .-f. I � - S Y r .. 7 e- - -)

APPLIC_ANZ'? AMr: COer-K
ADDITIONAL NAMES: q4l f CL l�-f-� r .
AEC DESIG 1 DEVELOP
(WM y ARE_4-_�_ PROJ DESC C� _�
W (Val only take i)
WORK: tg 1 t
(W'ila only lake 4)
MAJNT:
(Will only 4)
•
IMP: OW . (4-9-
(will only take 6)
ACTION IRATION
DREDGE&PILL REQUIRED: 1 -l 2-e .
C_AMA MAJOR DEVE. ,REQUIRE): I ( /

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
•
Name of individual applying for permit Ci0 A 'x3 LAr^/Li/It/A-
Address of property (L ) ,41tht- rid NC
J cj4f�
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. nsi0 � k/17�r0
I have no objections to this proposal. �'�/r�'�ad SG�F
If yo ve 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.
7/5-/?,p�Signature & Date
-7 Print Name
-'( o S‘ n.:=&7 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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(s,,,' SENDER:
:O ■Complete items 1 and/or 2 for additional services. I also wish to receive the
m ■complete items 3,aa,and 4b. following services(for an
Si ■Print your name and address on the reverse of this form so that we can return this extra fee):
card to you.
j •Attach this form to the front of the mailpiece,or on the back if space does not 1. El Addressee's Address
d permit.
, ■Write'Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery
r •The Return Receipt will show to whom the article was delivered and the date
c delivered. Consult postmaster for fee.
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v 3.Article Addressed to: 4a.Article Number
cu . �4,4) 1°� t ai3') 39b') 2505
El'L� �/�'`ri1� 4b.Service Type
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ElExpress Mail IDInsured
0 )') vb/O J md. 2i0sy ❑ Return Receipt for Merchandise El COD
a 7.Date of Delivery
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5. ceived By: (Print Name) 8.Addressee's Address(Only if requested
w ,f,i / e t-v-,0 and fee is paid) i
g 6.Signature:(Addressee orAgenyf);
PS Form 3811, December 1994 102595-97-B-0179 Domestic Return Receipt

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