20068D - Evans

GENERAL PERMIT COMPUTER FORM __mom
APPLICANT NAME: p V‘ ua ti 5
ADDITIONAL NAMES: S. vv vw / /UorL
AEC DESIG: (' V&J e Gt./ , P • DEVELOP AREA:_D o f_.. PROJ DESC:-P - I
(Will only take 6) / (Will only take 1)
WORK: R (D (b(r a 6 L - 3, b
• (Will only take 4) f e
.S.ct`i
MAIN t
(Will onlyy take 4)
IMP: b W b
La
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED:CAMA MAJOR DEVEL,REQUIRED: �'�,_ �[ ( 5('1, 'J y

_ e
CAMA AND DREDGE AND FILL
GENERAL iN 0201168-
C
�
PERMIT
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 u_ /. oc
Applicant Name T 54"Ur l) E✓/DNS rYv tom/ NAM- Phone Number (9i') �S7g. — h 5-7
Address / -2 1 474.N' C/PFa K /Pd
City b✓/l/)j j/l/&,72Y* State it/C• Zip 2.itS-L///
Project Location (County,State Road, Water Body, etc.) s4/4E / .4bJ4CE't' i'l-iste A C R e."'
MA/ tio't'A Go .
Type of Project Activity /'R;vR-fs P/�,e
it-R:pAR;AN cokP,60P( Pelt .SNavPy by 4-666c SuRvey;'j n i.) - 31- 9�
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: (O-/K New ew y it-o✓e& Co , ti ar=spet-liU f P7`: pyre fs Lr,/ci;n.) theTh:V 1494- Al,C',
, H- ir/i t, /V 4-e y ct i hPr s e d-r ', v2 -Tv to". sia tic-1,*0,
PROJECT DESCRIPTION l SKETCH ..ice `_ . �.i C� (SCALE: / I� y0 ' )
Pier(dock)length f0 �iUfa (�' ►�,1_�'�` ` lc tie= R.;OF�RZ,Ark, C(�R i0)ok.
4.1c Siede p' RC
Groin length , ` 1
f�
1 --•11, i5t m;,y,5Zt3�K
number
Bulkhead length J 1
O
max.distance offshore
Basin,channel dimensions C
0 1 ,_
cubic yards W ,T ` d
7
Boat ramp dimensions � `/ r `rt S
X `!
w
rik Other 7I 4 /`)\X /y'. .4 00°"
0 bA\) it Li f-7 c ` c6.- \J)
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• /07 r`-u7CN ( PPK Rc( _��`
R
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any /
violation of these terms may subject the permittee to a fine, '
imprisonment or civil action; and may cause the permit to be applicant's signature
come null and void.
This permit must be on the project site and accessible to the permit o ficer's signature
permit officer when the project is inspected for compliance. /
The applicant certifies by signing this permit that 1) this pro- -- (.— 6- 5
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 W ,,)pv
objections to the proposed work. attachments

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_PI,_COASTAL jtilkNaGEKENT
aalac_Per R/PARIAN PF-0,tATILONER NOTIFTCUIsalinayz2, FgEA
Of Individual App For Fair. "1-794\/
Ad:.1reass Of Pre;erty: no/10
-
eritAIL.
or titre #, 5 rest or Rod c _t1 County)
,•,ii:eby certLy . tr:d . I -1..on prcrerty ad, ,-unt t.v.e above-
,
f4:4inced propert-j. appling for tni3 permit hts
c164;z:rib•d tc me as shc . -. On attacho4 drawing the development
axe or drawing , with dimen2lons,Id ba - ! 4
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lif' calncs lat tack- a mirlmr arFs .;,z.r:s4; ;4;-.1;:i wa.;.'/ed .z,4 me . (if you wish
tcth gliat iritirl the appropriate blank
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TalaThone Numbe- .1„:; -777

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER_ FORM
Name Of Individual Applying For Permit N
�i1� L7� '
Address Of Property: L1p/7 Ft—ui Greek pAO
7 nAln N�. M Aff/
(Lot or Streets #, 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.
I have no objections to this proposal.
If you have objections to what is being proposed , please write the
• Division of Coastal Manacement, . 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 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 do not wish to waive the 15'setback requirement.
Signature DateA • A
P -Nam.. J + ..��
7f ��� 7 S 6 D�HNR
Te _none Number With Area Code

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9570— mow.�.— _• .
' COASTAL MARINE CONSTRUCTION
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NCDL 831595 86-783{531
6314 WRIGH 910 256 6357
Y WILMINGTON NC 26403 `
r' DATE
PAY _St J_0 0 0---- y:
�t TO THE .�
d ' ORDER OF •ji DOLLARS ©r,zfr , 4A,, ,•w,:
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ACHO
Wachovls Bank,N . _ r 4
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