22415D - Miller

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CAMA AND DREDGE AND FILL
GENERAL N9 22415-D
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 l'r . 1.20v
Applicant Name Jokr1 tril t'e Phone Number 3a8 _ 1C140e)
Address �e'f . too N f 4'h CP)(\ `r- SkY'e e`` -11'
M
City T . Oki VC—) State N ) Zip OM 3(0-6-
Project Location County, State Road, Water Body,etc.) CO A S l OuJ C'O u n1 �D O(O4 Cnt 3+'L°f' 1
kr F , 1JCJ M Prn M la r1 CJ C cr A- 1
Type of Project Activi ' Nevi U. 0\Mr< 8 VziOM' ' fit PUr-k sip(\ nc 4 o C t— '4 u bed
PROJECT DESCRIPTION SKETCH (SCALE: IJUT To )
Pier(dock) length <---
Groin length
number
Bulkhead length
max.distance offshore
•
Basin,channel dimensions ,
A CAISA',n9 dock.,
cubic yards
• 101
Boat ramp dimensions
a 1 C I
Other ` - `t . ,
tr,(v\k,r-c 8 ►;r+- PcoPos<d 5\6' LoT
UnCoVe-re d
(----/ l'--, oit j )
This permit is subject to compliance with this application, site �
•
".
drawing and attached general and specific conditions. Any I 1
violation of these terms may subject the permittee to a fine, _ �'L► �/"3t� \ \\\///
imprisonment or civil action; and may cause the permit to be plicant's signature
come null and void. Nn , O
This permit must be on the project site and accessible to the perm-it-officer's officer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- A\kC ' i I1�C1 �V' it/0 31 nct`1
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 �t
adjacent riparian landowners certifying that they have no 1 `A 1200
attachments
objections to the proposed work.

K.�.� PER IT COM:PUTER FORM
ADDITIONAL N AIDES:
AEC DESIG: P T I E(43 DEN ,OP AREA:__.ap2. PROJ DESC: e(w.truly ukr s)
(wa1 only lake I)
woRK:. QL I t I _
(wa oah•u;<r 4)
M411t�T: - Jr10Q--)
only 4)
IMP: a (") i
ACTION ' IR4TION
DRY &FL REQUME>: • 8 3) 9ci i( 13 I 11
C A MAJOR DEN EL REQUIRE"D:

• DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPAR'IAN PROPERTY OWNER NOTIFICATION/WAIVER- FORM
Name Of Individual Applying For Permit: :S;44)VAdriak
Address Of Property: 6U10� r;� 5y
cur� C� �/fie •
(Lot or Stree 0, 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.
B13 I have no objections to this proposal .
If you have obiections to what is being 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. )
X V I do wish to waive the 15'setback requirement.
I do not, wish to waive the 15 'setback requirement.
•
Signature Date ` •
Print Name i��Signature Date
Date
A • _
L7 HNR
Telephone Number With Area Code
EE

C/ v:.NCE E KEE MA vO
NELVA R ALBURY.MAYOR PRO TEM
KENNETH D BATTS.COUNCL MEMBER
UHF C - TY t Z DOUGLAS C.MEDLIN.COUNCIL MEMBER
142B -- - O BOBBY C.SMITH,COUNOL MEMBER
-r LP TODD N THOMAS.COUNCIL MEMBER
\NORTH NORTH CAROLINA 28445
DWISInN OF COASTAL MANA EMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION
Applicant's Name:
Address Of Property: (9 .Y27 f CL4
Street #, Street Name, Citfof & nt
y
Applicant's Telephone Number /- 2)Q - ���f-/9'
I hereby certify that I own waterfront property adjacent to the above-referenced property. The
applicant has provided me a drawing of the the proposed development. Please initial the
statement below if you have no objections to the applicant's proposed development. Initialling
this block does not constitute a waiver of the required 15'setback from the riparian corridor
lines.
c)-- I have no objections to this proposal.
(2jLvUkl,-/ 7—/(P- 6L
gnature TA '. Date
n Li
'113/ taods Os r 24 - nn, tea 3(,
Print Name and Mailing Address
(gig) a '39g
Telephone Number With Area Code
If you have objections to the applicant's proposal, do not initial or sign this form. You should
contact the Local CAMA Permit Officer listed below as soon as possible to register your
concerns:
v. i2Df- 024/?s
Telephone: (a
p:a-Box 2475 • 214 N. New River Drive • Telephone [phone] • FAX: [phone]

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