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CAMA AND DREDGE AND FILL
GENERAL iN9 020053-1)
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 1744 . 1200
Applicant Name 1 -01 d Q R 4-e--tn Phone Number 3469-(97O1
Address 1311 -RtArC PtvJ '}"I► ktJerl
City -AA C I—LO NU‘i 11C—, State IvU Zip
Project Location (County, State Road, Water Body,etc.) (OAS iOUJ (014.,(Vkii I ' I Uii *1' 7" rt.C± I
S uc c ,.', I _Nei , 1\Av}n- M Ads c 1brr.t, 1
Type of Project Active y U f\LQ\J Cote a bock 1;ct
PROJECT DESCRIPTION SKETCH t V1 `�, V j\ y f' Add e'rn Al) (SCALE: Nor ` -0 )
Pier(dock)length
Groin length
number
Bulkhead length
max.distance offshore
Basin,channel dimensions III
1o1 Lift < A
cubic yards 0 0
Boat ramp dimensions Ck}S1•`^ b()C.-1- it(
Other 101 X. 111 .
1 linvo1m'crJ C < ,
t. bit)Pk 1 tc+
It
ria
X r
This permit is subject to compliance with this application, site 3AA4 t .,. `drawing and attached general and specific conditions. Any ��(/Wi/' �� ,L„1/41--)
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 officer's signature
permit officer when the project is inspected for compliance. Rre2
The applicant certifies by signing this permit that 1) this pro- 1 , 11 1 ig99
jest 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 744 _ I Zoo
objections to the proposed work. attachments
nA
PER_\7ILT COMPUTER FORM
APPLICA.CT NAIv1E: (? Oft- d Pft+
ADDITIONAL NA1vES: •
AEC DESIG: p T ` DEVELOP AREA:k PROJ DES C: P -
--�Q2
(Will only )
(WM only take I)
i WOE:take 4t 1_. I O X ti
MAII`T:
j
)
(W'Zi]only lake 4) •
IMP: 1 1 0 .
(..pi only take 6)
•
ACTION EIRATION
DREDGE&FIT.T REQ D: . (D f 1 )7 C C1.c I 11T-09
CAMA MAJOR DEVEL,REQUIRED.
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER_ FORM
Name Of Individual Applying For Permit: ///
—,117/ ��f-
Address Of Property: 7/L1e
(Lot or Street #�Stre �r R A/C'
n�`��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.
✓e, I have no objections to this proposal .
•
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 ob1ection 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. )
l/ 4/X I do wish to waive the 15 'setback requirement.
I do not wish to waive the 15'setback requirement.
jtv1
13 A(//e;,7„j ‘-‘
ig at re Date A
. : TImo- I I i 'Ai
Pr1nt Name .-�.ri
7T ? Ar a ��HNF�
e ephone Number With Are a Code
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER_ FORM
Name Of Individual Applying For Permit: /L`'41,4A./6( /?5-
Address Of Property: 71 Oa 7 f4 Lr
(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.
v/ 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,
Wilminaton , 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. )
¢to' V 1..— I do wish to waive the 15'setback
requirement.
I do not wish to waive the 15'setback requirement.
tPjl - , '�' � -1 - j
Signature DateA •PrintN e �V �RIfJ.P �v
gin ,r9 a 3-&-€) ��H N R Telephone Number With Area Code
y
ANTINORI CONSTRUCTION
896 HWY.210 �/ �L} � 858
t10LLY RIDGE,NC'28945 i'
Date 6 / 7 C • 66-19/630 NC
6070
i Pay to the be..,-0 ,Order of 1 $ 2{�eL
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I' NalionsBank,N.A.
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