18180D - Mack

CAMA AND DREDGE AND FILL
_ GENERAL NY 018180 _1
PERMIT
as authorized by the State of North Carolina
0 Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
-Tell in an area of environmental concern pursuant to 15A NCAC 1 I f. 1 l 0 0
Applicant Name ki tnaC-f1 % F S E>trs IQ a Phone Number (no) 2- 3t.
Address Q I S.tt`l. ' LA me
City lyF. State K) Y Zip IO. .$ 0
Project Location (Coup y, State Road, Water Body., etc.)
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Type of Project Activity
I�ctuic-t-fM
PROJECT DESCRIPTION SKETCH (SCALE: 11'_ ,D )
Pier(dock) length
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Groin length 0
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number 3
Bulkhead length k
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max.distant offshore OD V (['
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Basin,cha el dimensions
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le its:
cubic yards q
IBoat ramp dimensions rM %,Other Nx • 2
W ram .re"
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This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any Lit (/%rSC., -T-
violation of these terms may subject the permittee to a fine, applicant's signature
imprisonment or civil action; and may cause the permit to be-
come null and void. E.). --Per.1
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.The applicant certifies by signing this permit that 1) this pro- r .2.9 _ `^� ' O ^ irX to _'M
19
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 7 H- I O 0
objections to the proposed work. attachments
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
Name of individual applying for permit /��2 OHry �rT4IK
Address of property P S3/ SS l,�C M 72 * �°''m r II 6e/5-2/ v
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.,,,h,a it'.. rc /44.t.-62.74
4. 10,51z. L /rmfi /KJj Mdk-
---� 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, 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.
- - Signature & Date
Print Name
)/Z' - n rif 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]

.
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
Name of individual applying for permit Mil-
2 - J of A)
Address of property 3 S /JL' 9/2z 1°''' }6`414 C6" �;'°,
1
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. }.txyl( Atte
1i 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, 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.
yd / Signature & Date
‘N,. 1 /a-rn 072-4 / Print Name
7i o) e.g6. - 0'?7 2 ( 0 Oa79z-s`-r� -e-lephone 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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