23806D - Henderson

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-CAMA and DREDGE AND FILL
GENERAL _. , .. 238O6 — D
PERMIT
as authorized by the State of North Carolina
> ,,,•„-- Department of Environment and Natural Resources and the Coastal Resources Commission ,..
in an area of environmental concern pursuant to 15 NCAC 1 14 .13-
Applicant Name 0-
© 1 Nmv 1--if ND�Oi\. Phone Number 1iD4 4-a- l
Address 3 cLop.1 DIA" N e
City C_/'c czO Li 1,34 -. Acf'1' State RC ' ` Zip -0-8
Project Location (County, State Road, Water Body, etc.) - iTYIE., 1A 3Ve 1 ekcjiACETTI
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Type of Project Activity 4D DI Ti C'Y\ 6-,( I S T I e K
PROJECT DESCRIPTION SKETCH (SCALE: I (t = 1 )
Pier(dcjck)Length ffari t!glirg E14 Etls sr L
co X(v A f t t 110v\ , , i mi _.-....---
Groin Length II _ A 1 1
numberIII
Bulkhead Length
max.distance offshore 11 i
Basin,channel dimensions I- —IL —,.. -„, I 611. ai,„,...., i ,..,__
_.
cubic yards 1
s
imunitatt . m _.
eArtmommusimmuemum
Boat ramp dimensions ' r R,� O 3d• • i'_... , _IllingEA2211 dI RI�
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Other ii I
24 i
1111
.,_ to , �.
1111 III I. Y £ I RUB
This permit is subject to compliance with this application, site drawing _ t7L c/
and attached general and specific conditions.Any violation of these terms applicant's signature
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void. -
This permit must be on the project site and accessible to the permit of- permit officer's signature
ficer when the project is inspected for compliance. The applicant certi- ( (-- ¶3— 9 R 2. — E- t)0
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 Q�
been obtained from adjacent riparian landowners certifying that they
have no objections to the proposed work. attachment'
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER- FORM
Name Of Individual Applying For Permit:
Address Of Property:
(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.
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 , 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. )
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
Sig e-++ P 14 up Date
it r
PrifS Name ��__
Telephone Number With Area Code H N R

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER- FORM
Name Of Individual Applying For Permit:
Address Of Property:
(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.
I have no objections to this proposal .
If You have objections to what is being Dr000sed, please write the
Division of Coastal Manaaement, 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. )
I do wish to waive the 15 'setback requirement.
I do not wish to waive the 15'setback requirement.
8%h7 '- 9�
natureApp,77.00, Date ` •
Print e C
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Telephone I _INR
Number With Area E

` CERTIFICATION OF EXEMPTION-Y-
FROM REQUIRING A CAMA 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 15 NCAC Subchapter 7K.0203.
applicant Name `.�211NK) v 1-tr-'I;A,.. c
address 2�, -i7 c.,( 4-
` � � Phone Numberllt L� � � - �7�=,
. /y r 4_( `
roject Loca i Co(�nty, State Road, Way'Bod etc.) Sy State NiR�'Z?-k Zip ? 4 4 '.
C' C, IS e AA\ YCVcGzll
'� ?��S j Imo; l�; . ATV / A 7 (�< r ,U -�—
ype and Dimensions of Project -Db YY ,o c,I is i�y cy i Li �I A , C��
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(I) }Rrzik,, pi.l
ro project \_.)
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proposed to be located and constructed as described This certification of exemption from requiring a CAMA permit is
)ove is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expiration,
Jirement pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be necessary
AMA permit requirements does not alleviate the necessity of to continue this certification.
fur obtaining any other State, Federal,or Local authorization.
>KETCH
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person who proceeds with a development without the con- -� /, ,
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of a CAMA official under the mistaken assumption that the i'' Z7 2 /'-/:�1��/�I ,r,,.z
lopment is exempted,will be in violation of the CAMA if there _ pl carft's sign e'
subsequent determination that a permit was required for the �-'6
lopment. ��
CAMA icial's s gnature
applicant certifies by signing this exemption that(1)the ap- � j— _1 /
nt has read and will abide by the conditions of this exemp- Issuing date
7
and(2)a written statement has been obtained from adjacent ( I -
miners certifying that they have no objections to the

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HENDERSON'S SEAFOOD 2496 j'
PH.919-458-4279
1. 203 FLORIDA AVE. 66-2/531
CAROLINA BEACH, NC 28428 �/ 8 19 19 18
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6 3 PAY /2 i. 1 $ _ • ©0
TO THE , A
t ORDER OF /^�
' --ti--1. 9 �K�/ D DOLLARS 1:1G m°.
t NationisBank
NationsBank,N.A. (Carolinas)
North Carolina • I
FOR
?e y.f (.Ze/ y)
1110024960 1:053 L000 251: L8384 L83 iI' C,Pabi(1,0
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