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CAMA AND DREDGE AND FILL
GENERAL :/ sru 22684 —
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 'H- P--000
Applicant Name 1th"On y % FA S qv% Phone Number C'' z.SL 4a62
Address 2.12- CfF aC-4-ter DR
City \w)f-i 6 G{'"'SV LQQQ g.e.ac c. State ^) C- Zip 2- 4o
Sfi1"7 8
Project Location (County, State Road, Water Body,etc.) nr -- i �-ji Ft[ rM 01'rs Ck-1'N kreQ_j
4,0 .
Type of Project Activity 11 t�� h*j - •
s11 Dtf k.
PROJECT DESCRIPTION SKETCH (SCALE: 1 Il_ 40 I )
1'Y10 E. s C ha i iu*-t.
Pier(dock) length
Groin length .f
)(CST'.
%.
number
PiSe- , �� <2) e,I I
Bulkhead length / -
..pi,- - , q.-
max.distance offshore
Basin,channel dimensions / / 13/ 4
C, 14
cubic yards f� fJ �- M•• 1 1 :
gi
■ 1, 4.
Boat ramp dimensions i
/
Other .
li. - 14 xe,
-2+D- "
This permit is subject to compliance with this application, site v� _\
drawing and attached general and specific conditions. Any CpGt21,..9
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.
.-").---(2-0-1.---15-‘r---L.
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. q
The applicant certifies by signing this permit that 1) this pro- t 2_- , -9 I 3 - 1 `c
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 7f Z0�
objections to the proposed work. attachments
. . . . - - - . - .- .... -1-b -,
Nws
If
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
Name of individual applying for permit 6-.k.
Address of property JO S G IL, AI/k g' t i'y* Tr d/ni
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.
S.. 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.
1111- � Signature & Date
Yvicx I cam. FciYY Print Name
I(l0) 7 l c7- 0), O z 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 (910) 256-3062
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
Name of individual applying for permit UCrl mL'`101.
Address of property <( ( 1 5
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.
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.)
G«A"
I DO wish to waive the 15' setback requirement.
I DO NOT wish to waive the 15' setback requirement.
�l- ( ASignature & Date
Ar-tV A -c-en-1/ Print Name
q\ 0 - as6. 6 5 Telephone Number w/ Area Code
PLEASE SIGN AND RETURN TO; F&S Marine Contractors,lnc.
P.O. Box 868
Wrightsville Beach, N.C. 28480
Phone/Fax (910) 256-3062
��5 f&S Marine Contractors, Inc,
/� �I� � P.O.Box 868
/ n Q �� 1"C Wrightsville Beach,NC 28480
(910)256.3062
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• F AND S MARINE CONTRACTORS, INC.
P. O. BOX 868, TEL. 256-3062
WRIGHTSVILLE BEACH, NC 28480 i 66-85/531
DATE
a�C� / 0272005809
PAY d✓
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TO THE , �� . I--
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CCentura Bank, `:--;:-_: '^^. . : .- „'�����=�, �1
I Wilmington,NC 28401 , •
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