19797D - Martin

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" CAMA AND DREDGE AND FILL
..
GENERAL i 019797 - Q
—1�
_)
PERMIT
as authorized by the State of North Carolina
0 Department of Environment, Health, and Natural Resources and the Coastal R ource Coom9ission
in an area of environmental concern pursuant to 15A NCAC ' / ,
Applicant Name Me )V'''‘ c7" '"Q Al 'ur4-i,✓` Phone Number
Address J 3 q A ,;--0 Cu,, K
HD.City /et C,. 58,eli k_ L..... State `v Zip -8-17 (=.)'
Project Location (County, State Road, Water Body, etc.) / q 31 sr y A l re Ca nu I S 1'� 404 ' /5
/titur , iaieleA )lu�� / et T `,,AS (,.,IBC./'l' r'-., U/1 -Ts a CC is
I
Type of Projecttctivity Ccan)4I�L +- ntC >' ill / /��A-4 /ir'/- t ACo�rrCd ) oil ,� yS.+ 5tNe
a-F P c "a cl®`k . 5 �-� c k tis 6er &V 1 vo 0 -r o eg54- Sid(
pc (‘jhl,..• All ( �, a1"1757s -a • 0/1. /0.)00 4. // G,,, /
PROJECT DESCRIPTION SKETCH (SCALE: No�')0 5(y )
Pier(dock) length /+1(d/1- "A (IC US//�
Groin length
liepi
number �cd- ,..., -I�y 1,4 \ Ali
Bulkhead length ,r�T O O bOLK J VVV
max.distance offshore !�
Basin,channel dimensions
cubic yards
Boat ramp dimensions
Other 1/ o41/ /.,+T . 5 0
/a ' x /4/'
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any
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. /1(
' G--7,A,_ __
This permit must be on the project site and accessible to the "-- (/1 permit officer's signature
permit officer when the project is inspected for compliance. ..,�
- s
The applicant certifies by signing this permit that 1) this pro- (� fr/- 5 / '/
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 n
adjacent riparian landowners certifying that they have no ! / / , /Ol D
objections to the proposed work. attachments
_. e,

GENERAL PERMIT - COMPUTER FORM
•
F_E'LD REP: air- .f1Q0
APP FEE: 50.,
PERMIT NO: Of /2Q COUNTY: /'J 11
AEC L>2S'IG: WATER BODY:
AP.PLI T: , I A2. : PA S..1 W':, 'd- •i 1/G,01.cy /►r a r ..1i.-, . • •
ADDITIOINIAL NAME(S) : . .. ... .. . -
MA - -
ILING ADDRESS: /� - y a . ..
CITY: • (A'`- cie�;A. - .w A .. STATE: . +.ZIP: '',0 , -.
PROJECT LOCATION:
7'?CLUDINC CITY :)> irsti;LITY (WHEN DIFFERENT FROM MAILING ADDRESS)
D s'V AREA: _ 0 0 5PROJECT DESC: r _/2 LAT (X) :. • _ LONG Y
WORE: f • - C ,
CODE LENGTH _ WIDTH DEPTH CODE • LENGTH — '; WIDTH DEPTH `-T ) •
MNT: _) ,'
C `)% LENGTH WIDTH DEPTH CODE LENGTH WIDTH DEPTH - -
_)
- _ . CODE SQUARE'-FEET•_ ( - - - - _ -
- CODE - SQUARE FEET , CODE SQUARE FEET
ACTION c.EXPIRATION
:: DREDGE AND FILL REQUIRED Jf----1�. _ �i I-
-
LAMA Mai:!OR DEVELO• ra REQUIRED: •
************************** *******************ii***********4****** * ********1
CODESFOR- AEC DESIGNATIONS
-"OR" Ocean Hazard - "CW" - Coastal Wetlands
"EW" Estuarine Waters = "FC"• Fragile Coastal Natural/Cultural"ES" -- Estuarine Shoreline „PW":-_ Public Water Supply
"PT" Public'Trust OR".
. • " Outstanding Resource Water .
_ CODES FOR PROJECT =
l s iv .te, sully an individual "r" Federal
"O" Hcmmarcia3- "L„- Local Government
-"S . StaCtite---;-_-:-.-- - - _"H" Housing Development
_ . - - "O" Other ;-.•
t-- _ = CODES FOR DESCRIPTION -
-"11" Bulkheads, Riprap z "16"_UtilitTy lanes
iers, Docks, :Boathouses •� ."17,.: Emergency Repairs .
"13" Boat Ramps - ."18" Beach Bulldozing
-"14"' Wooderi Groins:- "19" Temporary Structures
"15" If inter:=-.roe ^f Basins, Channels, Ditches

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
PIER/FLOATING DOCK
enA/ I hereby certify that I own property adjacent to
Ah& iD cv h / '' " s, property located at
l / /d��SF
( lot , block, road, etc. )
on —S a .4 s i ��
(water body) on Holden Beach
North Carolina . He Has described to me as shown below the
development he is proposing at that location and I have no
objections to his proposal . I understand that a pier must be
set back a minimum distance o9f 15 feet from my area of
riparian access unless waived by me.
116 do not wish to
(circle one)
waive that setback requirement .
Description and/or drawing of proposed
development :lo ment :
(to filled in by individualpropsing development )Q L / a 2,1byl- 1 *J4
- - ,e_�:- , . /
Signature /n '
G , fi.a
Nam We) ' --'3 i
Phon Nu ber

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
PIER/FLOATING DOCK
I hereby certify that I own property adjacent to
property located at
( lot , block, oad etc. )
on <'P A t :tea
(water body) on Holden Beach
North Carolina. He Has described to me as shown below the
development he is proposing at that location and I have no
objections to his proposal . i understand that a pier must be
set back a minimum distance o9f 15 feet from my area of
riparian access unless waived by me. L dojdT o not wish to
-i circle one)
waive that setback requirement .
Description and/or drawing of proposed development :
be filled in by individual propsing development ) (to
©� es�d A'd 47 ���7 �v e S��� �h x� STi 73e f oee
S456 ? t'f 0
/r7.-2=01,
Signature
Name
Phone Number

F 374.11
s.._�.;r7 ua�4.u. .,,_�,.n ;�sv�wmvr��-<n�xa�rsm�c.. _ - - W-�,,..r_nm�.
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VARNAM'S DOCKS & BULKHEADS j
86 VARNAM TOWN RD. 1,4
SUPPLY, NC 28462 6} 66-112/531
DATE 1�5 — ` �
"� T
Q�i�� ORDER OTHE OF C E -A)i I son) C/�.) I
J� l i$�
l J'c/Idtr(cd G) //a(3 tac DOLLARS �s4 y .,., I•
I
j / L�U e2101 BB&T
1 a,
n c m*comvnnr
3226 HOLDEN BEACH ROAD SW
SUPP ,NC 28462
FOR l w/+ICE �.Fi l/�Y• (1.4! hT'L-�_ .G�'_r1C( Y" PIP 11
—
n'000O2837))' 1:053LOLL2LI: 52L767607LH' _,
L� `_� ,r„,„ m,°3 �h r rr , .=.e,„.„3.. ‘ £�.,rmuA._.7.,nm_ .mm- ,n n,r7:= _ -meter . ,-
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