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CAMA AND DREDGE AND FILL
GENERAL PERMIT �N o, ni9796
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 girl r r a /
RApplicant Name B 1 // n Phone Number
Address f 9 ! DoIpA/n 54-
City Ho/c( B.ekL 1 n State /N C. ,Zip ? *$ �
Project Location (County, State Road, Water Body,etc.) f / bt)4 4"'A 54- a I-44d*°--+ 2-u t L1
V A /h n - m u C Oct K I / 6 c,i.stadi(-if- Cr0 & r
Type of Project Activity , I 0/1 $' r4Lt /0/' X / / ok"17 /�-1 0/► So�"1'�� S1 �( Lr:7T�'
prJpc r-ki, 5D ✓-�l, s, Je 4 e 1 h b +— 44.s wcl I V CO) /p -F 4- 0� St'�lX+.-K
Al ( = A d 1 , .Pi a � ? . 1•Z' - 5 #4 ii appal .
PROJECT DESCRIPTION SKETCH (SCALE: A 74. L. cc4/()
Pier(dock) length '• T
Groin length
number
Bulkhead length . do' C ,--�.�. N
1
max.distance offshore X' ��y
_ S'-- Ay/ ,
Basin,channel dimensions
/1)0ck)
D
cubic yards
Boat ramp dimensions - - 50
Other 4'44 h/ rL .
10 ' X /Hi /hi 7 D Ip 4 j1L
,.
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any i r� 1
v"
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 PI— permit officer's signature
permit officer when the project is inspected for compliance. �• -�' �9
The applicant certifies by signing this permit that 1) this pro- -
_
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 V
adjacent riparian landowners certifying that they have no /(% °-D
objections to the proposed work. attachments
GENERAL PERMIT - COMPU ER FORM -
T
47-7
FIELD REP: Pq/"ker.— !�
APP FEE- -. S. V` -
PERMITNO:_ 0t i q 96-- A - COU►,TTY: �3E'✓n S Lv/.�, .
AEC i SIG: P T E. W WATER BODY: n'1 1 n + /4-1 n
1 . / 1L �
APPLI°L?,.h� ' NAME:: Sill lI . Hi - , .
ADDITIONA NANE(s) : 1. . ._ - _.
IA MAILING ADDRESS: id*".,.
. '•Ill _ •yC;rt7I1 fr,- `.>f . PHONE: - -
-• : CITY: tb/ / _ �7•Cw
f`r C{M STATE: N ZIP: :A E. `� 2.
PROJECT LOCATION:
?`'.C.UL'.NG CI?Y Jei If L;,ITY .- .- -
(WHEN DIFFERENT FROM MAILINGADDRESS)
DEV AREA: _ •_ _ PROJECT DESC: F -I ., LAT (X) LONG
WORR: (�_t.. .1
(Y) -
L _ 1 _ _ _) (_:_ _ _ _ _ _ _ _ _
-, CODE LENGTH WIDTH DEPTH CODE LENGTH WIDTH DEPTH --
MNT: fi'rDIll LENGTH WIDTH • DEPTH CODE LENGTH :_- WIDTH DEPTH
IMP: e�1 -- - i4 ( - )
•
- _ . CODE SQUARE FEET.: . . - CODE SQUARE FEET -
- CODE S4UF,RE FEET
. . ACTION - .-_:::. .... ...EXPIRATION
DREDGE AND FILL REQUIRED: " " • I--- 5 .y 9
LAMA MA OR DEVELO- R" REQUIRED:
****i***********, *******4* **************************************t#*********1
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r .. -
CODES. FOR AEC DESIGNATIONS. :-- _ _.
"OH" - Ocean Hazard "CW" - Coastal WetlSnds
"EW" Estuarine Waters "FC".-: 'Fragile Coastal- Natural/Cultural"ES - Estuarine Shoreline "PW��
- Public Water= Supply
:ITT". Public Trust "OR" .= Outstanding-:Resource Water =_
CODES FOR PROJECTS _
- . -"P" : v te, usu fly an individual "F"- Federal"C" Ccmndreial- "L"- Local G overnme nt- ." 3" Ot31sty - • _ :," - Housing Development"S" Stae_,-- � - "0" Other
- : -... CODES FOR DESCRIPTION - • -
-nll" Bulkheads Riprap - 't 1• _IItil
12 Piers, Docks, Boathouses - - gen_.y: Res -
�"17n. Ea►ergency� Repairs . -
"13" Boat Ramps _ „13" Beach Bulldozing
-"14" Wooden Groin s . "19" Temporary, Structures
"15" 2.:tr,ainteni ce ::f-Basins, Channels, Ditches
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit : �{ i ( P(./4 4_
Address Of Property : l 1 7 0Q ip
J- ldideA &cth Svc
( 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 or sandbags 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 setbac , you must initial the appropriate blank
below. )
I do wish to waive the 15 ' setback requirement .(104;‘,/;:1)
O'DA
I do not wish to waive the 15 ' setback requirement.
Si re k Date A . .
Pr nt ame
��N9(7`/ I—I N
Telephone Number With Area Code
1)(Oridd -4- 1
I er/
•
I �
I
H7 i h' it-Kt
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit: f ? 1 Pyriq.
Address Of Property: I LI 7 OQ 1p hf s+.
-6 ldm mach NC-
(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 or sandbags 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.
Z- r)--1/4 )2 _/ AWA
S,�'gnatur Date
Print Name
ss sy� - 9-7 q5 DEHNIF{
Tm 1 cr,hnnn M mhar W i th AroA CHAP
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i VARNAM'S DOCKS & BULKHEADS
I:
86 VARNAM TOWN RD. '
SUPPLY, NC 28462 66-112/531
I DATE I V__ Cr I �iI,
PAY 0 E .1-]-11)K. sc.-7(A) „,..
TO THE I, I �i�
ORDER OF ,,
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, �- DOLLARS O War: 1
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82101 B��Q�Si rrtwo Nufidiztd a i 1
enn NCrl eAAN.NO A/10 mOe.COMPANY It
3226 HOLDEN BEACH ROAD SW
SUPP NC 28462 '�
lit FOR l U/�'1�Q Lli� Gl/ vflu__ .cLvnc4�- '
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