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CAMA AND DREDGE AND FILL
GENERAL Ni.- 92O259--D
PERMIT
as authorized by the State of North Carolina
0 Department of Environment, Health,and Natural Resources and tli Co stal Resources Commission
in an area of environmental concern pursuant to 15A NCAC +1 . t 0O
Applicant Name "' e. 5 k p Wf 4 C k Phone Number
Address 10 L_f\ kr(1 t r "f' 1.1 n
City 3-re\,,-4-1•N 'le V1 7 State JUCIJ Zip a 7.7 7 I
Project Location (County, State Road,Water Body,eI I
5u r P C',4-1, ►JO Mrt.r,-- nde_ Pre1A
co ve.r d bo NA- 1, '-k- dc^ow P, 1 Z n G
Type ofProject Activity u(� \
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PROJECT DESCRIPTION SKETCH (SCALE: OT To )
�-' NA tr)r- PncJ� C
Pier(dock) length —..-_
Groin length
number
Bulkhead length
max.distance offshore 'a(
l >
Basin,channel dimensions •'
lc)% `''(')
Of\T cubic yards L‘f TBoat ramp dimensions 1 9. 3,Nammommiw_ ' f
C
Other 1a' Y. lay f- I.SI C.X1S'k-i ^`� doek� Sccct'd Dec I
UnCove. 'r ci Le oc 1 ► >4;n
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This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any '� C /,
violation of these terms may subject the permittee to a fine, „2 ,
imprisonment or civil action; and may cause the permit to be- ( applicant igna ure
come null and void. 1- '‘. tki• - 1---Q 0
This permit must be on the project site and accessible tot permit officer's signature
permit officer when the project is inspected for compliance. ,�• I
The applicant certifies by signing this permit that 1) this pro- c �ry'
� ''"��LI/`t , (ctC19� 1\4 V' j 4 1 {C1 qC1
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 ?I • I200
objections to the proposed work. attachments It
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DIVISION OF COASTAL MANAGEMENT
AD ACFNT RIPARIAN PROPERTY OWNFR NOTIFTCATION/WAIVER FORM
Name Of Individual Applying For Permit: ST6 V6 S/H P A.V4TC
Address Of Property: Le b S g (U th STee 7—
Saar Crry AJC
(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'rrie 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.
OPA- ia--r e r
If you have objections to what is being proposed, please write_ the Division of Coastal
Management, 127 North Cardinal Drive, Wilmingon, North Carolina, 28405 or cal1910 395-
3900 within 10 days of receipt&f 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.)
V I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
/111iiirA
• Sign ur // Date r
Print Name NCDENR
9/0-327 a5
Number With Area Code
Telephone N CAROUNA DEPARTMENT of
P ENVIRONMENT
ENT AND NATURAL RESOURCES
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNFR NOTWICATTON/WATVER FORM
Name Of Individual Applying For Permit: G
Address Of Property: � 14z4 Sfic.E. 7` •
S'L l/..c C 177 C�
(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 toitie 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.
9A— &,qT
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 North Cardinal Drive_ 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
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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.
Signature Date461,471'41A
�t/A t,i E
,2 w t3 o C CS
Print Na/one 7g/ Q 5 l S— NCDENR
Telephone Number With Area Code �TM CAROUNA DEPARTMENT of
p ENVIRONMENT AND NATURAL RESOURCES
or de tails.®
document. See back
__-.. _ [1�5 r c u r i l r n h a n c r d
\ I -E^.m � mrm� -
D & B MARINE CONSTRUCTION 1977rl
PHONE(910)327-2140 r
56 30/531
143 CANAL DRIVE f , I 1�j 457 II
P.O.BOX NC DATE � " _I
SNEADS FERRY, 28460
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PAY b N .�._
TO THE �� R
ORDER OF 1M DOLLARS CIoW.^-'
W
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" d MIST CITIZENS 457
Flrst-0 lms Bank g bust Company /�
BANK Snoads Ferry,N C 28460 1� __--
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1 FOR ' �� >..
� II'OO L9770 1:053 L003001:00457 L3 L5 2
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