19763D - Dickinson

i-
CAMA AND DREDGE AND FILL
GENERAL N9 019763--0
PERMIT
as authorized by the State of North Carolina
0 Department of Environment, Health,and Natural Resources and the oa al Resources Commission
in an area of environmental concern pursuant to 15A NCAC • /d 0 J
Applicant Na e R°br--4- D mi ;C '`/A 5 tort 1 � r- Phone Number
Address /U '1 PG /c ( C (.2r-cen Co t-T
City C, c7 '�ok .1 i u State // S C' Zip �a 1/a / 0
Project
Location (County, State Road, Water body, etc.) /a 7 O o I P n I^ �4 >l Je^ (3 P�l (^
41t,)n- M t C Ac4 lf9 [5rJA5tilt./( Co._1n
/� J L ( /H
Type f Project Activ y l_o/1S 1��c", /0 / �( /t(4 N fV+ �` $ k ' rl= /
c1� c- . p-It ( oNJ 1 (JNt o Q e4 ht 0 9fl. I) 00 s �ujl 1fp/� ,
4pph6-1,,.-I his rt (_etvCtJ tau lv� r � o •� �►� � �� Sloe />el � 6• -�o
p I4c-C D�4+ / /.F-1 /�) Side SC�,6PL. K , Tjocc-i- I',i# /s lr1 ' x / '
PROJECT DESCRIPTION SKETCH (SCALE:/,1./ 19,4 cr�i )
Pier(dock) length < hh/�1 (_�✓--.
/V� un — Mu cAC e � )�u
Groin length
0 /01 0 ______ . Af
number g" Ulu l
Bulkhead length
/3'
I-1 --.
max.distance offshore
/0' �O 0
Basin,channel dimensions
7
cubic yards
Boat ramp dimensions
Other1Al'(d �0 (/ t I '
fd3 DO /i9A,'A S -L-
F1..41-, - D oJ/
-g ' �'X/6
This permit is subject to compliance with this application, site Al ,
drawing and attached general and specific conditions. Any /7
violation of these terms may subject the permittee to a fine,
imprisonment or civil action; and may cause the permit to be (5----.)
applicant's signature
come null and void.
This permit must be on the project site and accessible to the C? V Cj permit officer's signature
permit officer when the project is inspected for compliance. _ _ 1 �/
The applicant certifies by signing this permit that 1) this pro- y
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 O
adjacent riparian landowners certifying that they have no /
objections to the proposed work. attachments
-a . 1

GENERAL PERMIT — COMPUTER FORM -
FIELD REP: l A r K Q/- APP F y EE:
PERMIT NO: 0 1 "J , r b7- t) - COUNTY: !`�;•S
'. `
AEC DESIG: E ' WATER BODY: ' - _,
APPLICANT NAME: I L
ADDITIONAL NAME(S)
MAILING ADDRESS: I a•LQ �QC' C '�` PHONE:
q 4� �.�.L; .
CITY: Gc-$1k-)�� t c.( STATE: � ZIP: 00
PROJECT LOCATION:
INCLUDING CITY OR LOCALITY (WHEN DIFFERENT FROM MAILING ADDRESS)
DEV AREA: _ _. O .6 1,_PROJECT DESC: P /°\ LAT (X) : LONG
(Y)
WORK: (XE _ J D _- r
CODE LENGTH WIDTH DEPTH CODE LENGTH WIDTH DEPTH ,
MNT: (- —
CODE LENGTH WIDTH DEPTH CODE LENGTH WIDTH DEPTH
IMP: ( )
CODE SQUARE FEET CODE SQUARE FEET CODE SQUARE FEET
- ACTION EXPIRATION
DREDGE AND FILL REQUIRED: ' Tr et —9 :.. `-
CAMA MAJOR DEVELOPMENT REQUIRED:
******************.**********************************************************,
= CODES FOR AEC DESIGNATIONS
"OH" — Ocean Hazard "CW" — Coastal Wetlands
"EW" Estuarine Waters "FC":- -Fragile: Coastal Natural/Cultural
"DES" — Estuarine Shoreline "PW" - Public Water Supply
"PT" - Public Trust = "OR" - Outstanding Resource Water .
•
- CODES FOIL PROJECT -
,"P" Private, usually an individual = "F", Fedral
"C",. Commercial - _ • "L" ,
Local Government
"II" Utility _ - "H" Housing Development
"S" State : _ _ "0"_Other _
L CODES FOR DESCRIPTION -
-"11" Bulkheads, Riprap "16" Utility Lines
n12" Piers, Docks,": Boathouses - _"17" Emergency Repairs .
"13" Boat Ramps - "18" Beach Bulldozing
14 Wooden Groins: "19" Temporary Structures
"15" Maintenance of Basins, Channels, Ditches • - - • _

,
' D
TSTOi OF COASTAL N T___V ____ ____._ADJACFNI RIPARIAN p OP -owNER NOTIICATIO N Wply:R_ FORM
Name Of !Cldividual
Applying For Permit :t : o6er�
B Acores o= Prcperty ; �2 3 Dolphin Drive '��'� I,
Holden Beach , N .C. 28462
r er or Street Street Brunswick Co.
or P.oad, city & Cou
I hereby certifyntY)
I her aced property.
that
I own property adjacent
has
described renc to- op- ty. The individual applying to the
as �, _ above-
referenced proposing . ho1•;n on the attached Y ng for this ev loP ens
should are provided de �,;. to description or drawing, wng ith
d me sign ,
/� - letter . h dimensions,
_Id_
I have no objections c- ,-q
-ct i ons to this proposal . [.„,._.„3
r ' E 1fsali ,/,/E/16 Gti2 \ 3`7)" rPh,�/2�r;U�youhve obi Jp, v 2ono- - s_oo-whatis being
-_-_— COcS �- 1 7`+� proposed, i o
D 1 ir1Ot°n ,nao' c�-1r,nt D- ve xt c
North Carolina .
1-7Cardinalr -t the
Wil - 4 Drive Exton= ion .
o=* ��� io� - this or�----_ °� � call 910 � -3_0 0 within
�s ro o_ E^t1°�;; f notice . No response3 _ 5 0 _n io
_ - you have been notified by is nisi d M the same
--------_. -- - - Ceram; p ; �d Mail
LIITR SECTION
i understand ., _ ..
that a pier, dock, ,-
1 house , l ; r- mooring pilings,
fromou m area must be set back a minimum g , bdistancer, b15'
� m VE ta `of riparian aCCess unless waivedby distance you of wish
setback, by me .
bolo:;. ) you must initial the appropriate
nk
apprcoriate blank
I do wish to waive the 15 ' setback requirement .
---(... 1S I e°not wish to waive the 15 ' sCtback requirement
, 1)
S i J ne E - Z _
_ Date APrint Ham_ i,7 P/✓., A •
r
L 5 •
��r
Telephone Number -� - --
With Area Code DBE--INJ �
12I __Do/p ''il/ bi--" U e

;d
r
DIVISION -OF COASTAL MANAGEMENT
ADJACENT RIPAP,IAN PROPERTY OWNE R NOTIFICATION WAIVEZ3 FORM
•
•
Name Of Individual Applying For Permit:
L .
Address Of Property: 3 • ,'� ��' �'uJ:
(Lot or Street , Street or Road ; •
City & County)
I hereby certify that I
own property adjacent to the above-
referencedproperty.
descdescribed to me as shown on the attacheividual d applying for thispermit
evel ens
they
are providediwithg. descriptionh or drawing,
the development
letter, ng' with dimensions,
a.
„�� I have no objections to this proposal.
/ a-•
If yOu have Obl eCL i
ons to what is beina nronosed ,
Division of Coastal M-, please write the
wivisio on . North al =naaement ' 127 Cardinal Drive t
Carolina , 28405 or cal Extension
days of receipt of this notice . No resnonse9is considered5-3900 wthe s 10
as no obiection if you been the same
have _n notified
by certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwaterboat
y , must be set back •
from my ripe_ , a minimum distance of 15'
area of riparian access unless waived by
tot waive the setback, you must initial' me. (If you wank i below. ) the appropriate blank
di��� I do wish to waive the 15 ' s •
etback requirement .
I aOnot wish to waive the
15 'setback requirement.
•
Gam'
Si 6tull�i L" Date, 7
Prim Ny,e —
.......„,lf�,
Telephone Number With AreaC r
Cope
L..1 —7 FR

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66
531
P.O. BOX 53441
FAY
DOLLARS ae=
PAY
To Tvr
OF
FIDE
&inO B SC .0 21, 2 1
FOR 0000187t,116 logos
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