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CAMA AND DREDGE AND FILL
GENERAL 919781_ (J
PERM I T
as authorized by the State of North Carolina
Department of Environment, Health,and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC 17,- /4
Applicant Name ' rm M L b O/14 i el Phone Number
Address (�a y r/7 FMrAM I,9 54--4 P8
City 1. (.1 r kb, P State ," C., Zip oZ 3 a I
5
P��gqject Location (County,Mate Ro d, W ter Body, etc.) 3 5 49 3 k i ie r VIZ' P dA O f LA/ d 4
KC' ncyr Simonrs 1¢(� on A / SraMSuit ac CaN-)it /
Type of Project Activity caA5 �'(�- j°Y' X I9d' p IC r w1+k /6'X /a ' 4'A NN c 4 wilt r Wu''� P,d • 14i1
Cons �r.c.���� 5-1101 he of4° /!4s /- /SJVI— in r c e r r-i�,v- Corr. d or /ii1P . e
q•k• /ly 1Dc/4" /4��wuru o� /leaf$ A�-r! eJ 11- D - CCert ( CHGnile( Adeo�'1Jir/on
` C g14"uc. h 7/4. / 0 SA. 4Apsl_ PtIi refair GXfs�i� /91(x/6' Am.49,-erAcJ dock
PROJECT DESCRIPTION, SKETCH / r (SCALE: A/01. y� )
Pier(dock) length i/rX/Ca f IV
Groin length 1
number � Z15,
Bulkhead length
max.distance offshore
B . channel dimensions
cubic yards
Boat ramp dimensions I r r
Other t"fle YJ I ' X��i r r (( V� N� t ✓� GJ re
gp4S'Aq'
Da'
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. 1I1/r--
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. / u
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 I ,
adjacent riparian landowners certifying that they have no !/-'/ 1 2 0 l7
attachments
objections to the proposed work.
.9
v- ....1..x4yL Y-"..MS'l1.1• - COMPUTER FORM
:LD REP:- , sRe �'
Fr.n.
EMIT NO: C.
47 ' /~� - .- COUNTY: /�vn/k Al/
: TThSIG: •l , R.), E,< p I l WATER BODY: Pr LA, _
fib /8
lITIU.t c NAME(S) : :. -. - . - •- • .
:LING ADDRESS: • •'- I. • ' -.-- " 'e`" �� ONE: �:. _
I • :, I
. CITY: (_iwr--- 'L STAT : •
JEC`� LOCATION: �J /Qk. c t A ... • i;W'P (Jvi.;►L,- .:.l'1 _ —
J,Cs;!' CITY UR It.�C:kLI?Y� }� ��
(WHEN DIFFERENT FROM MAIMING ADDRESS)
AREA: . _ ' PROJECT DESC: P J1 _ .
— —1-- -- — �o� LAT (X) . � � LONG (Y) :
' eg % '2.21 : -- Ei- 1-i- - . . lk . • -
CODE LENGTH WIDTH DEPTH .:j CODE LENGTH WIDTH DEPTH
CL) LEPIGTHY WIDTH DEPTH CODE LENGTH WIDTH DEPTH
Pt (D g ) . _ _ i•
:
CODE SQUARE FEET • CODE • . SQUARE FEET - CODE SQUARE FEET . )
: . ACTION
. E XPIRATIO( •
D GE AND FILL REQUIRED: ` -- =-:.I. q ' -- ,
. . . ...
A MAIOR DEVELO- no REQUIRED: ..
*i*************.***********************************************************
. _ _ ..'"- _ . - ,-.--.= - _ - -- _ _
CODES. FOR AEC DESIGNATIONS__
.Ocean Hazard "CW"- -_Coastal- Wetlands
Estuarine Waters • - -• °PC": Fragile: Coastal Natural/Cu- ltural -
_ '`Esfuariia Shoreline ."PW"_ - Public Water Supply _ ..- - -. -- -- :-•
_
.-.Public Trust :NOR" :- Outstanding. Resource Water
CODES FOR PROJECT-
?rivrte;7 asually an-. individual "F" Federal =
.cmmarcial _ - °LI- Local Government
Jtil.ty rcg" He -
Mate - using Development = _
- _ el On Other • �'
:CODES:FOR DESCRIPTION = - -
Bulkheads,-_ Riprap ` •., -:_ 16n. Utility.Lines . -
`Piers, Docks,'.Boathouses 1Z_ Emergency: Repairs.
Boat Ra ips`� _ _."18" Beach Bulldozing.''
Wooden Groins = - ,"19n. Temporary-Structures
Maintenance of Basins,' Channels, Ditches
•
1
DIVISION OF COASTAL MANAGEMENT
• ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER_ FORM
Name Of Individual Applying For Permit: /,QJl�c� j�S-//704J4 --e,
Address Of Property: 'T 6
(Lot oar Street #, Str r Road, C 't & Cou y)
I hereby certify - that I own prop rty . 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 pr000sed ,• pleas_e write the
• Division of Coastal Manaaement , . 127 Cardinal Drive Extension ,
Wilminaton , 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.
•
•
Signature Dae
1 / 5 AC-t=1 7-/- ,r
Print Name
- Y , _; �, ED Telephone Number With Area Code
DIVISION OF COASTAL MANAGEMENT
• ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WP.IVER_ FORM
Name Of Individual Applying For Permit: Z/),0(� r7- /4-(-0,%-.6 ,/,4:-.53,
Address Of Property: J ` - "L ; 5
(Lot or Street, reet' or Road, C t C
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 Manacement , . 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.
•
/- kAi
i re,f/
/ 1
Dates A .
Print Name. / �„�. r
79 ' Z �c<� p N Telephone Num r WithArea Code
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(,(J TIM McDONALD 66-85/531 595
,n{Y McDONALD
2487 FARM
c1J�[l 2487 F LIFE SCHOOL RD. Dnt�
CARTHAGE, NC 28327
910-949-2086
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the
order of m $ 55-0 .
`_ If r Dollars CI Et,'":
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MONEY MARKET INVESTMENT CCOU T
CENTURA BANK
$ CARTHAGE,NC 28327
PL°w5 a.•yFor ,
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