17642D - Clements

"CAMA AND DREDGE AND FILL 017642
GENERAL
PERMIT
as authorized by the State of North Carolina
10 Department of Environment, Health, and Natural Resources and the Coa�$tal Resources Commission
in an area of environmental concern pursuant to 15A NCAC -7 Coastal
1 2..G e
Applicant NameP - CL m'e kris % t—� 5 Mari N-C Phone Number 5-G.' 306.2
•
Address 4O S I h ar ► c, A-'y`� '
City �i L� I State 1'3 G- Zip �•2- d
5iiae
Project Location (County, State oad, Water Body, etc.) _____.: Cr �-o� �"�� -�, J / fl �-^--1
Type of Project Activity- • 4e/di -1—t.. c ( • ; �
lv� -� LiL S•�"T�y:.-� T
CI_A, 2125:3X -1 444-
PROJECT DESCRIPTION SKETCH • • (SCALE: I t►_ 2-0 )
11 N b V PI-
,
Pier(dock) length 4
t1.' 4 1
•
w-
:;;
I
ngth ! ' �( � "
�.
max.distance offshore r , ,
... __.. f.._...
Basin,channel dimensions
f &
I "''
cubic yards (
Boat rampdimensions e
j(1sTtufr pie r
Other FiCr+' 4r) X� . ` 9 t .
t �
WAI110. 4I i
This permit is subject'to compliance with this application, site 7 /��C
drawing and attached general and specific conditions. Any !..-�
violation of these terms may subject the permittee to a fine, 17,1..,,
imprisonment or civil action; and may cause the permit to be—
come null and void.
..)-P--)--'), C719---- -
This permit must be on the project site and accessible to the permit officer's signatur
permit officer when the project is inspected for compliance. J t �� / `I ��
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 dat
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no attachments �- - I Z9
objections to the proposed work.

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
Name of individual applying for permit 4 '6 6',bo ett-hne►z5
Address of property s?70 5- PI 41 :I /1r1- , 14.1)" /�,/��
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 of notification.
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, N. C. 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 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 & Date
MK o4 Print Name
— v4-/sPa Telephone Number w/ Area Code
PLEASE SIGN AND RETURN TO; F&S Marine Contractors
P.O. Box 868
Wrightsville Beach, N.C.
256-3062 28480

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
%Name of individual applying for permit •�'� y — ebnF /L'l-11 cM3
Address of property A> L 5 dfArz 4z'e A/ /,,,,46fmJ NC.,
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 of notification.
l/ I have no objections to this proposal. Ap
Lc
If you have objections to what is being proposed, please write the Division of
Coastal Management, 127 Cardinal Drive Extension, Wilmington, N. C. 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 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.
ae_t,I.SaL12.6614;/-iic,,L nriLdsitfi4ttW' 4,13:Air i')/Ykt, / 3 - I - q .?
alc4, 66.-54),4/1/taikac--4,4-print Name
%'_ 6 g6 -(7a I Telephone Number w/ Area Code
PLEASE SIGN AND RETURN TO; F&S Marine Contractors
P.O. Box 868
Wrightsville Beach, N.C.
256-3062 28480

4. f&S Marine Contractors, Mt,
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61v►:� (^ �,� WrightsviPe.O Beach,NC 28480
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