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CAMA AND DREDGE AND FILL
` GENERAL
-Y 118365 ---.0
PERMIT
as authorized by the State of North Carolina
10 Department of Environment, Health,and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC or? 1 - / / 0 J
Applicant Name �G n PS Phone Number ("; CA D) u — s 6q
Address TO j-e o r %/it ►.J D r•
City I—)�,A< 60 !- State Zip A o
Pro'ect Location (County, State Road, Water Body, etc.) / ? .2 -N / ' 0.2I 5-, r) S/ OA . / C.-%
is a 4, A o n /nig. /1 — M,,t,Cr e C c., At-4 ! f j J r I—J'I _Sw i L t e---:J . / L/
Typ ofProjectA tivit Da -l�'r.�ct A e w J/.�/,'i(�tJ 3lFi wy-E'<r'WWr-d .)F�-P Jo% f,'n fa✓I /1e, d.
A�Cw 4d i+�icud a /' A M Pel+ i5 A he a S Ff- u,.,+(r ww rd o-F he, rc.-'_.,�3/, /,i
of r<s►cl(,u .,4- I '5 1 0 0 i,t c�-. � . n .o e cc c+ w,.e+f r w«r cJ o. 6 0/k A el cL
Aid0A /A( iv+ O t c)ot- I sole prPtr�/ . hit (-Ac1 �-ti{ID,1 ) o-f c7N'. //'r sAl/ YPDil
PROJECT DESCRIPTION SKETCH i (SCALE: A "-- i- S� Y; )<.
Pier(dock) length l.'‘ NGroin length
numberA
Bu head length (00 �^<4J �^ `m �! a^� I
" e c—r
max.distance offshore
N -----'Prop.srd g.,/k Ar.,ci All.1n...C,,A"r ",,..
Basin,channel dimensions
cubic yards [� 5o r 5 J I -
Boat ramp dimensions [[[[1�`���--� 11113� �r�
I)t A 6 4". ‘I,
Other
..""•( to D01,04,„ 54- 13 $
o0/ph;"sf
This permit is subject to compliance with this application, site4 �
drawing and attached general and specific conditions. Anyyi --. ;----2-'
violation of these terms may subject the permittee to a fine,
imprisonment or civil action; and may cause the permit to be—
come null and void. �`(/'" �
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. ( ,;
The applicant certifies by signing this permit that 1) this pro mot]
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 /
objections to the proposed work. attachments
. . . . . . .. _ .. . _ .. ._. . ^� f� --1-...
�tilii - L.ur-.rupr R FORM
0
FIELD 'F�E? r (1 ADP FEE: p
•,-la. NO: Of 3 -6 S —
-- � COUNTY: !'✓it‘we L.
AEC DISIG: P/d ff WATER BODY: 4VLtA. �,f-
a PP z,Nr' 0 c,v cs� 4 r-6d -
DDDI ONAL' xiii :iE(S) : �J-
•
2�iAILi�1G ADL �; 35: /erjte1 _
PHONE: 2
- :. CITY: /4-5/te b.�v--a. STATE: Ai d-"
• .ZIP: �� �-0
PF.DJECT I CAI. ��I: I �\i? v-(`l® i)v 1, �, ., �- 1: e I `
IN ".UDTNG ".:' 9R -,x ,L�-1 (WHEN DIFFERENT FROM MAILING ADDRESS)
D V Ak /
EA; • D O PROJECT DESC: �` - / I LAT (X)
LONG (Y)
WC"3K 0 (LEI+ ._ j-b C�7 -1 - (_ __ . -. . _ )
_ _ _ _ _ _ _ _ _ _
- CODE LENGTH WIDTH DEPTH CODE LENGTH WIDTH DEPTH
11%1T:- (- _ _ _) (-
-. CODI LENGTH WIDTH - DEPTH CODE LENGTH WIDTH- - � —)
- DEPTH
IM.p: (57E 6 '-?) ( • )
C:;)D� SQUARE FEET CODE SQUARE FEET ( )
CODE SQUARE FEET
ACTION EXPIRATIONo� .
DREDGE A3 i) FILL REQUIRED: C I - 1 r .q / .- ¶ 4
LAMA Xf_JC;R DEVELOPMENT REQUIRED:
***ItxRf.y.z, 4-*i,-***************************************************************
_ CODES FOR AEC DESIG1 TIONS - -
_
"OH" - Ocean Hazard "CW" - Coastal Wetlands
"IX" - BstuE+ri tle Waters 'AFC".- Fragile Coastal Natural/Cultural
In - Es'_ rL:;e Shoreline -' "PW" - Public Water Supply
"PT" Pu13f7 T.:UstORrr
Outstanding Resource Water ._ , .
_CODES FOR PROJECT-
"P" Priv , ...sually an individual- "F" Federal
"C" Comm=rc.”.1- • - _ "L" Local Government II Utility - - - "H" Housing Development. _"S" Star= - - _ "0" Other - - -
.- -• CODES FOR DESCRIPTION"11"
Bulkheads, Riprap , " :
" .ti - 16 -Utility Dines
Piers,-, Docks, : Boathouses = 17 "_ __=
12 -.
"13" Boat Ramps-. -, -: ;- • _. . - = : - --" ' _
Emergency Repairs
"14" Wooden Groins: -Basins
- _ - r18� Beach Bulldozing -
- - - 19 Temporary Structures
"15" v- .--1 .:_ -w c f Basins, Channels, Ditches -
Us p 2 �-Z 9
aRece�At o 82 6 4 8
Sur or C -7
9znr of use for Coverts ee pr q
s�c�/ - 'rlernapona/_ha�,Main
Ak , . Maid se UdIdlld3:)
P�sr 3�r t v e re''e�
C�- �•S kY� e ssaippe uantai ayl to 1U6ii a
qi
Posra�l/L4r-I/PCodec Deal services. of edOlanua}O dol J9A0 9Ull le plod
ge a reverse of this form so that _-
celiwedP A �+C, a mailpiece,or on the back if space does not 1. ❑ Addressee's Address .Z
ee a
Ct.41 , a 9 y id'on the a ailpiece below the article number. 2. 0 Restricted Delivery v
par0errv. o whom the article was •delivered and the date `C
4. Resrnct'D lbw- Consult postmaster for fee. `,
h
o) Reru er, 4,F._ , � 4a.Article Number a
cc
m Rec br T
E
Q- a�wmq� • �eots�o,,,�e�rr�e: +�� `�: l �Y� 4b.Service Type
0 r -'ess —" )9ro n ❑ Registered ❑ Certified c
c� o°TAC Po�ageB�d /' G ,C 0 Express Mail 0 Insured w
P
mark n �s -��t SC 0 Return Receipt for Merchandise 0 COD
ci. Or are en1� o
aqJ-1� 7. Date of Delivery
Q. 0
: (Print Name) 8.Addressee's Address(Only if requested 1
and fee is paid) co
t
I—
r(Addressee or Agent)
PS a11. December 1994 102595-97-B-0179 Domestic Return Receipt
DIVISION OF COASTAL MANAGEMENT
• ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit: ,,0 0,- / 5 / L/
Address Of Property: d70 )OL2(-4/AV •,2.
`401--b04 • '6e7lei1 N . e .
(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 .
Wi lmi ncton . 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 m.:v •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.
_ na z-�!�� Toci
.c i ur
/y� 9_4/D/ Date •
r � Al;Tl _ a.: /
Telephone /5y3 pH R
Number With Area Code
FUNCTION=> A NEXT PERMIT=> GENERAL PERMIT ENTRY/UPDATE RRD16C
PERMIT NO: GP18365 DISTRICT: I COUNTY: BRUNSWICK
AEC DESIG: ES EW PT APP FEE: 50 . 00 REGIONAL REP: PARKER
APPLICANT NAME: BARNES, DOUG
MAILING ADDRESS: 380 CLEARVIEW DR
CITY: ASHBORO STATE: NC ZIP: 27203
LOCATION: 138 & 140 DOLPHIN ST WATER BODY: HOLDEN BEACH
LOCATION ADDRESS : (WHEN DIFFERENT FROM MAILING)
CITY: HOLDEN BEACH STATE: NC ZIP:
DEV AREA: 0 . 09 PROJECT DESC: P-11 STATE PLANE COORD X: Y:
WORK: bh 100 4 00 0 0 0 00 0 0 0 00 0 0 0 00 C
MNT: 0 0 00 0 0 0 00 0 0 0 00 0 0 0 00 C
IMP: sb 400 0 0 0 0 0
ACTION EXPIRATION
DREDGE AND FILL: 09 09 98 12 09 98
CAMA MAJOR DEVELOPMENT:
MESSAGE: INV ACTION DATE,
PF1=HELP PF2=MAIN MENU PF3=PERMIT MENU PF4= PREVIOUS SCREEN PF5=ADD NAMES
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