20618D - Brossia

CAMA AND DREDGE AND FILL .
�i GENERAL ^' ? 1$ ^ es
�Y_
PERMIT
as authorized by the State of North Carolina
0 Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC 7 H- 1 A .1:,
Applicant Name �� `ass �4 Phone Number
Address a-3 0b 6rD c+Cr
City 7 e t r.l 6 r i State 0 4 , Zip Ail'6 S/
Project Location (County,Statue Ro4, Water Body, e,tc.) 1.a"f tt // wi 4 d'A1 J R'✓ e— S.,4 el
o ^ ko c. Kw.2,d /llLI r?ivt'- near- <,_0pA14 /r � r✓�S w ' c /( (3 .J
Type of Proj t Activity CO d t-/1 .,Lid— /A ' k / ? r A,_k 4- /' 'F-I' q d) t c (A 'I' t'o
,e.)et , 4,, 7--- ti,a.\ .4_ fl0 4 •-,h cry k . All c. r fr Li of —A 4l I{
d /e 1- /S p-- /.rSt je eaL `} tpGrt, cor r d .r-- Au '
cI fro Lke d 7 J . /A a'D Sulu if ct/ ) r./
PROJECT DESCRIPTION SKETCH (SCALE: )
Pier(dock) length
Groin length / 2 /� Ctpp1�o /_?0 11 lti/ ,� r O
number �' Twe.t. Yr
Bulkhead length Wetr �K G
�
max.distance offshore
Basin,channel dimensions
cubic yards
Boat ramp dimensions/
Other I� . -1-- /` f-4-
/)' xl ?'
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,
imprisonment or civil action; and may cause the permit to be ap is signature
come null and void. f
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. q _ 3 D ^ o l ) 1. - -3 a - 97
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
adjacent riparian landowners certifying that they have no r?" / Z"
attachmentst
_ � L �
—
objections to the proposed work. �n� ('
i __.. __ ,, :_ .i__ r._._ _e .i__-i_ ___i___ ___..c._ .i. — i ! n it

-...•.,� r�ruulL - LUMi'UTER FORM
A_?_ FEE:
FIE:'
F .P: � trkC�• ? o07
-
-'= =",-1T NO: 010 & G i — 0
LT
`(�..� COh'TY: r.d.'� Lt�tC.I1
AEC DFSIG: F� 1 C I/') , 5 ` WATER BODY: 1-'oc--Kwo J
LPL CANT .E: i lei
-.DDIT'IONAL IJAME(S) : . ' . .._ . _. -
MAILING ADDRr'SS 4 .
5 It (.: -.V►_. 'Fr:1 CA LA PHONE - _ _
CITY: kir-r-41. �jvr• !
. - STATE Oft C.t0-• =_ZIP: 11- 3 55 l
PROJECT -I t�ti-a;lt; - ' rc�V f�- : 4 (� �r f
• IN"vUDIHG G'T;' 7R IJ3:' L:TY ` ' � ���'���I -' /V l'
(*HEN DIFFERENT FROM MAILING A'DmRESS)
DEV AREA: , t� :� 3 © •
PROJECT DES C:` /Z LAT (X) : LONG Y
(EL •- - - L __) (_ - _ _ _
; CODE LENGTH WIDTH -: DEPTH CODE - LENGTH -:- WIDTH - DEPTH ,
CODE LENGTH WIDTH DEPTH CODE LENGTH — —
WIDTH -DEP
IMP: 6 )
CDDE. S¢TJARE FEET • CODE SQUARE FEET
CODE' SQUARE FEET .
-
ACTION EXPIRATION
DREDGE AND FILL REQUIRED: -1 -3'-- --1 ' / 1.- -. .5 zt _
LAMA M7 JOR DEVELOPMENT REQUIRED:
********************************************************* *******************
- - r - -. . • _
` -- CODES. FOR AEC DESIGNATIONS-
"OH" - Ocean Hazard - "MI" - Coastal Wetlands
":=W" 7 £st arjne Waters "FC": Fragile Coastal Natural/Cultural
ES" - --_ av Shoreline
"PW"_-- Public Water Supply
-."PT" - Public Trust _ - "OR" :: Outstanding_Resurce Water
_
- - - CODES FOR PROJECT
„P�"t Privy,. , °Lt.sually an individual "F" Federal -
C Commercial "L" Local Government
,"II" 'Utility "H" Housing Development
"S" State = -_ - "O" Other - _
- CODES FOR DESCRIPTION _
"11" Bulkheads -..
Riprap - : a "_. Lines
_"12n_`Piers, Docl�s,__Boathouses - 16 IItility, _t _ _
'l13n Boat Ramps`. `. - - - _ - .�-TM17_"_ Emergency Repairs . �.. - -.
"13" oade� "18" Beach Bulldozing
Groins _ - "19". Temporaryy
"15" Hzl t"'=2T"^^e of Basins,' Channels, Ditches -- - Structures

The American Fish Company
iP,. t .O. Box 11046 [phone]
_ Southport, Noah Carolina 28461
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• DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit : ` /A0A44041t
Address Of Property: p�[Tl 11 40 , i,�s�'�sL
�zir. g
(Lot o t ee . -I#, 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.
k--- 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, 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 .
: /;,.// ll
turp
Date
'in' '
P izit Name
Telephone Number With Area Code

i
/E NDER: • • . I also wish to receive the
Complete items 1 and/or 2 for additional services.
Complete items 3,4a,and 4b. following services(for an
Princardt your name and address on the reverse of this form so that we can return this extra fee):
to you.
■Attach this form to the front of the mailpiece,or on the back if space does not 1.❑ Addressee's Address 11
permit.
•Write'Return Receipt Requested'on the mailpiece below the article number. 2.0 Restricted Delivery
•The Return Receipt will show to whom the article was delivered and the date
delivered. Consult postmaster for fee. Ti.
13.Article Addressed t 4a.Article Number_ \ m
i� rrYvi e n f C �� . Z D y /t� SL cc
t c 9 c\ r{-f1-N-1 (L-c/ . 4b.Service Type E
r
Fh
I -� if.k(� / C CIRegistered 0 Certified 12
1 ) J ' ❑ Express Mail ❑ Insured E.
/ -2
El Return Receipt for Merchandise El COD
`� 7.Datg..Qf Delivery Co
5.Received By: (Print Name) 8.Addressee's Address(Only if requested Y
and fee is paid) m
6.Si ure: ( ddr e or Agent) H
X /ik>
. PS o 1,Dectrber 1994 102595-98-B-0229 Domestic Return Receipt

FUNCTION=> A NEXT PERMIT=> GENERAL PERMIT ENTRY/UPDATE RRD161
PERMIT NO: GP020618 DISTRICT: I COUNTY: BRUNSWICK
AEC DESIG: PT CW ES EW APP FEE: 50 . 00 REGIONAL REP: PARKER
APPLICANT NAME: BROSSIA, BOB
MAILING ADDRESS : 23206 BRODEN
CITY: PERRYBURG STATE: OH ZIP: 43551
LOCATION: LOT 11 WINDING RIVER SUBDIV WATER BODY: FOLLY RIVER
LOCATION ADDRESS: NEAR SUPPLY (WHEN DIFFERENT FROM MAILING)
CITY: SUPPLY STATE: NC ZIP:
DEV AREA: 0 . 03 PROJECT DESC: P-12 STATE PLANE COORD X: Y:
WORK: bl 13 12 00 0 0 0 00 0 0 0 00 0 0 0 00 1
MNT: 0 0 00 0 0 0 00 0 0 0 00 0 0 0 00
IMP: ow 156 0 0 0 0 0
ACTION EXPIRATION
DREDGE AND FILL: 09 30 98 12 30 98
CAMA MAJOR DEVELOPMENT:
MESSAGE: INV ACTION DATE,
PF1=HELP PF2=MAIN MENU PF3=PERMIT MENU PF4= PREVIOUS SCREEN PF5=ADD NAMES

...mamo..m.... �_,�,� m Security enhanced document. See back for d e t a i I a.m._--• -
THE AMERICAN FISH CO. 60283
CHARLES H. OR KAREN Z. PERRY
I P.O. BOX 11046,WEST BAY ST. 56 30/531
SOUTHPORT,NC 28461 Q —�� �' �t 453 i
DATE 1 i
PAY
OR ER OF �� C�� �- (VO
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FIRST CITIZENS 453
BANKF,nt-Citizonu Bank&Truat Comparry '
Southport,NA.28465 i
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