18221D - Green

1.
• CAMA AND DREDGE AND FILL
r GENERAL be: O18221
PERM I T
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 714 , Iaoo
Applicant Name \1 I �P��11 Phone Number (ill) ""
V. 5a0
Address P+ 0 ,�rX cIDin ,f t1
City ��f t Ct State NU �-7 Zip c.28 L1 `CS
Project Location (County, State Road, Water Body, etc.)—_Pd1`' coun+l / 15 nou-1h ko�
-Tun') guf r c.:+ , LiC1,) Ptr,KS t" C i "-An
Type of Project Activity IJe &J p%C dol., LA nctu6ter'dt icocv4 IZ4f
* A1k ��rk)c-ktte s r u 5* be- g 1r n t nu r- of Ro' Greg, `4- l'r edc� 0 P
'�.1,:k ex A 1 d h A v\nc�l Pre bc� IA kee_f,nq u ..-14, NI.?ct n"t per- ker+cl 161.1e J +
PROJECT DESCRIPTION SKETCH (SCALE: )
Pier(dock) length' I v I �An N -,
NI( 4. wide) GhgAne I 3'
Groin length Iw, �Q�� Qnq�
number ( ___._ _-__...>W `n........, • la: a
Bulkhead length o 91 tkot 4�Ar\ ^ }
� 0 7 n
max.distance�5offshore' �� , �� ��
6r
Basin,channel dimensions
rt
tc(
cubic yards 00
Boat ramp dimensions
Other 1V Ln dOCk-
Ito' X au1 )P4&
Qqj kJ/4,V ,41 ‘,414 ,„ :v 4 i V
I tincQJC.4 (I
L Ff- 0J -1, LAT
CAV
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 applicant's signature
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- GVI�,.. ' 19Ci p4*crat
I ?ject is consistent with the local land use plan and all local (v� , issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no 14, (aQc)
objections to the proposed work.
attachments
1r-- A 0

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: PR1 I ar e-e-n
ADDITIONAL NAMES:
AEC DESIG: P T ' G 04.J DEVELOP AREA:
(Will only take 6) -- 3 PROD DESC: P - /01
(Will only take 1)
WORK: P '10 X co/ b C. /8 x le
(Will only take 4
C ,to
MAINT:
(Will only take 4)
: 0w ego o(A)
(wit]only take 6) L W 38 4
ACTION EXPIRATION
DREDGE&FILL REQUIRED: 5/1 3 1 `S 8 ` 13 /9 8
CAMA MAJOR DEVEL REQUIRED:

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VANCE E.KEE,MAYOR
jI
% t V NORTH CAROLINA 28445 ROBERT KILROY.ATTORNEY
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIF7)
I hereby certify that I own property adjacent to-NS I c— L i,J-A GCE v0 's
(Name of Property Owner)
property located at ,;;.1 % s.
(Lot, Block, Road, etc.)
on ax,vJ Ks C.ti,p►J roc___ , in SL. c I i f -- E►.)7O-._ Q N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pier/uncovered boat lift
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
db
�( I do not wish to wa
ive the setback requirement.
I do wish to waive that setback requirement. p7 a 1
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
, ,4-k S...,21c4-)C__-
Print or Type Name
-
Telephone Number
Date: .f 1 4 a
_ _ - *t4--_ - --. _s--,.... - - -74: " - .._7^ - --Tic$` � , y_....,-,"A-._..a-

• JR F C/�.
G> VANCE E.KEE.MAYOR
`� TODD N.THOMAS.MAYOR PRO TEM
N `~/ Q KENNETH D.BATTS.COUNCIL MEMBER
UHF CITY DOUGLAS C.MEDLIN.COUNCIL MEMBER
O� �1� �.P4O LIONELL MIDOETT.COUNCIL MEMBER
111g RICHARD B.TURNER.COUNCIL MEMBER
NO RTN NORTH CAROLINA 2 8 4 4 5 ROBERT KILROY.ArroRNEY
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to�i FJ i L k L i h.f\ A GCE 's
(Name of Property Owner)
property located at 1 ' s •
(Lot, Block, Road, etc.)
on a4 vJ Ytis ati A tJ n c . , in 'S j -- rs3Z e� N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pier/uncovered boat lift
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I d4 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
SigfRure
Print or Type Name
328 -22S3
Telephone Number
i
Date: /2 MAY 9PJ
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do not cash. 7
present, 107 29 t
and the iuwF,cSafc©logo on back.If met I
found on the front of this check.'
green background
Look for:gC
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66-191 02
COASTAL REFORESTATION INC• r r 3 r��
DATE l�I
I'; P.O.BOX 2249 910-328-2354
� SURF CITY,NC 28445
Ek- - DOLLARS kI
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