19711D - Southerland

CAMA AND DREDGE AND FILL
GENERAL
--Y .t 219711—D
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 n N• Iwo c •►:, GO
Applicant Name lef\ntS 30LA�kc4IAr.c.1 Phone Number 910e.Y70^o). u/
Address i I (07 i"�i n A. IL't-^cd nn eoA r/ �{ , -
City fI M State &i�,J Zip a N 4
Project L cation (County State Road, Water Body, etc.) P d-Cr- rota(141.11 1162`7 ()CIS L/i^a nc/
Type of Project Activity NJ- J h cEl f� n M f tit
to r,A/ O u I k--/5°R rL.. d r e�At r U
iN
exis4, r'c Pier A{f� i �nn 1 C'i
6u IKbc."d is 10 ihei Ietr.<juunnc._ or rocK-- - Cnnelat r;<< r`nrsh 5rnss fp pu-1 1.n Lutk-hunt
PROJECT DESCRIPTION SKETCH fta1 ,W1 (SCALE: ) 1
NOT
Pier(dock) length
Groin length ejXt
number P L. V
Bulkhead length Z Q I
max.distance offshore SL n
Basin,channel dimensions
i
cubic yards C
tt
U'
Boat ramp dimensions o7
be_Io� k,5K'c.uA•kc ;.;.' Q`
Imo` ,.,;dv U/ � �i < , >
Other �� V \V kV I�
>4 M A�,n„k �, 1V 4?`'- �, III
�� bu 1( E�d
E1-15'it r-c-;. 1 ,,2 LOTS ( ) i'L"'
This permit is subject to compliance with this application, site � ����Z9J �/*;e**(1f',Wdrawing and attached general and specific conditions. Anyviolation 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.
This permit must be on the project site and accessible to th permit officer's signatun
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- II i 199 __" a. 9-9q
_ I
ject is consistent with the local land use plan and all local I issuing date �f expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no rl 14 . 11(� (r . 1 J©U
objections to the proposed work. attachments

litANIEKAL YLK[Vll.l. LUAU'U.I ER 10KM
APPLICANT NAME: `De»n i S So uft-le-rl#-rncl
ADDITIONAL NAMES:
AEC DESIG: C'S, C iJ, PT DEVELOP AREA: _ 0°A PROJ DESC: p - i3
(Will only take 6) (Will only lake 1)
WORK: 18 P c o f
(Will only takegi..4
V 'X a t
OrtZ
MAINT:
(Will only take 4)
IMP: '51S. 300
(will only 1176_
ACTION EXPIRATION
DREDGE&FILL REQUIRED: /t' I(- q 8 a- ([-q8
CAMA MAJOR DEVEL REQUIRED:

• -
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION,W IVER- FORM
Name Of Individual
Applying For Permit: /p /rti 1.5
Address Of ,IGt �✓(1
Property: L
(Jr. 1 , I /-c
(Lot or Stream #, Street or
Roma City & County
I hereby certify that I own roper
above-
referenced
property. The property adjacent to the ereEd n on individual applying for this permit has
to me as show the t--ey are proposing. attached drawinc the development
should be provided d__ with this description, or drawing, with dimensions,
rov_ �� letter.
I have no objections to this proposal.
If VCR have CbiEC' i c
�_cn_ to what is ci
Division of Coastal be nQ proposed . Clc=c= w_ ` }
Di vi - Management` 127 Cardinal ri e t.,=
- .. _neon . North Carolina . _nEl Drive Extension .
CcVE Of rEr =iOt of is notice .2840= cr call 91O 39=-3c00 within 10
ce No c
as no Oh�lE^t; Cn if vc have been notified
is CCTc;r�c� c� the same
by CErtifiEd Mail
l.a 1
WAIVER SECTION
I understand that a ier,
liftp , dock, mccrinc pilings, breakwater,
must be sat dis'tan er, boat
from house,my _ back a minimum distance f 1 ,
area Cf riparian access unless waived byu 5
to waiveaive the setback, you must initial me. (If ycll lank
the appropriate blank
•
w. )
I-�� d0 wish to waive t:e l J i yei
baCk TE^lllrcTeny
,
i do not
wish to waive the15 SEtbzCkrequirement.
A .
Print Name 9 �v R � (_ ,� �l !;
Telephone Number with Area HNR
Code E--

1 •
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER-FORM
Name Of Individual Applying For Permit: /12 (s (7
Address Of Property: /�i ^ lovft
r�i
(Lot or S e= #, Street or Road, City & County)
I hereby certify that I own roper
above-
referenced property. property adjacent to the eeric to me as The individual applying for this permit has
shown on the attached drawing the development
they are proposing. A description or drawing, with d;mens
should be provided with this letter. ion_,
I have no objections to 'this proposal.
If you have objections to what hat is being proposed , plea
Division of Coastal -� write the
Management. 127 Cardinal Drive Extension .
Wilmington . North Carolina . 28405 or call 910 305-3900 within 10
days of receipt of this
notice . No response is considered
as no objection if you have been notified by Ce_tifithe same
'' _fie Mai l
WAIVER SECTION
I understand that a pier, dock
house, lift , mooring pilings, breakwater, boat
must be set back a minimum distance of 15 '
from my area of riparian access unless waived b
to waive the setback, Y m=. (If you wish
below. ) you must initial the appropriate blank
6W
� I do wish to waive the 15 'setback requirement.
I do not wish to waive the 15 'setback requirement.
ature , //
Si 31p�
G L�ateA
!�d v2 S A .A
Fri. t Name -70
Telephone Number With Area Code H

FUNCTION=> A NEXT PERMIT=> GENERAL PERMIT ENTRY/UPDATE RRD16(
PERMIT NO: GP19711 DISTRICT: I COUNTY: PENDER
AEC bESIG: ES EW PT APP FEE: 50 . 00 REGIONAL REP: RUSSELL
APPLICANT NAME: SOUTHERLAND, DENNIS
MAILING ADDRESS: 1167 KINGS LANDING ROAD
CITY: HAMPSTEAD STATE: NC ZIP: 28443
LOCATION: SAME WATER BODY: AIWW
LOCATION ADDRESS: (WHEN DIFFERENT FROM MAILING)
CITY: HAMPSTEAD STATE: NC ZIP:
DEV AREA: 0 . 09 PROJECT DESC: P-13 STATE PLANE COORD X: Y:
WORK: BP 15 20 00 0 Bh 50 2 00 0 0 0 00 0 0 0 00
MNT: 0 0 00 0 0 0 00 0 0 0 00 0 0 0 00
IMP: SB 300 HG 100 0 0 0 0
ACTION EXPIRATION
DREDGE AND FILL: 11 11 98 02 11 98
CAMA MAJOR DEVELOPMENT:
MESSAGE: INV NEW WORK, INV EXPIRATION,
PF1=HELP PF2=MAIN MENU PF3=PERMIT MENU PF4= PREVIOUS SCREEN PF5=ADD NAMES

CAROLYN J. SOUTHERLAND 7966
DENNIS SOUTHERLAND,JR.
1165 KINGS LANDING RD. PH.[phone] //J
I IAMPSTEAD,NC 28443 7 19/ 66-19/530 NC
1858
Pay to the p
Order of
$
> J)00
Dollars
NationsBank
• Nationsl3ank,N.A.
•
For (f Pf2-4/i'M
96 : OOO L8307 L398ii 796E
C-,? ►Qi II