41600D Bumgarder best copy

AMA DREDGE & FILL
ERAL PERMIT
L Modification I]Complete Reissue 1 IPartial Reissue
Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and
NaturA Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCA,
Rules attached.
Applicant Name . ..... .lt -------------------- A f0, 1_ t,,' '
Project Locatiow
County
Address c) t z, - . . .... . ............................... . . .............. . . . . . . .................. . ................
Street Address/ State Road/ Lot #(s)
city, -State ZIP 2 9­1
.. .. . ............. .... ........ _(taw .. .
VJv,­,�
......... .... .. . ... .............
Phone # Fax #(
Subdivision,
Authorized Agent
C ity,50
ZIP
I J Cw r,�,tW Y, PTA JES I PTS
Affected
Phone#
RiverBasin
AEC(s)�: I 10EA HHF t_] 1H [J 'USA F I N/A
Adj.Body..-- ---- -- Y,/ ------------- Out /unkn)
1-1 Pws: I EC:
ORW: ( ...... .. .... e_\ no PNA yes Crit. Hab. yes no
'r esjA)
Closest Maj. Wtr.
Body-M.
Type of Project/ Activity W61, d", 1.
W)'q
"z -Z
(Scale;
Pier (dock) length
ti
Platform(s)9 x"
y
Finger pier(s)
. .. .... ...........
Groin length
number
Bulkhead/ Riprap length._
avg distance offshore
max distance offshore
Basin, channel
a
cubic yards
Boat ramp
iN
Boathousq'B
A Z­wJ 2, . ........ . .. .... ..
Beach Bulldozing
T.
Other
er
.. . . ..... ........ .......... . ....... ....
Shoreline Length_,,(('�,,::)
... . ... ..... 7 ...
... .. . . .... .....
SAV. ("Pot ' Igg,0 yes no
Sandbags: not sure yes
Moratorium. n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:
See note on back regarding River Basin rules.
Notes/ Special Conditions
e)
/ I
21,
W" 0` Please read compliance statement on back of permit"
Fee(s) Check #
7- . .. ... ... ....... . ....... . ..... \
issuing Date Expiration Date
. . ....... . ........ . ........... . ...................... .. . ........ .. . . - ----------- . ....... . . . . .....
Local Planning jUrisdiction Rover File Name

M- MIT-M-TMEM=3"- -
)
I/V/# O.L., )M
VU
M�= W
1 Applying For Permit -
ty:
/-V
r reet or Road, CitY & C!Oltnty) juWi.
tilat I own property adjacent to the al-,)ove--
Y. The individual applying for this permit. has
i shown on the attached drawing the developMelItr
A description or drawing, with dimensions,
with this letter.
ha�e no objections to this proposal.
lundux stand tha boat
ot pier, dock, mooring pilings, breakwater,
h,,Mve, lift or wags must be set back a minimum distance o14F 15'
(If YOU wish
froni my area ot i rian access unless waived by me
se Pinit appropriate I-Aank
t,:) waive the back, y�ou 9=1 ial the
below.)
I Oo wish to waive the 1.5,setback requirement.
wifjh to waive the 15'setback requirement.
MM
Ei
W in A-rea C(
C)nsjow county Plannitto Depazily
(304 College Sheet
Jackmonville, NC 8540

ADJA(_ LN I XIPAX16N FRQPEJ�TY OWN -ER XOTIFICATIQX/WAIVER FOFI%4
Name of Individual Applying, For Permit: rJ
Address of Property:
Y
(Lot or Street #, 55
(City and County)
AK(I`c
or Road)
/-,-" ( Y�'
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
I
are proposing. A description or drawing, with dimensions, should be provided with this letter.
"k-) � A ).S' 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, NC 28405 or call 910-395-3900
e�p
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.
t� 61 - I must 8
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift u t beset
bek a minimum distance of 151 from my area of riparian access - unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank bellow.) '
le'.:' ''91 A� J
Km
Sign Name
Print Name
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15' setback requirement.
Telephone Number with Area Code
Date

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