Fricke, William 80010C

®XCAMA / O DREDGE & FILL W 80010 A B O D
9. ENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue F 1Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality ' / /��
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC % !7
II205Rules attached.
Applicant Name { I l 1 r l P Project Location: County--a.f& VP—l)
Address �( j E _L) ��0 Street Address/ State Road/ Lot #(s)
Phone # (W)q, 5130 E-Mail
Authorized Agent_
Affected ❑ ewrrAEs `7 PTS
AEC(s): ❑OEA ❑HHF DIH ❑URA ❑WA
❑PM:
ORW: yew no PNA yes
Type of Project/ Activity
Subdivision__
City- ZIP _
Phone # (_) _River Basin
Adj. Wtr. Body � nat, an unkn
Closest Mal. Wtr. Body �4 S G(1l
Sri r r
�■■■ ■■■ immo ■ 10■1r7. ■. .■■■. .■■
OMEN MEIN MEN I
RUN
�IN01- IN
■�Mmi■1■■■ i mm ■�ii �, �■
B= ramp
Ro>tl>a,� x 3
Bode Bul oring
otherS
J
ShweRne LengthLb
SAV., not Alfa yet . _
Moramrknn: Itra yes no
Photos: yes C.
WalverAtnrhed: yes no
A building permit may be required by:
( Note Local Planning Jurisdiction),
F
PQSee note on back regarding River Basin rules.
e—

�G
®�XCAMA / ❑ DREDGE & FILL J NO 80010 A B Q D
ENEPtAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality �/
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 0 O''l.(l
_ a Rules attached.
Applicant Name l / Project Location: County St CcV n
Address 3 l �P��1 1/A, Li ve� Street Address/ State Road/ Lot #(s)�E
Phone # E-Mail
Authorized Agent J ,
—Affected El cw _41PTA .krs PTS
❑OFA ❑HHF ❑lH ❑UBA ❑N/A
AEC(s):
❑ PWS:
ORW: yes /(no,/ PNA yes
Type of Project/ Activity
Pier (dock) length 0 r/Z711L/
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length i
number
Bulkhead/ Riprap length r
avg distance offshore i
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathous / Boatli( '
r
i
Beach Bul ozing
Other J
Shoreline Length
SAV: not sure yes
Moratorium: n/a yes no
Photos: yes no
I
Waiver Attached: yes no
A building permit may be required by: L
( Note Local Planning jurisdiction)
Notes/ Special Conditions i,6 ry
I01-1 CAI /✓ J -S - -FI-n M A Y qoax�
{et✓� �7
e or Applicant Printed Name
Sign 9ure s's' Please read compliance statement on back of permit"
Application Feels) Check #
Subdivision
City ZIP
Phone# (_) River Basin W:S
Adj. Wtr. Body .f _ «v nat an unkn
Closest Maj. Wtr Body
u
�w
Permit
(Scale: �//150/ )
.l ti I I
See note on back regarding River Basin rules.
Sign 7e, i s�llyl
Issuink Datelxpir ion Date

RECEIVED
APR 08 2021
C}

I hereby certify that I own property adjacent to �'�/ / M /Z/% / L 's
/ (Name of operty Winer)
property located at
(Address, Lot, Blo k Road, etc.)
on �'1��� �I�E,P, in 4deLI N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatio .
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If :71
sh to waive the setback, you must initial the appropriate blank below.)
do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(Adjacent
Information)
(Revised Aug. R®R4A 8 zo
*Valid for one calendar year after signature'
DCldl-MND CITY

hereby certify that I own property adjac�ant to �// /� /��r�/�/ ��� c' / _c> = 's
property located
Lot, Block, Road,
(City/Town
TheZapplicas described to me, as shown below, the development proposed at the above
locahave no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVE ICTION /
I u tand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must set back a minimum distance of 15' from my area of riparian access unless waived by N
me. (If yo wish to waive the setback, you must initial the appropriate blank below.)
i// 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Date
in)
Telephg/ie Number/ ernai ,address
Dat � .U` RECEIVED
'Valid for one calendar year after signature'
(Revised Au!A pVf y)g 2021
DCM-MHD CITY

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
NAME OF PROPERTY OWNER APPLYING FOR PERMIT 64);11
MAILING ADDRESS
TELEPHONE NUMBER
I certify that I have authorized Steve Foley. `5 4
(2© 7) 9 3T 6/-ID
to act on my behalf, for the purpose of applying and obtaining all
for the proposed development of
f_C.,.< / — _J"
at my property located at:
permits necessary
APR D 6 ZON