88585C - Hilsinger, Ryan & Stanley, Patricia

'11111 CAMA D DREI
GENERAL I
C$New 0 Modification
FILL
MIT
mplete Reissue El Partial Reissue
N(� 9858-5 A B
Previous permit
Date previous permit issued
i
As authorized by the State of North Carolina, Depa ment cfEnvironrnantal Quality and the Coastal Resources Commission in an area of arwironniental concern pursuant to:
I SA NCAC Rules attached. General permit Rates avallableat the following link: vn6nyft.-nn�Mr f
J ffiA.
LA
fY
Applicant Name,
)1VtfioTi-ze4 Agent
Project Location (County):-
... ................... Address . . ......
City
state ZIP Street Add WStat Road/Lot #(s)
i . ........ 77'
Phone#
Email Subdivision
4.
City
NPTA
Body �- A 0 JknaVr�anlunk)
Affected Cw NEW FlEs pTS Adj. Wtr. El
A C (s) OEA 1HA UUw 0 SPIMA EIPWS Closest Mai, Wtr Body . . .........
ORW(*-/no PNA: yes(5D'
------------ - - -
(Scale:
I (rl;P 1 -11----, -- I ----

�1*oCOW41 CYCAMA ❑ DREDGE & FILL 9 88585 A B (0 D
GENERAL PERMIT Previous permit
y � Date previous permit issued
JNew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
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 g` ' L ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name FN MiLU ��-
Address
City State ^ ZIP
9 .35
Phone # ( ) a��" 3
Email
Affected CW Y EW 4PTA
❑AEC(s): ❑ OEA IH❑�����A "```��`�`UW
ORWeno PNA: yes
Type of Project/ Activity
Shoreline Length
Access Length
rNPier (dock) length 1
Fixed Platform(s)
Floating Platform(s)
1
Finger pier(s) X
Total Platform area
Groin length/# "
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length —
Basin, channel —
Cubic yards
Boat ramp
s
Boathouse/ Boatlift
Beach Bulldozing —
Other f rvLLb ;f
SAV observed: yes Uo
Moratorium: n/a yes Site Photos: yesRiparian Waiver Attached: yes
A building permit/zoni g permit may b3erequi
Permit Conditions �./ i AMA
nt or Applicant PRIN
❑ ES ❑ PTS
❑ SPIMA ❑ PWS
?S11
jGthorized Agent G /NIK
Project Location (County): - 6j-d�
Street Address/Stat Road/Lot #(s)
Subdivision
City on M, ZIP
Closest Maj. Wtr. Body e � 14 W /
i
(Scale: , i
ul -_...,
❑ TA%add
EUSE/BUFFER (circle one)
Sen back regarding River Basin rules
❑ Seonal notes/conditions on back
COMPLIANCE STATEMENT.
Signature **Pip-ii1se read compliance statement on back of permit*
Application Fee(s)
Check #/IVloney Order Issuing bate
Expiration Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
e
i hereby certify that I own property adjacent to RVOLYN H I S
' — �roPertY '( (Nam of P Owner)
oroperty located at 23(D wj-y N-
(Address, Lot, Block, Road, etc.) N.C.
cr der n Cel, D e-
(Waterbody) F-- (City/Town and/or County)
Tre applicant has described to me, as shown below the development proposed at the above
iocation
I have no objection to this proposal.
I. have objections to this proposalt
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
Individual proposing development must fill in description below or attach a site drawing)
5 f % I
X
WAIVER SECTION
understand [''a` a pier. dock, mooring pilings breakwater. boathouse it, or groin!11-'st � sel. L
back a minimum distance of 15'from my area of riparian actcess-niesswaNed by me cif you
wi L . sh owa ve the setback you Must initial the appropriate blar,,R below.)
1 do wish to waive the 15'setback requirement.
1 do not wish to waive the 15' setback requirement.
(Property Owner Information)
St',-Ynainre
cr Type Ivam- 19
Po OQ x q C) C)
Mailing .address
ZnLLA�A
� Y'/scat4'0; :_
')t /Z;J
-F-91;oW,c,r)e Nj-:;mt)er
4 z
L
(Adjacent Property Owner Information)
Print or Tye �- t PJIame
Mailing Address
',ty1Sta1-n171r
L14V
Teie,oi,one Numoer
'P F 4
f-,-,.--sed of"
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ADJACENT RIPARIAN PROPERTY OW JER STATEMENT
+
i "e,,eby ce rtify "hat I own property adjacent to -s � no�� c-
_(Narnof Property Owner',
oroperty iocatted at 23C v F>O; lv�
(Address, Lot, Block, Road, etc.) (Waterbody) I - — ----- (cityrfown andlor County)
Tt,e apolicant has described to me. as shown below the development, proposed at the above
ocatiov..., ' 1 have no objectors to this proposa:.
I haveobjectionsto this proposal
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
individual proposing development must fill in description below or attach a site drawing)
f
WAIVER SECTION
-:71,ers?,arc t.;,.a" a pier. dock. moonna pilinas, breakwater. lboatiotse or groin —..st be set
2 ,ack —C m1mirnum distance of 15' from my area of ripanar, access jn,.ess vvaived by me k1. ycu
1-1 S�� k below .4;s�- -c wave �e seibacK. you must initiai the appropriate Mark �_ .
i do wish to wawetne 15'setback requirement.
r
d,) not wish W waive the 15' setback I ea uiremem.
Property Owner Information' (Adjacent Property Ownpr Informapon) - 2ZI e4-1, Pci4
N W,
Sign nire
Ba1 1+f- C-4 71, Js­ur 0, o. n vt
'rn t a r ryp e ►amp Print or Tyre hame
,19ifingAddress Upiling Address
IYA e C_ 2a5
C;ty1Sfat917,,p
!Y'S,&a:,GVz-`P
J 5:2 2. 9,
Teiept,,on-e %WnDer
22--
'Re,,..'sed ' 0"^A3i2612', s
JUN is 4
RECFRIVED
DCM-MHD CRY
JUN 14 zo&
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