HomeMy WebLinkAbout22421D - NC w
CAMA AND DREDGE AND FILL
GENERAL: 22421-b
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 1f1 • 12Dv
Applicant Name '`r \Id I.
Te Q u cCf'S Phone Number 9 j V 6C0 e 5 001
Address 6 q 7p,eft)d ?eAd
City FA A-k.,Jt 'I'C___ State N. CI1 Zip a8zot}
Project Location (County, State Road, Wat Body, etc.) PPA�W ( OU (\trcin,,,),
� O F VkPub 1 SiOC�nci
'Zorc� o. c 0( Al ,s P',-� LA trc1 , N ,f . CAPE fft /
Type of Project ctivity P,t^r f'. t,i1« t
PROJECT DESCRIPTION SKETCH (SCALE: IL If\J T )
Pier(dock)length D.
4-t
X C.o' (,J•,c(( J N C)1*\ Ct ST C.P p C
Groin length FU ` 1—
L ,fir t?ve r
number
Bulkhead length
max.distance offshore
Basin,channel dimensions
cubic yards
C. A
Boat ramp dimensions /
C 16
Other 1
r0r Lvc S,2u
This permit is subject to compliance with this application, site /c��i�-� C�
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 ' r — applicant's signature
come null and void. ��
This permit must be on the project site and accessible to '/ permit office s signature
permit officer when the project is inspected for complian' ` 4J( Ocykiv•-kiollql
The applicant certifies by signing this permit that 1) this pro- .a I0 ( 1959
ject is consistent with the local land use plan and all local 00 issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no 14-1 I200
objections to the proposed work. attachments
pfltd bt/ pQrSo(.e,.
LRAL PERMIT COMPUTER FORM
A.APLICANT?SANE: IV 0r1r C ro U i I d (; iP source S
ADDITIONAL NAM-PS: in O9v'S h I I t�1
A=C DESIG: P T DEVE.,OP AREA: .p03 PROJ DES C:5 - 12-
(Va3 only sake 6) (VeZ crab-bike 1)
---
wC�: . (` (Q�
(WE•only take 4)%
•
(Will only lake 4)
4t-t-
6)
ACTIONIRATION
DRAM&FI T R QUIR.. : . 6 / I O 19 M II ) 101 l�
CAMA MAJOR DEVL.REQUIRED:
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v SENDER: I also wish to receive the follow-
_
• ❑Complete items 1 15ndtor 2 for additional services. ing services(for an extra fee):
a• Complete items 34a,and 4b.
cn
0 Print your name ad address on the reverse of this form so that we can return this
• card to you.' 1. El Addressee's Address
d 0 Attach this form to the front of the mailpiece,or on the back if space does not
a, permit. 2. 0 Restricted Delivery
Y 0 Write'Return Receipt Requested'on the mailpiece below the article number.
• of The Return Receipt will show to whom the article was delivered and the date
n delivered.
n 3.Article Addressed to: 4a.Article Number
r z3 �372g992
4b.Service Type
0
o J O gO C. J/t4Ji S".7 E ❑ Registered ❑Certified
n
n f n c �� ❑ Express Mail 0 Insured
rJ .��J / $ 42 ❑ Return Receipt for Merchandise ❑COD
z 7.Date of Delivery L --..3 ±_gi__
_2 5.Received By: (Print Name) 8.Addressee's Address(Only if requested and
fee is paid)
i
i at grpssee or Agent)
o—
PS Form 3811,December 1994 102595-99-B-0223 Domestic Return Receipt
VIVDEJR: I also wish to receive the follow
omplete items 1 and/or 2 for additional services. ing services(for an extra fee):
omplete items 3,4a,and 4b.
rint your name and address on the reverse of this form so that we can return this ai
card to you. 1. ❑ Addressee's Address 0
u ❑Attach this form to the front of the mailpiece,or on the back if space does not
- perrrtit. 2. ❑ Restricted Delivery to
❑Write"Return Receipt Requested"on the mailpiece below the article number.
❑The Return Receipt will show to whom the article was delivered and the date o
j delivered. .0
U
3.Article Addressed to: /f�_ 4a.Artic Number (/ / m
CC
5. ,14r, r 1 'E f�,eowAi ,Z C3 0174 7�q ,
V n� 4b.Service Type
i 5 3 WO e lJ )2;V f4 )e ❑ Registered edified
0
1 , ❑ Express Mail ❑Insured
N
1 �jQCs!) . y/Z J ❑ Return Receipt for Merchandise ❑COD cn
0
C 7.Date of Delivery
• 0
A (/� >
f 5. Received By: (P t Name)��I �'�� 8.Addressee's A Tess (Onlyer sted and c
i j �,`�`cam fee is paid) F
i 6.Signature4 ( ddre�seeorAge .
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PS Form 3811,December 1994 102595-99-a-0223 Domestic Return Receipt
•
_ " i291
66-112/531
5211122530
MAR SHALL 8371 C. OR CHERYL L. RAY 0 /O —
PH. 465-8371 �� i
4025 CHERAW NC E28306
FAYETTEVILLE, $ s D D
�,� o��nns o:e e •
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to-tAe order n- /O •
53502 III'I� j
Boar 9CI. ASNIC
e 300 erO AN STREET
300 ROWA NC 28302
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FAYET--te_ E, If
Jig/ware1 Ca_ /:0531O11211: 5216922230 ' �'
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