18130D - Smith

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0 CAMA AND DREDGE AND FILL
�_,r
GENERAL 918130 _ D
PERMIT i‘i- ---0.
as authorized by the State of North Carolina
0 Department of Environment, Health, and Natural Resources and the Co stal Reso rces Commission
in an area of environmental concern pursuant to 15A NCAC 7I I t DO ( 20 Q
Applicant Name 3 I m ry Sin i n 4 r/n c d r lN�. Phone Number �.. L-3 or�,
Address i - RA( F 1 N l e ZS 12 Iv r>
City 1 t_hexi State INt CL Zip 2 rS 4 c S
1
Project Location (County, State oad, Water Body, etc.) y'T CA-Nkt -
Type of Project Activity
►'lLI C.� filer 4.1 60.1_ 1.). (
PROJECT DESCRIPTION ) SKETCH (SCALE: ) + I= 4 c..) ` )
Pier(dock) letlgth __1____- �—
3a. x .1'��
Groin length > G 1� NI �-
number I
Bulkhead length, d
I4S_LF
max.distan offshore I "I■
Basin,cha nel dimensions ‘c."-i— "---- ---------4, .
11
cubic yardsNfr —
x 1:
Boat ramp dimensions I q
-- 1Y�t 1rJ V '_° I
/JAIL
Other -
T-1-tF�-b 1 b x 11� - Ccv-crin,t� / - ----- / Exis71n►6 �UI-i
F 14xj- a-O�x s' Ida +�-- I y 5 -- ,.
41t. . .r:..
/
This permit is subject to compliance with this appttcation, site `'
drawing and attached general and specific conditions. Any Of (II C(=lir
violation 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 the permit officer's signature
permit officer when the project is inspected for compliance. 1 r 1 I
The applicant certifies by signing this permit that 1) this pro- )
ject is consistent with the local land use plan and all local issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no `7 1- i l U c) , 1 ZLDd
objections to the proposed work. attachments

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: J I hi, Sn
ADDITIONAL NAMES:
AEC DESIG: t,L)1 PT , (S DEVELOP AREA: PROJ DESC: - ( Z
(Will only take 6) ---- (Will only take 1)
WORK: 4 14S L` Le/ 1
1(Will only take) _
FS 20 t (/
MAINT:
(Will only take 4)
IMP:(will only take
ACTION EXPIRATION
DREDGE&FILL REQUIRED:
CAMA MAJOR DEVEL REQUIRED: 12 c1 4—l 2 -�I��

p •
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
O` ,
Name of individual applying for permit 1-1/11L. JiM m7 J1 ) 1)3
Address of property °13 8 -kb '� P2')A ►- P16 4-� Li 6m
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 are proposing. A description or drawing, with
dimensions should be provided with this letter of notification.
Please initial below if you have no objections.
f 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, N. C. 28405 or call 910-
395 3900 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.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater,boat house,lift or
sandbags must be set back a minimum of 15' from my area of riparian access
unless waived by me.(If you wish to waive the setback, you must initial the
appropriate blank below.)
I DO wish to waive the 15' setback requirement.
I DO NOT wish to waive the 15' setback requirement.
Ara, i ea, /*/S.gnature & Date
5 - / Print Name
1_/./}C-g -3 - 7i.68-2--z Telephone Number w/Area Code
r,J/5-a9—5- -- 3 3 G /
PLEASE SIGN AND RETURN TO; F&S Marine Contractors,Inc.
P.O. Box 868
Wrightsville Beach, N.C. 28480
Phone/Fax [phone]

°' SEN[,SR:
:C,'Complete items 1 and/or 2 for additional services. I also wish to receive the
• •Complete items 3,4a,and 4b. following services(for an
H ■Print your name and address on the reverse of this form so that we can return this extra fee):
card to you. i
j •Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address iI
d permit. I
w ■Write'Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery
•The Return Receipt will show to whom the article was delivered and the date
c delivered. Consult postmaster for fee. I
O• 3.Article Addressed to: 4a.Article Number
1) j2� n� 70111z 4b02,i s 36i 1
4b.Service Type
o
o , ❑ Registered Certified C
n 3 Z-, C1✓L2e7 'ct
j L J • El Express mati,.•> ❑ Insured
i [' / / ❑ Return Receipt for Merchandise ❑ COD •
a ,U y LX 4''� N( Z ')e 7 7. Date of Deliver
z t ,--\ 61(2 40 /' 1 I
3 5. Received :(Print arpe) 8.Addressee's Address(Only if requested
.0 and fee is paid) J
I
6.Sign tur : e or )
,X t, L
PS Fnrm 31311_ ar•.wmhwr 1944 102595-97-B-0179 Domestic Return Receiot

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. Mali. f&s marine Contractors, Inc.
Ita'eme i,Ar RO,Box 868
Wrightsville Beach,NC 28480
4/►-1K ri,., ey ivG [phone]
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22951
F AND S MARINE CONTRACTORS, INC.
P. O. BOX 868, TEL. [phone] 'i
WRIGHTSVILLE BEACH, NC 28480 /� �ti qn
`(� 66-85/531
J ' ) DATE 0272005809
PAY /} Cf� 1\ /LTO THE �fJ� 7, TT g
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ORDER OF I ho [yG
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N_ /— DOLLARS '®wY° °.m
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Century Bank.. e4/
li d (' r Wllmington.NC 2B40r
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i' u'000 2 29 S LII' . 1:0 5 3 L008 50':0 2 7 200 5809ii'
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