HomeMy WebLinkAbout42730_BRIGGS, GEORGE_20050909CAI�f=A / El DREDGE &FILL � _ ` W ` 11 IZ U N° 427301r,
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ENERAL PERMIT Previous permit#
El Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC l� U
ulf s attached.
Applicant NameG E'Or5c- �r % ci cif Project Location: County I� i T e-/ C-1:
Address 6 2 kqh 6/t ti i Yr Street Address/ State Road/ /Lot #(s)
City �C.ALA40r--f — State � C ZIP r2 rl �, 6 �f'rz�c:Xc. i /I f
Phone # Fax # ( ) Subdivision
Authorized Agent 'eu 04,4 City PAG vfi ZIP
Affected El�FFt CW �A El ES ES PTS Phone # ( ) River Basin O'Y
❑ oEA ❑ HHF ❑ IH [I(
USA ❑ N/A Adj. Wtr. Body 1✓ AEC(s): o� (-� I 1 ll-pr' nat) /man /unkn)
ORW: yes fn—) PNA yes / oo Crit. Hab. yes / no
Closest Maj. Wtr. Bodyram,
Type of Project/ ActivityC/ O c: L -70f i X G 2 4/, -,/ y •',
(Scale: /✓, — )
Pier (dock) length !' O XT — — -- — - --
Platform(s) 2 G 'K / U
Finger piers)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
i
(,�'Av-,✓1-C (
Shoreline Length
SAM not sure yes no - -
Sandbags: not sure yes no -
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no - -. - -- --
A building permit may be required by: I
Notes/ ISpecial Conditions +� ° < <� fkafl 1q ,. rt" PLC i"u'q CJ�
(_i" ri-tN n C 1
Agent
Signatule re 7P,,read compliance statement on back of permit
ylfl
Application Fee(s) Check #
Issuinbatel Expiration Date
r�✓y TO
Local Planning Jurisdiction Rover File Name
1
Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: 919-733-1495
Fax: 252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
Fax: 252-247-3330
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 910-395-3964
(Serves: Brunswick, New Hanover,
Onslow below New River Inlet- and
Pender Counties.)
is
DEC 0 9 2005
Morehead City DC�
Revised 06/29/05
Rene R. E. Briggs 66-30/ 05 4235
George A. Briggs
P.O. Box 921
Be¢uf,,t, NC 28516 DATE �S
pi -CO THE
O!:DER OF .—.— -- - -
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Louk lor. Micro Nint signature Ilnc, gray y and lincworl. First Citizens Bank logo on back. I(not present, do not cash.
FIRST CITIZENS 005
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l�lV Fioaulart, N.C. 285t6�
W—fi stdt�ens.com IIIVI/C�/Y�/1 1`{Ivfp�'/1_ L-7 •�
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❑ CAMA / 1:1 DREDGE & FILL
GENERAL PERMIT Pre permit#
L7New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
i] Rules attached.
Applicant Name 1 S Project Location: County
iJ 1
Address %'� �' �� y ��� �` r1 i �1 r ► Street Address/ State Road/ Lot #(s)
City l .; r"' r? t � �(f • State ZIP
Phone # ( ) ``.-0 — t �/ ` Fax # ( ) Subdivision
Authorized Agent Z ! 1 f'�' City '. ,l l ZIP
CW ❑ EW -[�fTA El ES ❑ PTS Phone # ( ) River Basin
Affected D OEA ❑ HHF ❑ ElElf IH UBA N/A [
AEC(s): Adj. Wtr. Body''' �' �' I irr na an nkn
❑ PWS: ElFC:
ORW: yes / no PNA yes /�oi Crit. Hab. yes / no Closest Maj. Wtr. Body n �I
Type of Project/ Activity
Pier (dock) length _
I I I r I I
Platform(s)-
Fingerpier(s)
. I (1
Groin length �—i �.�' U.L
number
Bulkhead/ Riprap length ! I
avg distance offshore I _
I max distance offshore ' � . _
i I I i i i iz- � -I-
Basin, channel - -
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
_-
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may 9 Y be required b :
Notes/ Special Conditions
Agent or Applicant Prigied Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Wc t � i e., 66
I
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuingt)ate? Expiration Date
r
Local Planningf urisdiction Rover File Name
Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
_'i Tar- Pamlico River Basin Buffer Rules Other:
� Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmen.al Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: 919-733-1495
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: 252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
Fax: 252-247-3330
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 910-395-3964
(Serves: Brunswick, New Hanover,
Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05
OF_
FAX
PHONE ❑ MODLE
MESSAGE_
SIGNED
PHONE LCA L
DATE — TI M
�jZ Z
CODE NUMDER EXTENSION
PHONED
RETURNED
YOUR CALL
LEA------.__
SE CALL
WILL CALL
AGAIN
-CA TCM 0
SEE YOU
WANTS TO
SEE YOU
IRM a ---
U.S.
er SeMms
LINDA RIKE REAL ESTATE,
LINDA RIKE & ED DAUGHETY
1410 ARENDELL STREET
MOREHEAD CITY, NC 28557
WWW.LINDARIKE.COM
E-MAIL: LINDA@LINDARIKE.COM
eAXW 'lU Q GRI
FAX: (252) 247-6936
UNITED STATES POSTAL SERVICE
.TA.04 FkA F i...
19 'Au
• Sender: Please print your name, address, and ZINW n this box
c,6blZ6E A MCGS
1'd -6 Q }C `5z j
-7,LFAoFbc -r-
1�,C'.2.?SIG
III It Iflilt IIIIfi „:I1I1,I,I1111111.)11111111itfill
■ Complete items 1, 2, and 3. Also complete A. Signature
item 4 if Restricted Delivery is desired. XC.�,�
■ Print your name and address on the reverse
so that we can return the card to you. B. R eived b (Pri
j ■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
❑ Agent
❑ Addressee
?=P I C. Date of DelivEW_'�
D. Is delivery address d4rent fr= item 1? ❑
If YES, enter delivery" ddres low:
0
(p
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y 2)
i �
I
3. Service Type r "+
❑
o
�
Certified Mail �� apr,.%Mail
❑ Registered RetwAoleceipt for M
=.,L
❑ Insured Mailer C.O-q M.
4. Restricted Delivery? (Extra F;Z
11
2. Article Number
(Transfer from service la 7003 3110 0002 9873 9692
PS Form 3811, February 2004 Domestic Return Receipt 1
Toqo 1IRA
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/VIOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to s
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.) 'CD
on in L�� �i�RE� 0
1�tzTrt R��/'C P N.C.
(Waterbody) ff new— aridWer County) 7.
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTIONAND/OR DRAWL\G OF PROPOSED DEVELOPMENT:
(To be filled in by indi�'idual proposing development)
Si;nature
Print or Type Name
71�3 - �--',W
Telephone Number
Date: Rosi , «-E
r o
SECTION .1200 - GENERAL PERMIT FOR CONSTRUCTION OF PIERS: DOCKS: AND BO@' HOUSE,
ESTUARINE AND PUBLIC TRUST WATERS AND OCEAN HAZARD ARC, ASZ' �
CD -„
15A NCAC 07H .1201 PURPOSE �C kf,
A permit under this Section shall allow the construction of new piers, docks, and boathouses in the estuarinnid pufMic trust
waters AECs and constriction of new piers and docks within coastal wetlands AECs according to the auth ty prdt�ded in
Subchapter 07J .1100 and according to the Rules in this Section. This permit shall not apply to oceanfrooreli&s or to
waters and shorelines adjacent to the Ocean Hazard AEC with the exception of those shorelines that feature 4i -acteristies_ of
the Estuarine Shoreline AEC. Such features include the presence of wetland vegetation, lower wave en r0y, and love er
erosion rates than the adjacent Ocean Erodible Area.
History Note: Authority G.S. 113A-107(a); 113A-107(b); 113A-113(b); 113A-118.1; 113A-124;
Eff. March 1, 1984;
Amended Eff. April 1, 2003.
15A NCAC 07H .1202 APPROVAL PROCEDURES
(a) The applicant must contact the Division of Coastal Management and complete an application form requesting approval for
development. The applicant shall provide information on site location, dimensions of the project area, and his name and
address.
(b) The applicant must provide:
(1) confirmation that a written statement has been obtained signed by the adjacent riparian property owners
indicating that they have no objections to the proposed work; or
(2) confirmation that the adj acent riparian property owners have been notified by certified mail of the proposed
work. Such notice shall instruct adjacent property owners to provide any comments on the proposed
development in writing for consideration by permitting officials to the Division of Coastal Management
within 10 days of receipt of the notice, and, indicate that no response will be interpreted as no objection.
DCM staff shall review all comments and determine, based on their relevance to the potential impacts of
the proposed project, if the proposed project can be approved by a General Permit. If DCM staff finds that
the comments are worthy of more in-depth review, the applicant shall be notified that he must submit an
application for a major development permit.
(c) Approval of individual projects shall be acknowledged in writing by the Division of Coastal Management and the
applicant shall be provided a copy of this Section.
(d) Constriction must be completed within 90 days of the approval of the permit or the permit expires.
(e) Any modification or addition to the approved project shall require prior approval from the Division of Coastal
Management.
History Note: Authority G.S. 113A-107(a); 113A-107(b); 113A-113(b); 113A-118.1; 113A-124;
Eff. March 1, 1984;
Amended Eff. August 1, 1998; January 1, 1990.
15A NCAC 07H .1203 PERMIT FEE
The applicant must pay a permit fee of one hundred dollars ($100.00) by check or money order payable to the Department.
History Note: Authority G.S, 113A-107; 113A-113(b); 113A-118.1; 113A-119; 113-119.1; 113A-124;
Eff. March 1, 1984;
Amended Eff. August 1, 2000; March 1, 1991.
15A NCAC 07H .1204 GENERAL CONDITIONS
(a) Piers authorized by this general permit shall be for the exclusive use of the land owner, or occupant and shall not provide
either leased or rented docking space or any other commercial services. Piers designed to provide docking space for more
than two boats shall, because of their greater potential for adverse impacts, be reviewed through the major permitting process
and, therefore, are not authorized by this general permit.
(b) lndividuals shall allow authorized representatives of the Department of Environment and Natural Resornrces to ma%e
ti
periodic inspections at any time deemed necessary in order to be sure that the activity being performed under the authority of
this general permit is in accordance with the terms and conditions prescribed herein.
(c) There shall be no unreasonable interference with navigation or use of the waters by the public by the existence of piers,
docks and boat houses.
(d) This permit will not be applicable to proposed construction where the Department believes that the proposed activity
might unnecessarily endanger adjoining properties; significantly affect historic, cultural, scenic, conservation or recreation
values, identified in G.S. 113A-102 and G.S. 113A-113(b)(4), nor that might significantly affect the quality of the human
environment.
(e) This permit does not eliminate the need to obtain any other required state, local, or federal authorization.
(f) Development carried out under this permit must be consistent with all local requirements, AEC Guidelines, and local land
use plans current at the time of authorization.
History Note: Authority G.S. 113A-107(a); 113A-107(b); 113A-113(b); 113A-118.1; 113A-124;
Eff. March 1, 1984;
Amended Eff. May], 1990;
RRC Objection due to ambiguity Eff. May 19, 1994;
Amended Eff. August 1, 1998; July 1, 1994.
15A NCAC 07H .1205 SPECIFIC CONDITIONS
(a) Piers, docks, and boat houses may extend or be located up to a maximum. of 400 feet waterward from the normal high
water line or the normal water level, whichever is applicable.
(b) Piers, docks, and boat houses shall not extend beyond the established pier length along the same shoreline for similar use.
This restriction shall not apply to piers 100 feet or less in length unless necessary to avoid unreasonable interference with
navigation or other uses of the waters by the public such as blocking established navigationroutes or interfering with access to
adjoining properties. The length of piers shall be measured from the waterward edge of any wetlands that border the water
body.
(c) Piers longer than 200 feet shall be permitted only if the proposed length gives access to deeper water at a rate of at least
one foot at each 100 foot increment of pier length longer than 200 feet, or if the additional length is necessary to span some
obstruction to navigation. Measurements to determine pier lengths shall be made from the waterward edge of any coastal
wetland vegetation, which borders the water body.
(d) Piers and docks shall be no wider than six feet and shall be elevated at least three feet above any coastal wetland substrate
as measured from the bottom of the decking.
(e) Any portion of a pier (either fixed or floating) extending from the main structure and six feet or less in width shall be
considered either a "T" or a finger pier.
(f) Except in the case of boat houses, any portion of a structure (either fixed or floating) greater than six feet wide shall be
considered a platform or deck.
(g) "T"s, finger piers, platforms, and decks of piers on lots with shorelines 100 feet or greater in length shall not exceed a
combined total area of 400 square feet. The combined total area for lots less than 100 feet shall not exceed four square feet
per linear foot of shoreline.
(h) Platforms and decks shall have no more than six feet of any dimension extending over coastal wetlands.
(i) The width requirements established in Paragraphs (d), (e), (0, (g) and (h) of this Rule shall not apply to pier structures in
existence on or before July 1, 2001 when structural modifications are needed to prevent or minimize storm damage. In these
cases, pilings and cross bracing maybe used to provide structural support as long as they do not extend more than of two feet
on either side of the principal structure. These modifications may not be used to expand the floor decking of platforms and
piers.
0) Boathouses shall not exceed 400 square feet and shall have sides extending no further than one-half the height of the walls
as measured in a downward direction from the top wall plate or header and only covering the top half of the walls.
Measurements of square footage shall be taken of the greatest exterior dimensions. Boathouses shall not be allowed on lots
with less than 75 linear feet of shoreline.
(k) The area enclosed by a boat lift shall not exceed 400 square feet.
(1) Piers, docks, decks, platforms and boat houses shall be single story. They may be roofed but shall not be designed to
allow second story use.
(m) Pier alignments along federally maintained channels must also meet Cores of Engineers regulations for pier construction
pursuant to Section 10 of the Rivers and Harbors Act.
(n) Piers, docks, and boat houses shall in no case extend more than 1 /4 the width of a natural water body, human -made canal
or basin. Measurements to determine widths of the water body, human -made canals or basins shall be made from the
waterward edge of coiist:al wetland vegetation which borders the water body. The 1/4 Length limit Ition shall not apply
when the proposed l: i is located between longer piers within 200 feet of the applicant's property. however, the proposed
pier shall not be longer than the pier
head line established by the adjacent
i
piers, nor, longer than 1/3 the width of
the water body.
(o) Piers, docks and boat houses shall
y ,k not interfere with the access to any
riparian property, and shall have a
minimum setback of 15 feet between
7 r' any part of the pier and the adjacent
property lines extended into the water
at the points that they intersect the
shoreline. The minimum setbacks
provided in the rule may be waived by
Y ^4
the written agreement of the adjacent
riparian owner(s), or when two
adjoining riparian owners are
co -applicants. Should the adjacent
property be sold before construction of
_ the pier commences, the applicant shall
obtain a written agreement with the new
owner waiving the minimum setback
and submit it to the Division of Coastal
Management prior to initiating any
t development of the pier, dock, or boat
EXAMPLES house. The line of division of areas of
RIPARIAN ACCESS AREAS
riparian access shall be established by
drawing a line along the channel or
PRQ)ECT. AREA deep water in front of the property, then
EDGE OF CHANNEL OR drawing a line perpendicular to the line
—`— DEEP WATER of the channel so that it intersects with
PROPERTY LINE
--- RIPARIAN LIMIT the shore at the point the upland
MEAN HIGH WATER property line meets the water's edge.
Application of this Rule may be aided
WATER by reference to the approved diagram in
Paragraph (r) of this Rule illustrating
the rule as applied to various shoreline
configurations. Copies of the diagram
may be obtained from the Division of Coastal Management. When shoreline configuration is such that a perpendicular
alignment cannot be achieved, the pier shall be aligned to meet the intent of this Rule to the maximum extent practicable.
(p) Piers, and mooring facilities shall be designed to provide docking space for no more than two boats.
(q) Applicants for authorization to construct a dock or pier shall provide notice of the permit application to the owner of any
part of a shellfish franchise or lease over which the proposed dock or pier would extend. The applicant shall allow the lease
holder the opportunity to mark a navigation route from the pier to the edge of the lease.
(r) The diagram shown below illustrates the various shoreline configurations:
History Note: Authority G.S. 113A-107(a); 113A-107(b); 113A-113(b); 113A-118.1; 113A-124;
Eff. March 1, 1984;
Amended Eff. December 1, 1991; May 1, 1990; March 1, 1990;
RR Objection due to ambiguity Eff. March 18, 1993;
Amended Eff. August 1, 1998; April 23, 1993;
Temporary Amendment Eff. December 20, 2001;
Amended Eff. April 1, 2003.
900
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1parian Corridor
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Pro peit,r Civnier
Name
<v BERG �Ai9r 5
F'rc�T.,rrt�j L.ii}e
!,,.it,.,.r
or, gl.�ilu} s l�� ��r• r�}. }Tr 0
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900
Dirner},ion:; of "Taaor"L"
or other platfonns ff nger
piers
Distance o-rer I',el h
�vldth
61-6
a
Distance from I•,-iarsh or
p Vater Level ivldch ever
applies or both
Si.rnple Nloifh crow—
r Spot Water
Depths
Ripa?ian Conido
r
y i� ,�I• I tt ,'
1d�tiFL,1lH�,f,or I-TUR
L,Jt 55'Idth
I?al:c_c-le where the j Nur_tu'Yti }{�.?i iBii}fit' iFa'. 11G'i
Property Owner Larne, Address, Location
Elate
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CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL iNI_A.NAGE-�N
s ADJACENT RIPARIAN PROPERTY ONy�`ER NOT IFIC f .
FORM
f
AUG 29, 2005
Name of individual applying for permit: Ch15
o RC-4
'— %mod CrtY
Address of property: �►� 1—£t�»zc�C 1ti�E CM
(,ot or street #, street or road)
(City & County)
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.
_ I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Ave., Morehead City, NC 28557 or call (252) 808-2808
within IO 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, boathouse, lift or sandbags
must be set back a minimum distance 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.
X I do not wish to waive the 15' setback requirement.
��- ' rl r f' li
Sig ture Date
Print Name
,P13 23 6- A412—
Telephone Number With Area Code
i'0urn vttvivt requf,—,wJ.aBa 83c cat r'7ip.j'%;Fs
Rene R. R. Briggs
George A. Briggs
P.O. Box 921
Beaufort, NC 28516
66-30/531
005
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BoauloA. N.C. 28576 y�
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