45176_PINE KNOLL ASSOC., INC._20060424

P.32
X6AjV1A /.----6'F;EDGE & FILL
N? 45176
GENERAL PERMIT Previous permit� E�'Modificaion --JComplQtQ Reissue--iPartial Reissue
Date previous permit issued
As authorized lir the State of North Carolina, Depha;-trnert rf Environment and Natural Resources
grid :he Coa=1 Resources Commission in an area of environmental eoncarn Pursuant to I$A NCAC
Applicant Name Praiect Location, County..
Addm4
Street Address/ State Road/ Lot #(.5)
Cut}''
. 1rj- L k".. H _rA. State j!�'. ZIP
Phone # Fa, Subdivision
Authorized Asient VA c., city---- ZIP
iP
Affected 71W 717-PtA PTS Phone # ver Basin
EA _�
AEC(s), �j HHF im: _'URA 7WA
Adj. Wtr. Body.
Li 1POS.- 1-1 S":
ORW: yes no PNA yes Crk. Nab. yes i no Closest Maj. Wtr. Body
Type of Proj6ci� Acttylty 777.7777,17477.
(Scale,
Pier (dock) lan�+.
Finger piw('s)..
Groin length fee
AN L.1_20D? . . .....
1 lkht�.W/ Lp length 1�tarce offshore X /�ir
-
max distance offshore
chamel
acat ramp
F$04LthCKre/ BO�dift_
Beach Bulliclo-zirs
Omer
SKC,Celhne Le
yes 110
sandlpagp.. nol sure Yft
n/a yes n
Photo&.
Wstytr Amd+ )k"
A building petImir may be reqjIli-ect t)y,
See row on back regard­i8 Rwer Basin rules.
Naces(Spel Conditions
Agent 'gent a 1;.. t Printed
rited
siffrwfure lam rud compliance wit -ri back ;fp9rrrj%-
111
7
Expiration D*w
TOTAL P.02

�-A—JA 1. 11 11.1J 1Y1 7X11_ — 1�1 t L 1�1 t{L (. t JJ' Jl KL' O L LJ E1J
DINISION or CoAsr_Al. N'I_AN_1,C71 /PENT
ADJACENT RIPARIAN PROPERTY 01111>`R NOTIFICATIONAVAIVER
FOR -NI
- ame of individual applying for permit: /vl n
Address of property:
(city & county)
I hereby certify that I own property adjacent to the above referenced property. The
i dvidual applying for this permit has described to me (as shown on the attached
r?) the development they are proposing. A description or drawing, with
d :erlsiors, 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 [phone]
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, 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
_ I do not wish to waive the 15' setback requirement.
-2--
Signature Date
Print Name J
JAN 1 1 200%
973
Telephone Number With Area Code Morehead City DCM
L'N.^,ea'.`:i {}`:i.l C'L2''f'3i ^!'�y —,-� f�•�••s:SiL^L. �'��-ter -

----��• CERTIFIED MAIL — IkETUIZN RECEIPT REQUESTED
DIVISION OF COAST.AI, Nil_ANAGE-NfENT
ADJACE\T RIPARIA:N PROPERTY OWNER tiOTIFICATIONAVAIVER
FORM
Name of individual applying for permit:
Address of property: "��R,�
(I or street N, 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 [phone]
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, 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 req_uirem.ent.
I do not wish to waive the 15' setback requirement.
Sig z e Date
Print Name
C1t� -5533 c q iG L4,)�'��1 md,il-
Telephone Number With Area Code
F031YET11-N
fill
19JAN 1 1 2007 kv
Morehead City G@M
adj:3L' m r:-:, ?i'L�

PINE KNOLL ASSOCIATION INC 5183
PO BOX 905 66-112/631
ATLANTIC BEACH, NC 28512-0905 BRANCH 02M
DATE
PAY
TO THE /�" " e $
ORDER OF / ✓✓
p S�Bu,l,y
DOLLARS
— BRANCH BIANKINCOMPANY
1-80 14KBBi BBT.com .
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FOR
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