41943_EDWARDS, ANNE AND FRANK_20050719 (2)

IXICA5AA / DREDGE & FILL 1V ? 41943
W:G NERAL PERMIT
Previous permit #
New 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
Rules attached.
i,U Applicant Name 14A(L 4' Yam, d5 Project Location: County 0,,9, kre- 6"o
Address "l `75 Bad YI e Li (, Street Address/ State Road/ Lot #(s)
City- Raeke-flS1a►Jd State tJC- zip 9953 f q75 Vhytlte-w_�r
Phone # (a %L) Fax # ( _ ) Subdivision —
Authorized Agent City—1442Ke1- �5 0- ZIP �g✓r" 3
Affected -VCW )<CW —\-*TA ES PTS Phone # (u2��) 71�g ' ` 74 River Basin Gt%h OCL-4
AEC(s): OEA HHF IH UBA N/A Ad'. Wtr. Body s �'�2t f5 " y'iV9143we"PWS: FC: 1 yORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body �� 5P tl
i
Type of Project/ Activity Ltni 5 4--r(j } Q- j X 3yy W ,�wct y Y 6 2 5 k 50 14C'C e55 cZ
(Scale: 41 'r>` )
Pier (dock) length__51k3?0 �v
"
Platform(s) _ /d ,k 2U I\'II1� �ati� Mo��k y
Finger pier(s) I\ f
Groin length
number I /Q
Bulkhead/ Riprap length
avg distance offshore
max distance offshore IU
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
J2C�D
Other
Shoreline Length
SAM not sure
yes
no
Sandbags: not sure
yes
no
!
Moratorium: n/a
yes
no
I
tj
Photos:
yes
no
-----�--
-
Waiver Attached:
yes
no
A building permit may be required by:
0/4/L ram' 7
�U
See note on back regarding
River Basin rules.
Notes/ Special Conditions,)
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Agent o li r ed N e
ig ature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
Local Planningf urisdiction� hover File Name

e%
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOA��TL--IFTIBOATIIOUSE)
I hereby certify that I own property adjacent to rA^+jv- tNA-wl-a
(Name of Property Owner)
property located at i MW ► 't v,
(Street Address, Lot, Block, Road, etc.)
on -T-K &^-4 ,in /-4,-yticrr4s z-A—D ,N.C.
(Waterbody) (Town and/or County)
He/she.has describedto me, as shown below, the development he/she is proposing at that
location. and I have no objections to this 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 have indicated my intentions by initialing below:
I do not agree to waive the 15' setback requirement.
(initials)
I do agree to waive the 15' setback requirement.
(initials)
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
` 7 17 s T r u .v � � /� 3 ' u r Q tZ ✓Liry'� 5. i -D w A-- l- K- { �J
G a 1vNr7r c-r—iar G NG _D<> 5r ,.v C,
------------------------------------------------------------------------------------------------------ - ----------
Signature
4) //a
Print or Type Name
3 0 y -7?2--3 9
Telephone Number
Date: � - /Z

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PIL.INGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to Td
's
(Name of Property Owner)
property located at
(Street Address, Lot, Block, Road, etc.)
on rcc1'f6tf0&_Q4A 73ez ,in ee;_4�r/� r6.6kA-v4,N.C.
(Waterbody) (Town and/or County)
He/she has described to me, as -shown below, the development he/she is proposing at that
location and ,1 have no objections to this proposal. ' . , I understand that a pier/mgoring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (1 T) from my area of
riparian access unless waived by me. I have indicated my intentions by initialing below:
I do not agree to waive the 15' setback requirement.
(initial
I do agree to waive the 15' setback requirement.
(initials)
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
S4natur
Print or Type Nam
25 2
Telephone Number
Date: - r— / (!!� --
__J

.:r
ANNE D EDWARDS 1469
FRANK D EDWARDS 6&21/530
475 Bayview Dr BRgWCH 77e19
P O Box 100 ate
Harkers Island, NC 28531
CT WACHOVIA
+' Wachovia Bank, N.A. ;-oq
wacho�viiaa.ccoomm
For-40
,on q :Lnnn P 19i: LO 1008 1131 LE