Diamond, Ron (2)

LiICAMA / LI DREDGE & FILL No. 73310 A B
°
WGENERAL PERMIT Previous permit#
�New ❑Modification ❑Complete Reissue [-]Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC r%
- ((\ - Rules attached.
Applicant Name i 1. All I "11 I Project Location: County
Address L/ I IStreet Address/ State Road/ Lot #(s)
City \ State / zip
Phone # (r /' )- % �! E-Mail Subdivision
Authorized Agent City / ZIP
Affected ❑CW ,nEW PTA _,MES ❑PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no ` PNA yes / no
Phone # O River Basin -
I
Adj. Wtr. Body 1 1> i' _ _ _(nat /man /unkn)
I
Closest Maj. Wtr. Body
0 NONE
ilomm liommom IEEE IN NO ME 0
Jim M MENEM MEN 0 No MEE M
MEN
max distance offshore
cubic yards
'Mch Bulldozing_
reline Length
MI
M
IN,
111
0
IN
ME,
NINE
0=0m
•
MEN
0
OEM
0
ME
SEEN
M
0
MEN
I
MEMO
MEMO
0
Ell
M
am
M
ENE,
M
am
ENE
am—
ME
Mi
MEN
NONE
M
M
so
M
0
M
0
OEM
IN
ON
ENE
ME
ME
M
NONE
M
0
MEMO
ENE
MENNEN
ENE
No
0
ME
0
MEMO
NONNI
a=
0
IN
so
IN
SEEN
MEMO
ommommi
am
IN
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0
Agent or Applicant Printed Dame.
Signat re *' Please read compliance statement on back ofpermit**
Application Fee(s) Check #
Permit0(ficer's Printed NamePrinted Name j�
$ignasure
Issuing Da a Exp ration Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own Property adjacent toynalot F AYi" Ptg~ ld_s
Property4$1 Orienimi Rol. (Name of Property Owner)
Ton
located at
on _J h�� (Address, Lot, Block, Road, .)
T0(Qr. in _Q rkInict.l, Ifco , N.C.
(Waterbody) (Cityrrown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
to t n.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual'proposft detretopmentCautst 01 in descriPbw belowor attmc* a site drawing)
dun© DIA or^ol POPC1714, Qara11c135N
propeo-y LxiS � Pfopowt �am� I �CoPet'
.r�— 2Xf5'tl
V0
f WAIVER SECTION —� Reuse
I understand that a picr, dock, Inooring pilings, boat ramp, breakwater, boathouse lift, or groin
must be set back a minimum distance of 1 ,' from my area of riparian guess unless waived by
n1e. (If you wish to waive the setback. you must initial the appropriate blank below.)
—__ ._ I do wish to waive the 15' selback requirement.
I do not wish to vraive the 1 F setback requirement.
rekAtxVraN^. r address a
Fiore -- ---
'Va[d for one calendar year after Signature'
Information)
Ynr:t Cr TAG'k
Y3Rl eH L-ee Rd 0
hf 4 A Vress
3G Z*1 r✓C 2$sIu
Q1Y/ lalUVZip
Z 2-G70 - ySO G
Tokip IYumberYemailaddrese
—
rir:,
(ReVISW Aug. 20 rf;

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ROnatd Ays�CQ.'or. DI0.MDFIG�_'s
properly located at 4$1 Orf emai Rd (Name of Property Owner)
Shop
�� (Address, Lot Block, Road, y
on _- . In_Q rkiii .1. 1h,1 CO , N.C.
(Waterbody) (City%1 own and/or County)
The applicant has described to me, as shown below. the dovelopnx:nt proposed at the above
locaWn.
I have no objection to this Proposal.
I have objections to this propose].
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual propoWng devafpntont must fr It in description below or attach a site drawing)
n0 �IAv�owcl PrnperiA I Paco-l(rd 3SN
Qe-ope� 1 Lx�S+i Pwposed 2e�m � /
� i-Prnnr�-1-tA
I I r 0\cc i
i,
5 u , `"o
�Neuse
WAIVER SECTION I understand that a pier, dock. nJ?
woring pilings, hoat ramp, breakwater, boathouse, lif, or groin
must be set back a minimum distance of 1 5' from my area of riparian•, access unless wtived by
me. (If you v}ish to waive the setback. you must initial the appropriate blank below.)
_-_ Lf I do wish to waive the 15' sotbdck requirement.
I do not wish to waive the 15' setback requirement.
(Hevr.5W Aug. 2014;
'Valid for one ca;endar year alien signanre'