McNeill Assoc.

:1�111DAMA / ❑ DREDGE Fi FILL A B
ENERAL PERMIT Previous permit# —
ew ❑Modification ❑Complete Reissue ❑d
Date previous permit issuePartial Reissue � �
As authorized by the State of North Carolina, Department of Environmental � Jaliry
and the Coastal Resources Commission in an area of environmental concern n rsuant to I SA NCAC RJ%attached.
�% '� 1 Ave ( _ Project Location: CountyCr ''�
Applicant N me � �J--
w.ia�e« �7 / Y '� �'r'rW G� _ --_ Street Ad,d�ss�StatetRPad/ Lot #(s)�__
City ��ctiJJUnJ _Stat¢J✓C ZIPS
Phone --
Authorized Agent ---rr ----
❑ EW ❑ PTA ❑ PTS
Affected . ❑ O HHF ❑ IH ❑ USA � NSA
AEC(s):
❑ PWS:
®RW: yes / no) PNA es) no
Type of Project/ Activity
Pier (dock) length_
Fixed Platform(s) _
Floating Platform(s)
Finger pier(s)—
Groin length _
O O'
max distance offshore—`'
Basin, channel
I
--
cubic yards
Boat ramp
Boathouse/ Boatlift.
�\
Beach Bulldozing_
I
- I
Shoreline Length
_.
SAV: not sure yes no I
Moratorium: n/a yes,�I
Photos:
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
City _ _ ZIP
Phone # (—_)___ River Basin
Adj. Wtr. Body_-- �d
Closest Mal. Wtr. Body
/e
(Scaler
:nt or A licant P 'nted Name
**Pleaser Pad iancestatementonbackofpermit**
-- _ 771 --
Pllca ion Feels) Check#
f
X v
See note n back
f�It.�
L
River Basjn rules.
IAst. ♦ /�

From: [e-mail]
Subject: Please sign and return
Date: July 16, 2019 at 11:53 AM To: [e-mail]
CERTIFIED MAIL • RE]URN RECEIPT REOUEc..TED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERT( OWNER NOTIFICATION/WAIVER FORM
Name of Property owner. flv\'Joc 14vo ASWQ t Af S 'LNG. I
AddressofProperty: l*aI6 k,4111N1, 20- Cletlhti��P. J8s8�
(Lot of Street It. £4reet or Road, City d County) !l :.
Agenrs Name #: &Di'L fy" ¢ 10E11 I _ Mailing Addrec sa: 1001 1 (Qi �YK %' I ^4
Agenrs phone #-.OLS9-rit10-4'dol0 SwArtsikeo, �C�
).. afw
I hereby certify that I own property adjacent to the above referenced property. The Individual
applying for this permit has described to me as churn on the attached drewing the deve:opmenl
Ql eare proposing. �Qg pj�n or drewinc�Mth dmensions. must he provided with this letter.
lee e +l �< rre
1 have no objections to this proper al. 1 have objections to this proposal.
if you he" objections to what Is boingproposrK,you must notify the Division of CossialManagement
(DCM) In writing within 10 days of mcelpt of This notice. Contact Information for DCM oMfces it
available at rft :/Avww.ikccpns falmonp o! )&,# f.0w -Mgmistafl4LIki orbycalling 1.ae6�4RCOAST,
No response Is considorod ft came as no otipcilon If you have been not/Rad by CerNfled Mall.
WAIVER SECTION
1 understand that a pier, dock, mooring pilin(s, boat ramp, breakwater, boathouse, or Ilft must
be set back a minimum distance of IV from Ty area of riparian access unless waived by me. (If.
you wish to waive the setback, you must inl Jai the appropriate blank below.)
u� 1 do wish to waive the 15'solb3ck requirement.
I do not wish to waive the t i setback requirement. i
(Property Owner Information)
PYO)Del(( l uo A5sce t hk&5s '
Signature
Print or Type Name
::01 NIQL& �oo�
Mallft Address
Qwlwarzo
asa auco �aav
Telephone Number/EmaAAddress
Property Oyyne) informatlon)
,63AA_,$I II �1YLt1
Melling Address
NyF0It , VA 235ile
Citylstatisop
1410) I I 1 -2186'
Tolophono Number/EmaaAddress
.51.31 / Ili
Date
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: "(Y�e1�e1 ii pwo A,<,g CtA 8S \ 10()-,
Address of Property: t-Q-a e) ( .%�Eucra� �, VktuW U17 \RA 5kd1 w, ��g�
(Lot or Street #, Street or Road, City & County)
Agent's Name #: vy-\,Q QQ� t i
Agent's phone #: a651- c)k� 'q aaZ)
Mailing Address: 60 tt
P2-�C-tt=p
t v 16)
a\S(Oo,eo • HQ-, ae,�104
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
the are roposingg A descri tion or drawing,with dimensions must be rovided with this letter.
P1 k52p �QY f� RC fro
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http✓/www.nccoastalmanaoement.net/web/cm/staff-listing or by calling 1-888-4RCOA S T.
No resnonse is considered the same as no oblection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.
(Property Owner Information)
Signature
Print or Type Name
t'D l ��p
Mailing Address
"40stoo?a .NC a S9A
City/state/zip
aSa ayb -Orate
Telephone Number/Email Address
3 (> M R V aot`7
(R' arian Property Owner Information)
tgnature
Print or Type Name
Mailing Address
s�.�li� , rse o2 t68z
City/State2ip
as2- 3i3- !/8b
Telephone Number/ Email Address
�/ 3 a /,2a l
Date Date
(Revised Aug. 2014)

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