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^ CAMA / El DREDGE & FILL No. 73456 A B ` G' D
GENERAL 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 I SA NCAC o ,� / /,
Applicant Name ( L] Rules attached.
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❑ PWS:
ORW: yes / no' PNA `yes)/ no
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Agent or Applicant Prted inName
1 '
Signature - Please read compllance statement on back of pe i **
Application Feels) ' Check
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Steve and Sally Seehafer's
(Name of Property Owner)
property located at 385 Mills Road, Lot #8_
(Address, Lot, Block, Road, etc.)
on Gideon Creek in _Oriental N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
� locatia
! I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Please see attached map.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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
_Steve Seehafer
Print or Type Name
_385 Mills Road
Mailing Address
Oriental, NC 38571
City/State/Zip
_252/249-2030
Telephone Number
Date
(Adjacent Property Owner Information)
Signature
Nyi_ A_
Print or Type Name
26 I AI Li,S
Mailing Address
City/State/Zip
Telephone Number
t� A"-' 27� 2ol q
Date
(Revised 611812012)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Steve and Sally Seehafer's
(Name of Property Owner)
property located at 385 Mills Road, Lot #8_
(Address, Lot, Block, Road, etc.)
on Gideon Creek in _Oriental , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
— X. I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Please see attached map.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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.)
/ _S !0� i do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
_Steve Seehafer
Print or Type Name
_385 Mills Road
Mailing Address
_Oriental, NC 38571
City/State/Zip
_252/249-2030
Telephone Number
Date
(Adjacent Property Owner
Date
(Revised 611812012)