Lang, Albert

®hCAMA / El DREDGE & FILL No. 75924
�. A B C �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
I ❑Rules attached.
Applicant Name I, ! ` i Project Location: County
Address Street Address/ State Road/ Lot #(s) CF
City - t i _ State ZIP- ` ( -
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Phone # ( ) E-Mail Subdivision f ) ;
Authorized Agent
Affected O OW El EW F PTA ❑ ES ❑ PTS
AEC(s): 00EA ❑HHF FIH ❑USA ❑N/A
❑ PWS:
ORW: yes / no PNA yes / no
City ZIP
Phone # ( ) / t River Basin F
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Adj. Wtr. Body ` i (naF /man /unkn)
Closest Maj. Wtr. Body
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A gent or Appli_ nt Printed Name
Signature .x Please read compliance statement on backof permit
Application Fee(s) Check#
r, '. /I
Permit Officer's Printed Npme
Signature
Issuing Date Expiration Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Mary and Albert Lang's property located at 907
Osprey Ct New Bern, NC 28560 (Lot 16 Harbour Pointe Township, Craven County)
(Address, Lot, Block, Road, etc.)
on Broad Creek, in New Bern, N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to rpe, as shown be] w, the developme�nt proposed at thq above,
location. l�n i ; , '-�/�/ 1� �'e, 71' o ��ptlrngS
x I have no objection to this proposal. V G�
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)
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.
k I do not wish to waive the 15' setback requirement.
(Property Ow nformation)
Signature
X-L6e2r-.r YIA2 / G A ✓lam
Print or Type Name
Date
((AjAdjacent Property Owner Information) 'Xx�gwt
Signature
�I t-L4,tm S. S£E2k( t Ecc&N St-L4,tm S. SFE2_k(`) t Ecc&N S. aEERy
Print or Type Name
y'cr oS pRp�CTi
Mailing Address Z8 5 G o
Nftv 8FA4/
City/StatelZip
Z03 — 65'5-- N 1 3 7
Telephone Nu ber
to/zt�,9
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Mary and Albert Lang's property located at 907
Osprey Ct New Bern, NC 28560 (Lot 16 Harbour Pointe Township, Craven County)
(Address, Lot, Block, Road, etc.)
on Broad Creek, in New Bern,.N.C.
(Waterbody) (City/Town and/or County)
The applic nt/has described to e, as shown bel w, the dernvelopm/ant proposed at th�J above/
IoCatlo �( &h % `�o .3Q�CJ� l r�'s✓ e. O - t- ��!/P�S �c EXISTIY�C ©cx{�.
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)
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 vyaive 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.
(Ploperty Ow nformation)
Signature
IUl epT-e 0 2V L4&/I -
FVnt or Type Name
�71-a�a-C-7/it
Telep,Pone Number
Date
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