71848D - Sanders

-.('CAMA / Q,DREDGE &FILL No. 74791 A B C
GENERAL PERMIT Previous permit#
ANew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As f uthorized by the State of North Carolina, Department of Environmental Quality �� / / / rQ D t 12 oV „1
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC /�'
❑RA1 �s attached.
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Applicant Name `� ey N 5 1 T 4 / Project Location: County t�" `_ qel ''
Address 1 b
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City J& (G W`
State &_ ZIP T � l 1i
Phone 41W)6W —I(©Mail
Authorized Agent
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ORW: yes��
PNA yes
Street Address/ State Road/ Lot #(s)
Subdivisi n
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zip
Phone # ( River Basin
Adj. Wtr. Body AI 'V V✓ ,(r9TC—n.An /unkn)
Closest Maj. Wtr. Body C) 10's'A-N4>
Type of Project/ Activity I N`jTP�lt, l;-t) L"r
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Pier (
Fixes
Flom
Fingr
Groi
Basir
Boat
Boat
Beac
06
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A building permit may be required by:
( Note Local Planning jurisdiction),
Notes/ Special Conditions J
F' (I-- W - ❑ See note on back regarding River Basin rules.
F
(Agent or Applicant Printed Name
r
ignature ** Please read compliance statement on back of permit*
4 - -'
Ap�tion Fee(s) Check #
CS
-12,.2 • I
Date
?,27
Expiration Date

NC Division of Coastal Management
9 Cashier's Official Receipt
Received From: A4
Permit No.: IF i P
/
Applicant's Name: �LVIIJ
Project Address:
9435 A B CUDD
Date: Z2, 20 J
lea 0
Check No.: ./
Countv:
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applica
Signature of Field Representatly
CERTIFIED MAIL RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAA,N� PROPERTY OWNER NOTIFICATIONIWAIVER FORM
timper ae+Jf Proty Jwner 'hC
Address of Property e,iz 'l A 9c 11 c n , ti. r.,.l a,.a3; kAd 11
11 (Lot or street s Street or Road, Csy s Coupy)
Ayer•.:s Namea N%A I"r\ L�/L 01/`, Mailing Address 12 Crrt-)e C4r%, k
Agent c phone x "11C &ZC, t/!& I A&S t-� , kt') ()C Z -Q q4
hereby r 'I`) tnat I Own PLOP" adpoent to the above -eterenc.e7 property The mdvi0ised
acpiying to, this pe,md has described to me as shown cn the atlaxtec drawvg. the developtnrw
they are proposing A descrfobon or draw+rw wdt d n` h. s 1 pet Ilsrr
x I h.ite w ob_imtiuns to this prtiptnal. _ 1 have ob/ectluto to thus proposal
H yoi, have objections to wMf is being proposed, you must notify The Orvuron of Coup/ Nanayueerw
(OCYr in writing within 10 days of receipt of This nonce Contact inf.,—v.n for Ocu offs a
awarrao/e et or by ca/lino 1-sdgJRCOAST No
response is conrrdered rha fame as no oD/eCnon /you haw baed onried Dy Caftl/Ia0 sssLL
WAIVER SECTION
I understanC that a pier dock. mooring pit', b,eakwalerboathouse lift or groin must be set
beck a minimum distance of 15' from my —a o1 riparian access unless wtnved by me. (If You
wish to waive the setback, you must Inftlal the appropnate blank below i
�, /7 do -Sr tc waive the 9 seta:. -equ•rement
1( Y do not wish to waive the 15 se -back requirement
(PrOOarN
Sigwru-
Hnf or Type Nan,
Nero Addl.ac
Tetao wants,
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djaeeflt Propa O I R- bd—nobptl
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P-rr �r type Neme _.—"-
Malk Address��
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Telephone Number
Revved &1&2w
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Date:
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Date:

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DCM 1�t�ILMINGTON, NC
NOV 0 4 2019
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RECEIVED
DCM WILMINGTON, NC
NOV 0 4 2019

CERTIF ED MAiL RETURN RECE
DIVISION OF COASTAL MAP %�
ADJfo::;ENT RIPARIAN PROPERTY OWNER No �, f"t,4
Name of property Owner:P>>?t'
_ C-f—
Address of property: (Lot or Street #, Street or Roal
Agent's Name #: o" /�� ►''►1 �'� M a i I I
Agent's phone #:)t-
waaw
i hereby certify that 1 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
they are proposing. A esc i 'on r drawin wit i erasion must b rovi ed with Iq
r
Xx I have no objections to this proposal. I have objections to this Proposal -
If you have objections to what 1s being proposed, you must notify the Dlvlslon of Coastal Management
(DCM) in writing within 40 days of receipt of this notice. Contact information for DCM offices is
available at trnrrw.nccoas-888
tairrrrtni3rrr�arzit�e'/�a?r1 �4 �A�� �Avq{6 been nor otified by1CertlNed Mail
AST. No
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 1 S from my area of riparian access unless waived by me. (it you
wish to waive the setback, you must_. initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
x 1 do not wish to waive the 15' setback requirement.
(Prope Owns In rmatf n}VIM
Se
:a*
Print or Type Name
Mailing Address
City/Stat ip
/� � o
Telep tone Number
Date
(Adjacent Pr erty Owner Informat(on)
Sign sr e
Print or Type Name v�
31 d ca pdd-
Mailing Address
lot 7Yl( Nc `�
V � L�___
Ciry/s�elZi�, `�A
Telephone`Nuulmbber
Date
Revised 6118/2012
ft t-f z
i
RECEIVED
-- .- -_-. - DCM WI-L:MINGTON, NC
NOV 0 4 2019

Letter of agent
have retained Mark Clements DBA, Clements
Marine Construction Inc, to make application", any and all permits needed to start
construction on the work requested for our property or properties.
By allowing Mr. Clements to make such applications l do understand that this will in no
way relieve me of any obligations to perform all work according to the building codes of
North Carolina, CANIA, DWQ or any other state and or county ordinances.
date
Contact information
RECEIVE
NOV 0 4 2019
NC