60610D - Lassiter

",VAMA / DREDGE & FILL N O . 6 Q
EN ERAL PERMIT Previous permit # "/17
MONew ' -jModification Complete Reissue ---Partial Reissue Date previous permit issued_
orized by the State of North Carolina, Department of Environment and Natural Resources -70 I Z O O
Coastal Resources Commission in an area of environmental concern 7pursuant to 15A NCAC
❑ Ru attached.
ant Name A oA � " L A5'2 (r! Project Location: County f ,fd A�J
�41 /% f 6LO State Ak ZIP - 7s
#17&),7l Fax #( )
ized Agent �-& M "
d Ci CW ),LW ETA ] ES PTS
❑ OEA ❑ HHF 1H = UBA N/A
❑ PWS: r FC:
yes n PNA yes / f%,� Crit.Hab. yes 4!5
Street Address/ State 11 t #(s)
,qV 32
Subdivision //►►�
City ��✓� t� • ZIP
Phone # () �— / River Basin
Adj. Wtr. Bod7�' 4Aq
Closest Maj. Wttr. Body t V'-V 5ac'w
3f Project/ Activity r 1� ` : r iliL"Gc s 5r / fit
/
lock) length Op 0 IL_
length
umber
:ad/ Riprap length
vg distance offshore
iax distance offshore
channel r'
ubic yards
imp
)use/ Boatlift
i
Bulldozing
ne Length
notsure yes ® l-
gs: not sure yes / b�
)rium: n/a yes
yes
Attached:
ling permit may be required by:
Ps(i�
60M
/ r,
❑ See note on back regarding River Basin
f ./

JAtA6S 4�� aSSit�R
963 2
�,U2F�i-fl,NC
1

�plicant: E ���j l Permit
ate: -7
:scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
DISTURB TYPE
bltat Name Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp, impacts)
I FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
�I'd Dredge ❑ Fill ❑ Both ❑ Ot
, 2U
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

To:919103470748 PaSe:3-1
9-2010 11:12 From:DCM MHDCTY
r,E TIFIFD MA.iL, RETURN RECEIPT R'EQUE�TED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Individual applying for Permit'.R
rty Lf o32 y �� SU2F 6► 4
addr�ss of . prn}g—
(Lot or Street #, Street or Road, City & County)
I hereby certify that ! own property adjacent to the above referenced property The individual
applying for this parmit has described to me as shown on the attached drawing the development
they are pro osing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call [phone] within
90 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mall. _
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatiiR or sandbags must
be set back a minimum distance of 15' from my area of riparian .access unless waived by me. (If
you wish to ive the setback, you must initial the appropriate blank below.)
&ffi�� do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Applicant information)
_ �.U. �or236
Malting Address
City/state2'ip WC
(Riparian Property Owner Information)
signalum
Prtnt or Type Name `_ ._

-19-2010 11:12 From:DCM MHDCTY To:919103470748 Pa9e:3,
CERTIFIED MAIL, RETURN RECEIPT REQUESTED
DIVISION OF COASTAL_ MANAGEMENT
.ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of individual applying for Permit: T+MK A . L4SSg6ft-
Address of Property:
(Lot or Street #, Street or Road, City & County)
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
they are proposing description or drawing, with dimensions, should be provided with this letter.
ve no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or can [phone] within
90 days of receipt of this notice.. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (if
4ou wishou wish to iv the setback, you must initial the appropriate blank below.)
Jo lash to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Applicant information)
Mailing Address
City/State/Zip
(Riparian Property Owner Information)
Signature
Print or Type Name