60776D - Robbins

❑-LAMA / ❑ KbREDGE & FILL
NO. 60
GENERAL PERMIT
Previous permit '# �—
!lew ❑Modification Complete Reissue Partial Reissue
Date previous permit issued
prized by the State of North Carolina, Department of Environment and
Natural Resources
��dd
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
/
nt Name� w t f /c� ,7 C +�� f �6 U1A�-
Project Location:
❑ Rules attached.
County
/
s �`/ IV • ��Joljja�� S
Street Address/ /Statte Rom Lot # s)
t/d 4ZA.✓ Statek— ZIP 24Z�
0 61 `r6Z" 06 # ( )
Subdivision
zed Agent �) p f�1 y. s i ,
City _ r/
/ zip
Cw :.W "ETA 3ef S _ _ PTS
Phone # River Basin
❑ OEA - HHF IH = UBA _! N/A
Adj. Wtr. Body
G�%/t//4'l� 07� SC (nat,
El PWS: J FC:
yes / no,. PNA yes Crit.Hab. yes
Closest Maj. Wtr. Body
if Project/ Activity
ock) length
pier(s)
ength
ber
Riprap length
ig distance offshore
iax distance offshore
:hannel
ibic yards
imp 'SC �—
,use/ Boatlift
Bulldozing
ne Length
not sure yes
gs: not sure yes
orium: n/a yes
yes
Attached: yes
ling permit may be required by: 1
q // '01 'e'4�
�tST/P } b x Z' fic�
v/
(Scale: / I
❑ See note on back regarding River Basin
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:t..11. 2012 9:06AM JERNIGAN'S NURSERY No.5911 P. 1002
CgRTIFIEQ MAIL-, RETURN RrEgEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM
Name of Property Owner: /LJeX,
Address of property: t: OJT' f c.
(Lot or Street #, Street or Road, City & County)
C-o
Applicant phone #: - 1/0 -� ~ 06� _ Mailing Address:
O Ir /l•C- 9 S ul-
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. A descriptionr dr h dimen5lons, Must t9 providedh' er.
/77A4. 0-1 have no objections to this proposal. 1 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 www.nccoastalmongement.tiet/contact dcm.htm or by calling 1-888-4RCOAST. No
rea onse 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, 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 Ipltial the appropriate blank below.)
rAM4L *4-- 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pr pe of tlon) (Riparian Property Owner information)
r
i r
Signature Signature
Print or Type Name Print or Type !Name
i,I 41 n.,s'6w r'G . '&�- s-fflo—
L el 6-�_ ���

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: (vI415 cW /moo /�OiA-:
Address of Property: �n
(Lot or Street #, Street or Road, City & County)
Applicant phone #: 22b - ayd — 0410 Mailing Address: /O Z
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. A description or drawing with dimensions must be provided with this letter.
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 www.nccoastalmangement.net/contact dcm.htm or by calling 1-888-4RCOAST. 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, 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.)
'/✓S I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Print nr Tvna Name
(Riparian Property Owner Information)
ignature l
dv
Print or Type Name

sU��

oplicant:' �j�s' Permit #:
ate: If
,scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
bitat Name
DISTURB TYPE
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)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑ Fi Both ❑ Other ❑
//0
/ /Q
Dredge ❑ Fil Both ElOther ❑
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 ❑