53929D - Blackburn

ICAMA / E�DREDGE & FILL
3ENERAL PERMIT Previous permit#
]New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources 'T f -71� {{ f
-oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC tci (J`
ules attached.
it Name lATJ Project Location: County
l tT) 6F We �' �m i Street Address/ State Road/ Lot #(s) 7153 i2 � utl
l Iti1 j (Si(L t'� State W. ZIP Z a
Fax # ()
:ed Agent
Subdivision
City 61 l I? C'1W ZIP7 8&12
❑ CW ❑ EW [w •P A ❑ ES F1 PTS
Phone # ( )
River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
yes /(�o) PNA yes 16 Crit.Hab. yes / no
Adj. Wtr. Body NE (NF Cl Thg
Closest Maj. Wtr. Body e
f Project/ Activity'
1'
(Scale:
ck) length
I
I(S)
_
-I
.�zl
_..
_....-.
_..
& Idi
-
:ngth
mber
,dd Riprap length
g distance offshore_
ix distance offshore
nannel
bic yards
np
oo
ise/ Boatlift
,ulldozing
ie Length 7 -co r v
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■■■■ii�i■� ■li■■ ■■� III
❑ See note on back regarding River Basin r

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CISL-
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CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �1^A-rr,,,AJ
(Name of Property Owner)
property located at —13a tz" vC'r S•eGn RR- Sura,,o.L,J , f,. C-
(Lot, Block, Road, etc.
on
(mo—
�Tirt �—�cs� �. (��t�c. in N.C.
(Waterbody) (Town and/or County
Applicant's phone #: 9%co Mailing Address:
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Individual proposing development must fill in description below or attach a site drawing)
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in wr
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext. Wilmington, r
DCM representatives can also be contacted at [phone].
No response is considered the same as no objection if you have been notified by Certified Mail
(Property Ownformation) (Riparian Property Owner Information)
,s-ro o —1 1 w � 131_�t.k 2� :C� Vrc CA
Mailing Address Mailing Address

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to a^ ���-�'-lf-�o� ��. is
(Name of Property Owner)
property located at —ISO 'e"J o = &eL-k ` enN� ��--�
(Lot, Block, Road, etc.)
-Q.on VETo-i CIP•ST CP'ft ac-1� ) l.�cr N.C.
(«"aterbody) (Town and/or County)
Applicant's phone #: 91-o �t1[ � Mailing Address: '37-+00, ?—C=D
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. / - ,/ /y
4-A
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
-------------------------------------------------------------------------------------------------------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
S(4ao
Mailing Address , /� Sig ature
L. ), l _ r �t�. � ZF�r- a S /� o r1(�

J BLACKBURN FLOORING CONTRACTOR
3400 RED BERRY DR.
WILMINGTON, NC 28409
DATE— 7 iPAY TO
c�
ORDER OFE $ ZE
koc
DOLLAI
SUNTRUST RUS A CH RT 061000104
FOR
II'00214511' 1:053100L,C5e:000053107►,559Ila