52505D - Britt

ICAMA V I DREDGE & FILL
GENERAL PERMIT Previous permit #
Wew -Modification -_ Complete Reissue :Partial Reissue Date previous permit issued
•ized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 04 L `
ules attached.
t Name 11"e Nt'->Z's Project Location: County_ jD(.� *J%>i—!i2--
State �- ZIP 2� �) �j
( ) Fax # ( )
ed Agent T
CW /;,EW >51?TA LIES I PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
Street Address/ State Road/ Lot #(s)
' :',
�� i� (✓,�G4�
Subdivision
City ��SAZ (�
&S0,Gyk ZIP2-25LI
Phone # ( )
River Basin
Adj. Wtr. Body &PPP-S
6*p"J' (nat
--
yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body �S`N
Project/ Activity
it
(Scale:
:k)length
I(s)
ier(s)
igth
nber
f/ Riprap length
distance offshore
x distance offshore
cannel
)ic yards
ip
Boadi 11--
illdozing
Length
not sure yes no
r
>: not sure yes no
ium: n/a yes (%
yes
\ttached: yes L �o--------------------
ig permit may be required by. A': V t�NC.l
❑ See note on back regarding River Basin rt
Special Conditions

�r
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date 57-1 1 ^ Oq
Name of Property Owner Applying for Permit:
Mailing Address:
��
1 certify that I have authorized (agent) �(�V."1MPkO i>�ll�-� AAto act on im
behalf, for the purpose of applying for and obtaining all LAMA Permits necessary to
install or construct (activih) � V LA V=r
at (my property located at) 90(k 1 -6UVb� SLA ,
This certification is valid thru (date) —T t.h ,5_0 ZC0q .
s-lt •Dq
Property Owner Signature V Date

DIVISION OF COASTAL MANAGEWNT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
:te of Individual Applying For Permit F..i •t ll .'1t
Press of Property:
(Loot or Street #, Street or Road)
(City and County)
reby certify that I own property adjacent to the above -referenced property. The individual
dying for this permit has described to me as shown on the attached drawing the development they
proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
on have objections to what is berg proposed, please write the Division of Coastal
tlagement, 127. Cardinal Drive Extension, Wilmington, NC.28405 or call 910-395-3900
tin 10 days of receipt of this notice. No response is.considered the same as no objection if
have been notified by Certified Mad.
_ --WAIVER SECTION --
derstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
„ak a minimum distance of 15' from my;area of riparian access - unless waived by me. (If
wish to waive the setback, you must initial the appropriate blank below.)
R
Name
I do wish to waive the Isetback requirement
I do not wish to waive the IT setback nit
Date
AT. `_wl �_ WA

Bank of America
ACH R/T 053000196
ALLIED MARINE CONTRACTORS, LLC 08-03
910-367-2159
92 HAROLD CT. r-
HAMPSTEAD, NC 28443
PAY TO THE
ORDER OF ,' V
MEMO
110 0 0 3 SIG 8 Jim 1: 0 5 3000 L 9 61: 000684 7 L, 3 7 AUTHORIZED SIGNATURE