54027D - Cheek

�rCAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
;iNew ❑Modification [-]Complete Reissue ❑Partial Reissue Date previous permit issued
>rized by the State of North Carolina, Department of Environment and Natural Resources „ /2d c
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 1''
es attached.
nt Name L Ae' ,i r /,JC 64 Project Location: County 46,le u.r S ev/c
f . 61, � �(O �.� Street Address/ State Road/ Lot #(s),-76 �� 2
a// L P I&9c h State r` (f ZI P .2
S.- —62w12 Fax # (_)
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u CW (]EW E-"A ES ❑ PTS
❑ OEA ❑ HHF ❑ IH UBA ❑ N/A
❑ PWS: ❑ FC:
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imber
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ling permit may be required by: Qcow,✓ 2 -/'- See note on back regarding River Basin
i i n .,

AGA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
;hael F. Easley, Governor James H. Gregson, Director William G. Ross Jr.,
Authorized Agent Consent Agreement
90 j E is hereby authorized to act on my be
(Printed Name of Agent)
'der to obtain any CAMA permit(s) required for the property listed below. The authorization is limited t
:ific activities described in the attached sketch.
:ATION OF PROJECT:
)G 7� E PEN I N 5U L, A
�CE7�ry :1 5 L-E DOC + , N - C
Z-q54-4o9
PERTY OWNER MAILING ADDRESS:
T-SL.E DotcN 406 V-0. PHONE NO. 4910 71 - %zC.,Z_
HORIZED AGENT MAILING ADDRESS:
C) gb 2k
L�' t � s LE p,�� 0
28�19
PHONE NO ) O �55 30 &
iture of Property Owner;

DIVISION OF COASTAL NL NAGENIENT
ADJACENT P.IPARIAN PROPERTY 0VNER NOTIFICATION/VJAIVER FORD
Name of Individual Applying For Permit:
Address of Property:
(Lot or Street #, Street or Road)
Derr" — �_QLc
(City and County)
I hereby certify that I own property adjacent to the above -referenced property. The ind;
applying for this permit has described tome as shown on the attached drawing the developme
are proposing. A description or drawing. with dimensions, should be provided with this le
K I have no objections to this proposal.
If N,ou have objections to what is being proposed, please write the Division of C
Management, 127 'Cardinal Drive Extension, Wilmington, NC 28405 or call 910-79e
within 10 days of receipt of this notice. No response is considered the same as no objec
you have been notified by Certified Mail.
WAIVER SECTION
.r understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mus
bck a minimum distance of 15' from my area of riparian access - unless waived by me.
wish to waive the setback, -you must initial the appropriate blank below.)
l� I do wish to waive the l 5' setback requirement.
I do not wish to waive the 1 5' setback requirement.
ame
ate
5�u -a.v+ 60ap
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DIVISION OF COASTAL MANAGENIENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FOP]
Narr:e of Individual Applying For Permit:
Address of Property: 3!0 7�t¢ Pev 1 o.S Ala
(Lot or Street #, Street or Road)
©t�rN _TSlc. Fjccc v� - �✓'ry v�Svw
(City and County)
I hereby certiry that I own property adjacent to the above -referenced property. The in(
applying for this permit has described tome as sho%vn on the attached drawing the developm
are proposing. A description or drawing, with dimensions, should be provided with this li
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of
Management, 127 'Cardinal Drive Extension, Wilmington, NC 28405 or call 910-75
within 10 days of receipt of this notice. No response is considered the same as no obje
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, break--z�'ater, boat house or boat lift mug
ZI
bck a minimum distance of 15' from my area of riparian access - unless w2ived by me.
wish to «waive the setback, -you must initial the appropriate blank below-)
I do wish to waive the l S setback requirement.
Sign N6tne
I do not wish to waive the 15' setback requirement.
Date
f
l�r,.,r TAT AkVUCWA,

& MYERS CONSTRUCTION
P.O. BOX 5024
OCEAN ISLE EACH, N 28469
%X"7-
r, v C, c.1.o7 n ( -br. C.m •)
-A R HNC^AROL- — —
66-112-531
1160000 7 S 2011' i:0 S 3 LO L L 2 Li:000 S 2911193413 111'
o6l
AUTHOR SIGNATURE
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7520
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