53190D - Erickson

:AMA / DREDGE & FILL
Previous permit #
ENERAL PERMIT
Date previous permit issued
4w uModification -j'Complete Reissue ElPartiai Reissue
Eed by the State of North Carolina, Department of Environment and Natural Resources/�/�O
iastal Resources Commission in an area of environmental concern pursuant to 15A NCAC /%y des attached.
G� Project Location: County YOy^'S'✓ �c 'e
Name
Street Address/ State Road/ Lot #(s)
d StateN ZIP pz ozS� �
00y) -ZYXf Fax # (_) Subdivision
�c
A Agent �C � L .r J O s �"
City �%u I d o. -9 C ZIP
River
PTS Phone # O Ger� Basin L N
❑ CW C�'EW G1PTA �+�/'? /Gv 6.1
❑ oEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body oat (naIG
❑ PWS: ❑ FC: �/ G✓ A,/Closest Maj. Wtr. Body
yes /(.,!p _ PHA �y/es no Crit.Hab. yes / no
/`
Project/ Activity e
(Scale:
C
distance offshore
jbic yards
Mp
'Use/ Boatlift_
Bulldozing
IV. ILM
we MGM
ine Length
.trnot sure yes
.
-roteags: not sure yes
s: yes
...
Iding permit may be required by:
��u RyLa��PAr� /o �.e ��✓�� pd�'�I�P..-'!
:s/ Special Conditions , P.- I

ANA
WCD►ENR
North Carolina Department of Environment and natural Resources
Division of Coastal Management
hae� F. :Easiay, Governor James H. Gregson. Director
Authorizes! Agent Consent Agreement
William G Ross jr., Si
Z_ is hereby authorized to act on my beh
Prirteo Name of Agent)
der to obtain any CAMA permit(s) required for the property listed below. The authorization is limited tc
,ific activities described in the attached sketch.
ATION OF PROJECT:
12 Jul �D%'t-i S JJi"
ov,lo
)PERTY OWNER MAILING ADDRESS:
5e-e-P # ne- L , Eleie-kso�/
PHONE NO. 76,`-7I
HORIZED AGENT MAILING ADDRESS:
PHONE NO. '716 ya- OV,96?
ature of Property Owner:

DIVISION OF COASTAL ?�'IA'AGE'�fEI�T
ADJACENT IMPARIAN PRUPI✓1Z'r U\�- I✓ R.'OTIFICATIC7?N AIV"ER FOP��I
Name of Individual Applying For Permit: ► �
Address of Property: /' '7 �
(Lot or Street n, Street r Road)
(City and County)
I hereby certify that I own property adjacent to the above -referenced property. The indivi4
applying for this permit has described to me as shown on the attached drawing the development 1
are proposing. 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 Co;
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-:
within 10 days of receipt of this notice. No response is considered the same as no objecti
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, break -water, boat house or boat lift must 1
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (I
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
n1___ l.T_y-
Tate
AAA

20 07- 11
9 JConstruction 9%-W-3360nn, 9193156049
DSVIS1b� Ut= C I . "''T
J� jl?,Crv\T cm �rK'�UTIFICaTIC>?�'N�"AIVER_I 01"N1
C' : (
Namc o1 Indit'idUai _tpply inY For Permit: — �
Address of Propert% . / '/ ' / '
(Lot or Street #, Street or Road)
(City and County)
I hereby certify that i owit properly adjacent to the above -referenced property. The indivi..
applying, for this permit has described to me as shown on the attached drawing the development
are proposing. A description or drawing, with dimensions, should be provided with this late,
V/ I have no objections to this proposal.
If you have objections to what is being proposed, please write the Divisiou of Co;
Management, 127 Cardinal Drive Extension, 'Wilmington, NC 28405 or call 91.0-395-,!
within 10 days of receipt of this notice. No response is considered the same as no objectir
you have been notified by Certified Mgil.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift roust t
bek a minimum distance of 15' from my area of riparian access - unless waived by w e. (I:
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement -
I knot wish to waive the 1 ]' setback requirement.
'ap
Sign Name Date �� ; '
n t / _ .....

MARION K LANE GST EXEMPT T USR T
JOSEPHINE L ERICKSON WEE
349-L Co
ppperfield Blvd #377
Concord,lVC 28025
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Date
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