52490D - Harbour

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❑LAMA/ ❑DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
iorized by the State of North Carolina,Department of Environment and Natural Resources --^') ( Q
Coastal Resources Commission in an area of environmental concern pursuant to ISA NCAC
ules attached.
lint Name AQ-ate,,(I-- Y,,-s� '�J� Project Location: County PL' t_ !- -
s 1-z_ 1c-o _, '.4 Street Address/State Road/Lot#(s)
>k"C -F -1 State L) G ZIP Z- 9 LI t ►-a f"',
#(5'19 OS ._5 12 Fax#( ) Subdivision \-\r\CL-q-,1) S=')`' "3
ized Agent C 1-"C tIc.-)r-s '.& City SrAl2--,6: 6-1 T 1 ZIP 2 L`
,d ❑CW CAW %PTA DES ❑PTS Phone# ( ) River Basin.-
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
1: Adj.Wtr. Body 1 . i25,- -1st- S--)‘•".v"a ((na
❑ PWS: ❑FC: _
yes / no PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Bodes T"\ L �`"..)�
of Project/Activity t_ - L %-__.5
,,
(Scale: �
Jock)length
rm(s) II i
•pier(s)
length
lumber
:ad/Riprap length t 4S A".1 (-__ <4.-
tvg distance offshore { � —�'- "`i`'�
nax distance offshore
channel
:ubic yards
amp I
)use/Boatlift
Bulldozing
f i I
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Li
.—► 14 �..
b
inc Length 'S ' U
not sure yes {l I N "(;/
f l
tgs: not sure yes no/ I y 1
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Drium: n/a yes no.?
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yes na-1 i
r Attached: yes cnp� i
Jing permit may be required by: Su, k-L-F 6.-ZT_j See note on back regarding River Basin

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to �aL-t - S .,n —Ce<,;,A1nr, Q..5 's
(Name of Property Owner)
property located at % 1
(Lot, Block, Road, etc.)
on )0 p504 I 561410 , in ,N.C.
J (Waterbody) (Town and/or County)
He has described to me, as shown below,the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet(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)/
IkA
" do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to Vor-Lor 's
(Name of Property Owner)
property located at .44114 R-o\om
(Lot, Block,Road, etc.)
on f C,?9 If , in ••/,'\ , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet(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.)
I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)

LIGHTHOUSE MARINE CONSTRUCTION
P.O. BOX 2532
SURF CITY, NC 28445-0028 3 ,i / Z - 0
/
,� /J DATE
PAY
TO THE A) - 0 ?N/( I $ 26'
ORDER OF
Bank ofAmerica
ACH R!T 053000198
FOR A%a eD 1 y C� (ft•VIJ;� �'�-��J`-c-i�� ------
000346 20 1:053000 L961: 00065 L3 L L3670