53937D - Morgan

FCAMA / DREDGE & FILL
ENERAL PERMIT Previous permit #
'New _ Modification 'Complete Reissue Partial Reissue Date previous permit issued
rized by the State of Noreh Carolina, Department of Environment and Natural Resources �,l
Coastal Resources Commission in an area of environmental concern pursuant to I5A NCAC 1• avUU
T� j \' ules attached.
nt Name NIaYk avid 1}'cI( f Nl �t (i}1 Project Location: County I V(W IICYY1'
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•ized Agent ii VV1rny NOr- A., City '42 ►v1 G c ZIP ram
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?t1 : FFi> NO. : Aug. 15 2009 03:52PM °2
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILLvGS/B 14T '- : THOUSE)//��J
C t421\ t 0C3f�
I hereby certify that I own property adjacent t• L: 's
(Name f f Property Owner) is R.G'
�' rr- AA-4/ I 3 /t%__ ��. 1.
property located
(Lot,Block,Road, etc.)
on_ �C , in i f10r-/zOf/Bl1 ,N.C.
(Waterbody to ,IgF� t33 (Town and/o County) - i.63
Applicant's phone#: % T.s=isail Mailing Address:
41.4ikel5grak7Y6-15444..;-...)1, c-
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.)
1¢o 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)
(Information for Property Owner Applying (Riparian P rty Owner Information)
for Permit)
1 g3' Al 1 kt . Cam,►-_
Mailing Address
j ��� Signature
GtJ� t rnin e'lert�''
City/State;Zi Print or Type Name

1M : FAQ NO. : A . 15 2005 03:53PM P3
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to / tii.k (1/Pme of Properly Owner)
�
property located at 1 2,R
(Lot,Block,Road, etc.)
on C_v1/ , in `V ,N.C.
(Waterbody) (Town and/or County)
Applicant's phone#: ��'Lc') 5(i) Mailing Address: a S'31 1v..tJ ,04. 41
.vc e
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
.// 1 as wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by Individual proposing development)
rcS�+ r
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
r 7 it
Ma ha Address Signature
g sr S��j / / li /
tj)(ALI , I,/ ar )1 L = l _ ! 't) N."4 (Y`Gr/.v.r.:(
City/State/Zip „... .. Print or Tyne N

COASTAL MARINE DOCKS & BULKHEADS
NCDL 3831595
6314 WRIGHTSVILLE AVE 910-256-6357
WILMINGTON,NC 28403
0 PAY
DATE / / / 0 I
TO
DER OF T -I'-- &
lz-i-Lic,..4___r_J„---___ I 4`CJO
�c� DOLLARS
ft
WACHOVIA
Wachovia Bank,N.A.
Ywachovia.com
FOF P 5S !3 /1p a-✓
'0 L6 63I. ' :0530002 �9�. 20861 ?-
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