52533D - Olive

CAMA / DREDGE & FILL
IENERAL PERMIT • Previous permit#
New Modification iComplete Reissue El Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources �j LL,,
oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC I//• /2 00
i es attached.
:Name 1,J S ji,d 0 L, v - Project Location: County 32kisif'11i c%
P. to, 15,X 5 f/.S.5^ Street Address/State Road/Lot#(s)35 L e e S2
/.a 77 ✓,//e State/L ZIP2$Jo5
(24 )26J- 7P49 Fax#( ) Subdivision
ad Agent 7izACy /F/1r)424._ City P,-I ,L-Q &pc4 ZIP 27-Y�
❑CW CAW- Li-PTA Is�.E9 ❑PTS Phone# ( ) /�Riveerr Basin L.um
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PWS: ❑FC: /�
yes /ono PNA yes 7 Crit.Hab. yes / no Closest Maj.Wtr. Body )�/4✓1"""
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ttached: yes -— __ I i
ig permit may be required by:()CP4J 1 Si-e, 6lo c A See note on back regarding Riverve Basin rul
ipecial Conditions /8L( cat-al 'ire-,f i f' ,fj� /2 iG AS kv P// , c g/) O 7.(.f'._

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: Z,L)11.-1 s n 1 t
Address of Property: 3 5- (.ao S T
(Lot or Street #, Street or Road)
COATI, LI-5 lam 1PA-e-1-4 d
(City and County)
[ hereby certify that I own property adjacent to the above-referenced.property. The indivi(
ipplyin ff for this pei mit has described to me as shown on the attached drawing the development
ire proposing. A description or drawing, with dimensions, should be provided with this lettei
I have no objections to this proposal.
f you have objections to what is being proposed, please write the Division of Coa
Management,. 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3'
vithin 10 days of receipt of this notice. No response is considered the same as no objectio
ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
A bck a minimum distance of 15' from my area of riparian access - unless waived by me.
ou wish to waive the setback, you must initial the appropriate blank below.)
A I do wish to waive the 15' setback requirement.
Ir`a�
'�V\ I do not wish to waive the 15' setback requirement.
gn Name Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: LUl w ST - Ot / {e..
Address of Property:
(Lot or Street #, Street or Road)
COjtvt_ Te_24- C-
(City and County)
I hereby certify that I own property 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 lette
sid )(14- I have no objections to this ro osa p p I.
If you have objections to what is being proposed, please write the Division of Cog
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-2
within 10 days of receipt of this notice. No response is considered the same as no objectic
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mus
set bck a minimum distance of 15' from my area of riparian access - unless waived by me.
you 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.
( .
V7
Sign Name Date
AA

AVA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
F Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secre
Authorized Agent Consent Agreement
PICA � is hereby authorized to act on my behalf
(Printed Name of Agent)
r to obtain any MA permit(s) required for the property listed below. The authorization is limited to th
activities described in the attached sketch.
NON OF PROJECT:
L 'e
SwQr�
>L E C
5t,� 1C)C— r CJ >
ERTY OWNER MAILING ADDRESS:
3 �!
C do3as PHONE NO. quo- aLo3 - qa -t. )
)RIZED AGENT MAILING ADDRESS:
f — Ce Cuh J i�1�c77c1•-
3 ) 3Co
A-)(07 /I � c 15 j PHONE NO. � ' % J -- i`7 3
re of Property Owner: r el)(2A1J.-0

IIIIMINIIIIIMIMMMMIMMIMNIMmzmuzrimnwmnmmOMIMIMM
STEVEN T. FARMER
TRA COM SERVICES '
PH.910-754-2725
897 MIDDLEDAM RD SW 6
a =
SHALLOTTE,NC 28470-5857 l
PAY TO THE ______.a/� Ctato
ORDER OF -
________ ______ ,,,,,a„to
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„....,_________,
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