53931D - Padget

CAMA / DREDGE & FILL
ENERAL PERMIT Previous permit#
'New _Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC ?4A • 12 .4
Wes attached.
nt Name r'N r N Ct-0 pf\0 Tr- Project Location: County 1- ;lt
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ding permit may be required by: F t(2 . See note on back regarding River Basin
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-14-2009 03 :30 PM GREG GRAY 1 910 329 9151 P. 01
Air / irc4i C10 - 3` y
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILI'NGSBOATLXFT/BOATHOUSE)
I hereby certify that I own property adjacent to ,93 €'//3 CI4qP// 's
(Name of Property OWner)
property located at 10r ~14946 L2h'.
(Lot,Block, Road,etc.)
on , in (P/)/9/e, , N.C.
(Waterbody) (Town and/or County)
Applicant's phone#:% - ,O/Y Mailing Address: //--/Y,v9//41'4 ,572
.3fd57 rvo
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
2111/( I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To befitted in by individual proposing development) Iz'ro 1 y
7
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
//540/9/0944 �?� 99-1114-1t)1/4), �01.4. `
Mailing Address Signature
4,247 4111 yy -

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to l'ig4/0/0 j�s9c�, gg� 's
(Name of Property OWner)
property located at 421 fo j Q//i9.CQ ditP
(Lot,Block,Road,etc.)
on , in (,i/c4 ,N.C.
(Waterbody) (Town and/or County)
Applicant's phone#:7t—) 7D-4/07 y Mailing Address: ,//.S"
ff�ih.o i7ZT /Ye:
O
He has described to me, as shown below,the development he is proposing at that location,and,I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
Cbal-
„ —
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
//o 4 /�, be. s' e
Mailing Address Signature
./ .. /

Consent for Use of General Permit 7H.1200
Lot Number/Address: i `5 A L LA 20 Dif2,
County: Subdivision: (Y\Al. .1,20 7
Criteria:
(check all that apply)
.er" Primary Nursery Area.
EKLess than 2.0ft deep.
❑ Greater than 2.0ft but less than 3.0ft.
o Submerged Aquatic Vegetation.
❑ Bottom habitat.
Comments:
Decision:
Issue General 'e _!
o Elevate t• . or 9 it
NC Division of M-.T'- Fisheries Representative Date

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