53923D - Quintano

CAMA / DREDGE & FILL I^:
E N E RAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ' fPartial 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 I5A NCAC ,/b. )2O6
PRtiles attached.
t Name , ;4 4 I Cif Hai Ti?,✓. Project Location: County ijjQ y N,fwfcie
• .- r '47r. P e?,t/ C, C.c/.e Street Address/State Road/Lot#(s) 22 (-11,L rA
p2,,-N .5144 ei State/' C ZIP 2- r� 5.1 .2
(_ )-?7J- '2€ Fax#( ) Subdivision ,p
zed Agent _ City i/«,,.J 2 L Q(D'9<
4 zIP?iy,
d cw EW CE PTA E €S IIPTs Phone# ( ) River Basin LNiy,
OEA HHF E IH E UBA ❑N/A Adj.Wtr. Body C/7N/I C. o /AJ iw (nat,
PWS ❑FC:
yes / no PNA yes / no. Crit.Hab. yes / no Closest Maj.Wtr. Body /9/IA/h..
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mg distance offshore I HIIHIIH , ,�1
nax distance offshore ■■■■■■■ ■■■■ INIIIPME1111.1111MW11 ■■■ ■
channel IIIIIIHIIIIIIIH !! jIIIIIIIIHIII
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ding permit may be required by:J2CP,7e- ..jt/P ('Pi2 4 . n See note on back regarding River Basin
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: A3o bj r r : a r-
Address of Property: 7�. W iI I M i v.) T-01 Si-
(Lot or Street#,Street or Road
c eA.,,, ` A/C , ( u W,
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indiv
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 lett(
)-PA) X
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 28.105 or call 910-796-
within 10 days of receipt of this notice. No response is considered the same as no object
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier,dock, mooring pilings,breakwater,boat house or boat lift must
bck a minimum distance of 13' from my area of riparian access-unless waived by me. (
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 1 S setback requirement.
(? -Ip ?,„,0,7 x—X,-:„ i( I 0
r

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: Ro Le g. j (( u i ry
Address of Property: 7v2. •[J I /n/` r -11 5 j
(Lot or Street#,Street or Road) /
_ 0r� x S/ /- /✓ej UNS i
. (City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indi)
applying for this permit has described to me as shown on the attached drawing the developmer
are proposing. A description or drawing, with dimensions, should be provided with this ler
•1,2o'O`�
sse
% �
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of C
Management, 127 Cardinal Drive Extension, Wilmington, NC 28403 or call 910-796
within 10 days of receipt of this notice. No response is considered the same as no objec
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier,dock,mooring pilings,breakwater,boat house or boat lift musi
bck a minimum distance of 13' from my area of riparian access- unless waived by me.
wish ttz 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.
7 20 o 1

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ao4e, _Qi,.:itano 124
271Ja! Ci/-ck 66-112/531
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