51350D - Gaitros

AMA / DREDGE & FILL lam?
ENERAL PERMIT Previous permit#
'lNew ' ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
orized by the State of North Carolina,Department of Environment and Natural Resources / j /l'^O
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC • LU
❑Rules attached.
nt Name gt"hC/ 6 (�':)'�/j/' 7> ' Project Location: County /t ti' % ,iF1Vp
s 223 1CIC4 le' _ Al , Street Address/State Road/Lot#(s)
/t 11,4- y J172,,,y State?l,1 e ZIP Z. G// / .5lZyst/
# ( _ ) 52/? , /4,4 Fax#( ) "-- Subdivision f'/, 9 ..7-5 .
ized Agent ,--- City �Gr,,.►1 ZIP -54,
d cw EW C PTA ❑ES CIPTS Phone# ( )�- 4's'1� River B in l'
OEA ❑HHF El IH ❑UBA CI N/A Adj.Wtr. Body fj/// 1/ .SD!-�r.��'/ r��' na;
PWS. ❑FC: / '/ ka r/
yes / no PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body / // S
of Project/Activity L (mayJ ;r.r/tfi.Ph < '�� e7 f-.9/'/ill 7e. ,,,.!'f- -1-1,0..,
,i94 /1'77 • (Scale: /•
dock)length 134/2'X lc / ii' s
rm(s) 1.S X l Q/
i
I
pier(s) I (.
length j I t 1111
{
number \ 1 LiiflI
Illii ._ _,
ead/Ri length
\���� . .v ate-
avg distance offshore MEM..� ;o■■ m.■.� `em 1 mm auto
max distance offshore 11111
, !PE!
PI11111111111
channel ,
cubic yards 1iiIII1Ui! i/i' , L
P
l •
ouse/Boatlift �Y,
1 Bulldozing I I _ / I
1 i1�m■■wsr■■ �oo ■m■■ ■ ■ ■
line Length / I i
"► ippiii
not sure yes no
ags: not sure yes of ' S • riu1IiIII!IAhi
ir1111134
orium: n/a yes ■�■.1I■��V�;alb ■u11�uuuuu■■u■1 311211r
s: yes n _PI ��■F.�211iMit �.� _...._...__
r Attached: yes V ) , , ' 41 -.,/.! )''1 'f, . ,
ding permit may be required by: A]I Cr7. t[-15,p1l�� y,
11 �1 l I �` �' t�f.I�❑See note on beck regarding River Basin
-/C....-:..I r...�a:a:--_ i)/,I. , J L� 1,n/1 a _ 1_ !-L. - i '/i// Z ,. .

►Zoitatd D. Qaitros 04-94 66-30/53133 9160
Qaitros
,Deuols/rire,Gt. �' cy
'm g/on,,NC28409 D`TF 512`7 '✓
L 1 / FAi F $ 00, €(�
".61
First Citizens a
fflrss citizens.com
31003001:00353666733211' 09160

Shell Bar/
n
Tidal Creek
0 ft. MLW
15 Ft. 17 Ft. 20 Ft. Co 15 ft.
< >< >< >< Y X >
•µ 1< ><ft ft. o, .
vi IHIi A*
X'+ Deck in V V
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scale: I in. = 30 Ft. 1�/`I/ x N
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4

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: R a a j d 6-a. ; 4sino
Address of Property: a 3 d e c di RA M .
(Lot or Street#, Street or Road)
(City and CouI y)
I hereby certify that I own property adjacent to the above-referenced property. The individu
applying for this permit has described to me as shown on the attached drawing the development thf
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coast:
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-721
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings,breakwater, boat house or boat Iift must be sE
bck a minimum distance of 15' from my area of riparian access -unless waived by me. (If yo
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.
0-C46-,4(96-66 —Or(
(145 Sign Name Date
RlitV,L L.fit- '704 P -
, DtAt13,-- 0
Print NameATICIFA

DIVISION OF COASTAL MANAGEMENT
. ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: k o„A Id ; rY.o T.
Address of Property: a a 3 6 6-4 t-1 a n( V
(Lot or Street#, Street or Road)
w I ►V,,,, 3., n) N inr-
am., ✓e
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individt
applying for this permit has described to me as shown on the attached drawing the development th
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coast
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-72
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be s
bck a minimum distance of 15' from my area of riparian access-unless waived by me. (Ifyc
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.
IKCI-1J7-tt---" Ge
q,)_6 C7
S' Name Date
1')6.-ti ;,, 4-cc_vt--in---
Print Name
•

DIVISION OF COASTAL MANAGEMENT
, ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: Ron, ) dl 6C , Av s
Address of Property: D.. 43 8 e . c 1 6 d .
(Lot or Street#, Street or Road)
W I I ' A e 4 4 n ✓1^
(City and Cty)
I hereby certify that I own property adjacent to the above-referenced property. The individt
applying for this permit has described to me as shown on the attached drawing the development th
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coasi
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-72
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier,dock, mooring pilings, breakwater, boat house or boat lift must be s
bck a minimum distance of 15' from my area of riparian access-unless waived by me. (Ifyi
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.
t � /0 — 9.a7
Sign Name Date
Si _CON Co A N o RJ
Print NameA p FA

/ `IMPORTANT MESSAGE)
FORR-4bb
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4 'nlie-c-A1(5CA-
SIGNED i
FORM U.0S 32P.A.��.���III��r���iii MADE