50268D - Kane

CAMA / DREDGE & FILL 1
ay T
EN ERAL PERMIT Previous permit#
_New IA Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
rued by the State of North Carolina,Department of Environment and Natural Resources _.� t f L v G
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC lT
( ❑Rul attached.
nt Name --d izGML Project Location: County W 1`f
s c r' .,7 •L Gt ; Street Address/State Road/Lot#(s)
n C am
1 / VVVV State Al C ZIP V(2 ck 27 -rX uJ c
#( ) T`-{ - i 1<- Fax# ( ) _ _- -__ _- Subdivision U
•ized Agent __. 0tA.A. City LA ! I-1A^ ZIP r b- `
-d cw 'EW L PTA __ES PTS Phone# ( ) River Basin `_
! OEA ❑HHF L IH ❑UBA ❑N/A I: Adj.Wtr. Body C rr (nat
L PWS: ❑FC:
yes / no PNAj / no Crit.Hab. yes / no Closest Maj.Wtr. Body ��4.-
of Project/Activity (A5 G 1( { Z X f 2 i 44
(Scale:/V (
dock)length
irm(s)
1
r pier(s)
1 length 1
number j
lead/Riprap length
avg distance offshore _
max distance offshore
,channel I 'iie
{ i 40
cubic yards
-ampI j I _ IlkjLA ,Z 'it lit
I I
i Bulldozing _._.I ___....._. ), Rid) �d1j�
I
,v,../...
line Length /6 6 7.,11- it; •
not sure yes j
ags: not sure yes (119 - —
:orium: n/a yes cso
—r
i l
s: yes eTio /L
it Attached: yes __1 i !1 I �I,,G...
ding permit may be required by: ! " +t- See note on back regarding River Basin
,- i 1 t- 0 Is I , I / � ,� - • _ /

EDWARD F KANE 66-21/530
8927 SHIPWATCH DR. 0 2 3
WILM,NGTON,NC 28412 ) v
5394285 T1 DATE `-' _
PAY TO 1E ' V F� Y�/�C N/jr"(� ,c
ORDER OF
60
ell,
=i---•` vt `v G� �CJ`� DOLLARS Bi Faaw.ea.oeaa
on 99dt,
WA(ra.JVIA BANK,N.A.
NOTES l7 T%!� 50. (L — - - ���-�v
1:053000 2 L9': LO L00 2894649411' 20 23
New Racing a2119 ©2006 The Styles Check Company 1-SO0 356.0353 www.styleschecks.com Race Images by Gary Ga Nastase

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: r .t_
Address of Property: Left '# 6 ? z S INP wa+a k 0�"
(Lot or Street#, Street or Road)
\► -1 rv. ;N J -e �1 Hd ' r
(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 aftached drawing the development
are proposing. A description or drawing, with dimensions, should be provided with this lette.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coa
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7
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 must bf
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If
wish to waive the setback, you must initial the appropriate blank below.)
✓( c;
U I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
accc
Sign Name Date
,Cc> Cl ( LI V 1
Print Name A�at��•

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NO 11FICATION/WAIVER FORM
Name of Individual Applying For Permit: Eti.weLv-& ' K ecru.-e_
Address of Property: I-,Orlf 4 S( ,2 Z S Imo,p wc($C L 0 r;
(Lot or Street =. Street or Road)
\N-) % i-Iv\ ;%Not fOIN k3 t ‘^-) 1---/a.k.o.rt.(-
(City and County) V
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 lerte
I have no objections to this proposal.
If you have o ff,.4
ctions tow
_ wha
t is being proposed, please write the Division of Coo
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-"
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 must bi
bck a minimum distance of 15' from my area of riparian access- unless waived by me. (If
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.
.,„41, t) ,
6--,--oia
ign Name ( Date
i
-?ai r " A-,1 c r_ ,�,�.
Print Name © .
r

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: (j_%„0 cxx- t4 K�,�.�
Address of Property: Lc. S 92Z S p,,.lca L Or,
(Lot or Street #, Street or Road)
W , l rv\i r l-c. e v Nanov e_r
(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 lerte.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coo
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7
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 must be
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If
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.
eC
Sian Name ate
Print Name 4•s

Arc
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
:heel F.Easley, Governor James H.Gregson, Director William G.Ross Jr., S
Authorized Agent Consent Agreement
)101,J 6.p.0,41" is hereby authorized to act on my be'r
(Printed Name of Agent)
'der to obtain any CAMA permit(s) required for the property listed below. The authorization is limited tc
:ific activities described in the attached sketch.
:ATION OF PROJECT:
Pua.4- k 3 Er?27
/141 p ,VC.
)PERTY OWNER MAILING ADDRESS:
ir u-)6Lr CA-V1't--
t C o2. (-( r 2 PHONE N O. q f a- `?9 9-
"HORIZED AGENT MAILING ADDRESS:
I ( Nc 2B' 7°2 a'
PHONE NO. S(1 z
iature of Property Owner: j y, �---

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