51935D - Niblock

EttAMA/ ❑DREDGE & FILL N°
3ENERAL PERMIT Previous permit#
mew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
prized by the State of North Carolina,Department of Environment and Natural Resources `/
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7/� /< G (/
rile
f L s attached.
it Name (, /JJi,a,en /y/,jL 0CA Project Location: County 3 R „,p r r✓i C JC
?ii 6 ^ (6, // ,f/r. Street Address/State Road/Lot#(s)1/ &f e 1,)Ai
f CG q d State))/ C ZIP 2 7627 ti-
t 9a0 77- -9 ig' Fax#( ) Subdivision .�
:ed Agent e (• k L4i f City Or Pr9,4 Z I p tas./c h ZIP 2 7`4
❑CW [4€W [a-PTA RES ❑PTS Phone# ( ) River Basin 64,4
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❑OEA ❑HHF ❑IH ❑UBA ❑N/A
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Adj.Wtr. Bodyrg,14 t o 67/1-141/ (n4
❑PWS: ❑FC:
yes(n PNA yesry •' Crit.Hab. yes / no Closest Maj.Wtr. Body �� ��
F Project/Activity , 'l L2 c,91< /— L uy�., 2) C k •, #2d 8 .OG/9 7' /f i' / a
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imber ��� I , l
id/Riprap length k ii
g distance offshore '\1 , 1pr. 6' 1
ax distance offshore ? l ., ,r ' j f
hannel l i if S 0••
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yes t —+�' t L......_.. �"
Attached: yes no �tak• 7"'11
ing permit may be required by: CSC PO Al i S I e o,9C* H See note on back regarding River Basin r

THE BACK OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATER MARK HOLD AT AN ANGLE TO VIEW
MONEY INTEGRATED PAYMENT SYSTEMS,INC.•ISSUER
1 R D E R" Greenwood Village,Colorado
08-823149662
y:,I,i41 , _ _ 82-40/1021
02 ?. t ;66 f t..:.'. AT I M
PAY, EXACTLY POUR HUNDRED::.:.,. J t .-J:.A;.. AND
0E/1/P vri 7 l sT
7.41 ASER' DDRE5567
�J� PURCHASER,aIGNER FOP DRAWER
�y P CHARER aT SIGNING VOV AGREE TO THE TERM4 ON THE REVERSE SIDE.
d Design i rvice mark of Western Union HoldIn^^gs.In.,,,-; ble at Wells Fargo B^ •rand J nu ctIon-Downtown,N.A.,Grand Junction,Colorado -
DOI: L,0088 23 L 4 9 6 6 2' "
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AVA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F.Easley,Governor James H.Gregson,Director William G. Ross Jr.,
Authorized Agent Consent Agreement
=l ( $5/ /-g' is hereby authorized to act on my be.
)rder to obtain any CAMA permit(s) required for the property listed below. The authorization is limited t
)cific activities described in the attached sketch.
CATION OF PROJECT:
ea.4 C
DPERTY OWNER MAILING ADDRESS:
PHONENO.7b ' 76E)-" 4 /
'HORDED AGENT MAILING ADDRESS:
'ff /
Ly T
A5 5 ju./Ce_5
PHONE NO. 4/?G-- .`/6-_3..2.? / 70-j-5,e

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/W/AIVER FORM
Name of Individual Applying For Permit: 7{/; /l i a rt'l It' i 'If <c�U/.
Address of Property: 7/ /,i,/;!il 2 ry J J
(Lot or Street#, Stre{or Road)
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The
individual applying for this permit has described to me as shown on the attached drawing
the development they 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 call Debbie Wilson with the
Division of Coastal Management, 127 Cardinal Drive Extension, Wilmington, NC
28405 or call 910-796-7215 within 10 days of the receipt of this notice. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, moorings pilings, breakwater, boat house or boat lift
must be set back a minimum distance of 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 wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
7

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12 07:33 8 1 Construction 910-846-3360» 843 664 2357 P 713
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICA TON/WAIVER FORM
1 � //0//
N:une of Individual Applying For Permit: ! ( i ct /yi Ja 0 G. .
Address of Property: 7/ ll///1,'rvi d►'u .Sr ,..
. (Lot or Street#, Sne�E or Road)
©C&IX/ VS/e-.i 'C- _______/frWXJ_5ai,'G- __
(City and County)
1 hereby certify that I own property adjacent to the above-referenced property. The
individual applying for this permit has described to me as shown on tiK attached drawing
the development they are proposing. A description or drawing,with dimensions, should
be provided with this letter.
I1 have no objections to this proposal.
If you have objections to what is being proposed,please call Debbie Wilson with the
Division of Coastal Management, 127 Cardinal Drive Extension, Wilmington, NC
28405 or call 910-796-7215 within 10 days of the receipt of this notice. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier,dock, moorings pilings,breakwater, boat house or boat lift
must be set back a minimum distance of 15' from my area of ripariao access-unless
waived by me. (If you wish to waive the setback,you must initial the appropriate
blank below.)
,.....,Ad7-...„....--
1 do wish to waive the 15' setback requirement.
T do not wish to waive the 15' setback requirement.
.•,:m.a....ze?....."..............................•
to/tz_ 4,-;
Sign: atne Date

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: Ui./l//'AhA.
Address of Property: ? 7/ U/1
(Lot or Street#, Street oad)
©C,ea iv />°l a re/AA-La;c F ,
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The
individual applying for this permit has described to me as shown on the attached drawing
the development they are proposing. A description or drawing, with dimensions, should
be provided wit this letter.
CI have no objections to this proposal.
If you have jections to what is being proposed,please call Debbie Wilson with the
Division of Coastal Management, 127 Cardinal Drive Extension,Wilmington,NC
28405 or call 910-796-7215 within 10 days of the receipt of this notice. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, moorings pilings,breakwater, boat house or boat lift
must be set back a minimum distance of 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.)
T4-./4 C,A.L . I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.