49179D - Bullard

ICAMA / DREDGE & FILL
.ENERAL PERMIT Previous permit#
New Modification Complete Reissue l Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources /2
2oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 4r
El Rules attached.
it Name jGw►e t U k`(Ci,2/ Project Location: County %4 t1." / ~y''j
9659 / /J�Z Xe0H/ Street Address/State Road/Lot#(s)
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:ed Agent , 4t(i .e- (d'+-V, City _ l - ZIP I� S//G7�
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/ no PNA / no Crit.Hab. yes / no Closest Maj.Wtr. Body /�'j'�'
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ng permit may be required by: /I� tQ. 1 I See note on back regarding Rivera in ri

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1INE CONSTRUCTION INC. 2888
PH.910-793-4143
IUTH COLLEGE RD PMB 326 66-7172/2531
.MINGTON,NC 28412 y
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: <)A �' �j41( (-'1/J
Address of Property: 76,” 1 „?0.,2 _
(Lot or Street 4, Street Road)
(JLA-- POE
(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 developme
are proposing. A descript'on or drawing, with dimensions, should be provided with this lel
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 28405 or call 910-79E
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 ie.r, dock, mooring pilings, water, boat house or boat lift must
bck a minimum distance of--1&' from my of riparian access - unless waived by me. I
wish to waive the setback, you m>g:fnitial the appropriate blank below.)
r�
wish to waive the 1 5' s k requirement.
a
- I do not wish to waive the 15' setback require
Sign ame Date
jOhN S Ate„_

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORiti
Name of Individual Applying For Permit: i ft; k .,Jl L—C)
Address of Property: ?(Ty /?/f/' ,Lf.L zr 0
(Lot or Street #, Street or Road)
6.44_ .,V6 d-e-(/92-
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The inc
applying for this permit has described to me as shown on the attached drawing the developm
are proposing. A description or drawing, with dimensions, should be provided with this I
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-7!
within 10 days of receipt of this notice. No response is considered the same as no obj(
you have been notified by Certified Mail.
WAIVER SECTION
I understand tha •r, dock, mooring pilings, break-w • , *oat house or boat lift mu
bck a minimum distance o om my area o '.arian access - unless waived by me
wish to waive the setback, you must the appropriate blank below.)
I do to waive the 15' setback requi - -- -it.
I do not wish to waive the 15' setback requirement.
/tau-�-..- QaiR 7 G S3 M yr-I (� � �1
'Sim Name Date
_ _ . .—— ✓r — -ram w-ter

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management Wham G.Ross Jr., Sea
gel F.Easley, Governor
James H.Gregson,Director
Authorized Agent Consent Agreement
i^iMc��I j ���Z� ��,�� � ''f is hereby authorized to act on my beha
C �- (Printed Name of Agent) listed below. The authorization is limited to
ier to obtain any CAMA permit(s) required for the property
ific activities described in the attached sketch.
:AT1ON OF PROJECT:
vu
OPERTY OWNER MAILING ADDRESS:
✓th r t2-1
C. 0
PHONE NO. (/0) '3/- BY/
UTHORIZED AGENT MAILING ADDRESS:
•
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PHONE NO. 9/d ?0
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