48315D - Jernigan

ICAMA/ J DREDGE & FILL 4
3ENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
-ized by the State of North Carolina,Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to I5A NCAC—1 , l l(›0 f j'LoI,
DgRules attached.
t Name EIT H cL►J'y Cs'L\�...) Project Location: County O1•3t...,3
K•P4-500 C.cxd‘�� Street Address/State Road/Lot#(s)
"�t r'C-oCLD StateV 1A ZIP 2ISSL-► \°\ ?-2vtirLSr5_>i, .r" ,Z_
6W )Z8$ $S) b Fax#( ) Subdivision
ed Agent CityS► EApS Vc212 .-,-I ZIP ZS'', (.
❑CW XEW PTA I ES ❑PTS Phone# ( ) River Basin '/ i-
OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body 0 Ev✓ 12.1.V CZ n /r
❑ PWS: ❑FC: _
yes ,Guam PNA yes Crit.Hab. yes / no Closest Maj.Wtr. Body W a'y`" ►t-
'Project/Activity ?L.r>G_€ E.)c'LS1 I J(- 3‘"1r)<-!-\S.ate 'z' S r], 4 'CI '. ?
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I distance offshore
x distance offshore
cannel — i
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illdozing I 1
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not yes no
not sure yes C� i f L -+
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: n/a yes �
yes (IDL 1
attached: yes IC) ,---- I
1g permit may be required by SfyOu....•••) (2) . I See note on back regarding River Basin rt.

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ROBERT MILLIS Be strong rsudtag
NCDL 9852538 all you who hope in the Lor L a• 35
313 OLD FOLKSTONE ROAD —P.i �' ° + ,
HOLLY RIDGE, NC 28445 pate O ']/O7
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: e 1.4ke‘ h
Address of Property: j e,S 1.1
(Lot or Street#, Street or Road)
Sneads �e(r , IJC On)5101 .1 �(0 AA-
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individua
applying for this permit has described to me as shown on the attached drawing the development the]
are proposing. A descrir ion or drawing, with dimensions, should be provided with this letter.
I have no objections to this ro osal.
P P
If you have objections to what is being proposed, please write the Division of Coasta
Management, 1.27 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 i
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 se
bek a minimum distance of 15' from my area of riparian access - unless waived by me. (If vo
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
1 " "_+ I do not wish to waive the '"1� setback requirement.
5"k ;Oti 7
Sim Name Date
ZOtet "A
Print Name

• DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: `,4
Address of Property: S Q %vt rs pC �2
(Lot or Street#, Street or Road)
O .Je .s 6o0N CS/ICadS Fe
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individu2
applying for this permit has described to me as shown on the attached drawing_the development the
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 lift must be si
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (Ifvo
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.
1,11 e 41,4U <131102
Sign Name Date
(.2)1//1
,
Print Name AA