51938D - Lawrence

JCAMA/ ElDREDGE & FILL 5
3ENERAL PERMIT Previous permit#
'New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
,rized by the State of North Carolina,Department of Environment and Natural Resources /
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7/�, �/
[Lades attached.
it NameML, 'A/0,./ 2 go/re 0.—,c . Project Location: County ea N.rrc,/.c,k
3 O Q G / L 07 a / ,P_ Street Address/State Road/Lot#(s)2-79 _)c'Z4
i e? 4kon.1',r State\/ C- ZI P2 7-rs`7 1) it .
t(7/0) 73 -6 22i Fax#( ) Subdivision ie Q 4/4 k1 L nni el, 3
ted Agent Cf a_ra 3 c o,4 S City .S7p�r fr ZIP 2 7/1
❑CW QEW %PTA .❑.ES ❑PTS Phone# ( ) River Basin GN��
❑OEA ❑HHF ❑IH ❑UBA ❑N/A /
Adj.Wtr. Body/DCka,lcd0/5 4 g /
❑ PWS: ❑FC: /
yes °. PNA yes /Crass Crit.Hab. yes / no Closest Maj.Wtr. Body �/ /'✓u✓
f Project/Activity p`7LA C.e CX LS T. f �22, u /7 15-P c/L*IA P9 0/ '-✓ i 9
�J /-
./-Ov 711/�/t i.✓ (Scale
)ck)length
((//
I
n(s) i '
)ier(s) 1
in/
42421: Ci..:51! A/14;f
amber { I
'prap length I ° ii MIN L.l ' I /
L.n
distance offshore `��,j
ax distance offshor I
hannel i I '
ibic yards 1 I � ii '6`
P
IV 191 0 d i ! r 0 ---, - - --V -
m o! Ll- -�` �` `d 1 v
use/Boatlift + j 1 1 t '
111• 11 1 1I -
jimo.:.
lulldozing 1 -
r
Pi.,/ 8:4 L J�'A#9E/ 71v
.� 1 , -
I if 4.-
le Length Q , +._ 7� P r 11 a/e i D, 1
not sure yes /too; �G �'
;s: not sure yes iiii - ■—■ f
rium: n/a yes 440, ■_■—II I 1
.- — —T —_.. —
yes L:5
Attached: yes fig -
ing permit may be required by: lik.1„/ct.'1--I (460,,. n See note on back regarding River Basin r

2//� 66-1215/541 pl
Date/ '
11
ICI,
CIYle I $ <2o .•,j
Dollars 6 ii
11
':8000 3 5896 500 2 1 2 2 �
PI
GUARDIAN®SAFETY BLUE WDBL

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
lichael F Easley. Governor Charles S. Jones, Director
William G. Ross Jr.
Authorized Agent Consent Agreement
�ec4 S is hereby authorized to act on my b
(Printed Name of Agent)
,rder to obtain any CAMA permit(s) required for the property listed below. The authorization is limited
!cific activities described in the attached sketch.
CATION OF PROJECT:
79 Derr;c/G Dr.
Ur, S 142nd;
ru SW, K cL()let
)PERTY OWNER MAILING ADDRESS:
0 0 0 fo y d Poe .
LU rn b ey--ten), C. a g' s) PHONE NO.7/Q 7? _ ,'
HORIZED AGENT MAILING ADDRESS:
'R-fe,So •.Sctr® h s
)-oD n v lil Cci Co)
PHONE NO. g/O- ,5 4 7- 7 q4 y
attire of Prnno_I/ ..1—

ADJACENT RIPARIAN PROPERTY OWNER N
MANAGEMENT
O'!'IFICATION/WAIVER FORM
Name of Individual Applying For Permit:
Address Of Property: eY)C
rric
01•'n
(Lot or Street # rc C., c.
Str t or Road, City & County)
I hereby certify that I own
referenced property adjacent to the above-
property. The individual applying for this
described to me as shown on the attached drawin permit has
they are Proposing. A description or drawing, 4 the dould be provided with this letter, g• with dimevelopmentensions,
Mould
I have no objections to this
Proposal .
f ou ou have ab `ectiana to what is
ivi of being roposed , lease write the
Coastal Management, 127 Cardinal
ilmington, North Carolina, 28405 Drive Extension,
395-3900
a s of recei t of this notice. No res tense s Oconsi dared Bred within 10
s no ob'ection if ou have been notified Certifiedthe same
Mail_
WAIVER SECTION
understand that a pier dock
•use mooring Pilings breakwater boat
lift or sandbags must be set back a'om my area of riparian access unless waived b m me.m di( If y of s
waive the setback, you must initial the � f You wish
appropriate blank below. )
I do wish to waive the 15 ' setback requirement.
I do not wish to waive the 15' setback requirement.