49103D - Langford

1CAMA/ , 'DREDGE & FILL
'ENERAL PERMIT Previous permit #
*New Modification Complete Reissue DPartial 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 I5A NCAC )J ) 1 C:)°
1~'Rules attached.
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Ang;ev-- nx., a751) I

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: DQS S La nod dON
Address of Property: i B 3 A t Ii9 a or ex u1,
(Lot or Street #, Street or Road)
Snead s - = 1 - 0 n n, � CD w- +
(City and County) y
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. description or drawing, with dimensions, should be provided with this letter.
1(.' I have no objections to this proposal.
[f you have objections to what is being proposed, please write the Division of Coastal
1vIanagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
rvithin 10 days of receipt of this notice. No response is considered the same as no objection ii
(ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier,dock, mooring pilings,breakwater,boat house or boat lift must be set
)ck a minimum distance of 15' from my area of riparian access -unless waived by me. (If you
vish to waive the setback, you must initial the appropriate blank below.)
/-S /<S I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
PcoLes
9�� a
,ign Name Date
l".

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: D Q S S LBYl G1 CIO N
Address of Property: 18 3 au)I► g a f o r Ba Ll , S n eccQ c
(Lot or Street #, Street or Road) >
EriS.adS .ierruj — DOsto1/3
(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 description or drawing, with dimensions, should be provided with this letter.
41P PfI 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 910-395-390
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 sf
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If yo
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.
4' -2V-
Sign Name (J Date