48352D - Lomax

AMA/ ❑DREDGE & FILL
7NFAIERAL PERMIT Previous permit#
'New ❑ModificationComplete Reissue III 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 I5A NCAC ,Al2 a 4
©-Rules attached.
t Name . /9J G L-o/'V Tx _ Project Location: County ,1Ye,y,vs6✓ A/e
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,f 0 / ' jf'NJCumI e- D/L. Street Address/State Road/Lot#(s) _"43/ /', p,
2 P9NJbell a StateNLZIP 2 7/v7 VI 1 Li9n/-e ..$ fit,/
(PG) 5 Y 7'effj Z Fax# ( ) Subdivision
ed Agent (4i1,/t /'1 7)2/94 e City _5,4,y/7 ZIP 2 r
❑CW ❑EW ❑.PTA 41 .E9— L PTS Phone# ( )- River Basin Lu M
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body / Ai &I (nat••/r
❑PWS: ❑FC:
/—� Closest Maj.Wtr. Body /' y w L"'
yes /: no PNA yes / no Crit.Hab. yes / no
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i/Riprap length I I4-- .741-1
distance offshore • ic: }_
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yes no 1
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ig permit may be required by: RRy,d•Scr,,c le C(,.,,,,, ty See note on back regarding River Basin ru

5�41
DAVID M LOMAX 5401
LINDA A LOMAX BRA-21/5.�(w
3816 Buncombe Dr ,� 0�!
Greensboro,NC 27407 '��1f� n )atr
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Pay to the I v C P� N R I T a oo 00
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raa WACHOVIA
Wachovia Bank,N.A.
wachovia.com
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7A'fir
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
el F.Easley, Governor Charles S.Jones,Director William G. Ross Jr., Se'
Authorized Agent Consent Agreement
Ckcrlc. s is hereby authorized to act on my behs
(Printed Name of Agent)
sr to obtain any CAMA permit(s) required for the property listed below. The authorization is limited to
is activities described in the attached sketch.
kTION OF PROJECT:
.31 R 1 V Q, - \licit.c One.. 6 w
i91y , �, . Q . a(4°2-
PERTY OWNER MAILING ADDRESS:
• - k n't-AY
t
31 to Zu.o c.o be t7R t V C...
-eeJc6boRD, \ - C d gocL PHONE NO.(II) 33(0 - 6y1 -0332.,
CO 33 is- to O 1 - 32 ! (o
HORIZED AGENT MAILING ADDRESS:
0.) kt 1/41•3
(\lc 2_00-
PHONE NO. V O v` � 0‘51.
_ n nn f

:UN.24.2005 8:41AM NCDENR NIRO NO.G58 P.
DrvrSION OF COASTAL MANAGEMENTN�1 VER FORMADJACENT RIPARIAN PROPERTY OWNER_NOTIFICAT� A�
Name of Individual Applying For Permit t,-.;)00 A P,11en o may: I .Da.v e el
Address of Property: 3 Ia"31 R.Y-e v-1 Vr .1 e k 2 n e. 5 i.k1
(Lot or Street#, Street or Road)
<3tApplA N. C� . 01� �lo 8rwnswie,
(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 desc . don 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 Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
within 10 days of 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,mooring pilings,breakwater,boat house or boat lift must be set
bck a minimum distance of 15' from my area of riparian access-unless waived by me. (If you
wise �, w iv@ the setback,you must initial the appropriate blank below.)
Ate ` — I do wish to waive the 15' setback requirement.
I do not wi:h to waive the 15' setback requirement.
,,, .ikA,, -..liniz.,_:(44,.", • ,),‘„), 7 . . •
Sign Name Date
- (1 ci -- -•:.VA C' '21 (2Qi v-_ I rR,- • : • vaci A -
Pent Nam t

JUN.24.2005 8:41AM NCDENR WIRO NO.e58 P.2
DIVISION OF QA.S.TAL MANAGEMENT VER FORM
ADJACENT RIPARIAN PROPPRTY OWNER NOTIFICA
Name of Individual Applying For permit h i n oa CU e n k o ma)G ) a Q- M ho estq Co u
Address of Property: 'Le 3) 1 1 V e v VI i e ve an e 5 w
(Lot or Street#, Street or Road)
3L �� , C . aBNI�=ru�SW►cK
(City and bounty)
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,
V I have no objections.to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
within 10 days of 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,mooring pilings,breakwater,boat house or boat lift must be set
bek 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 with to waive the 15' setback requirement.
" J.:le—if,-
S i ame Date
Uteek.ti v+ti. irye •
•
AlicrA
r;
Print Marne