49155D - Miller

]CAMA/ ❑DREDGE & FILL
3ENERAL PERMIT Previous permit#
New .❑Modification ❑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 15A NCAC 211. 12 0 0
[C,}R`les attached.
t NameT9Cx „- Bp/J/vi,.o el/ 1 L0.._ Project Location: County: iev.,csc lick
l5'lj R �' s L,Q., 'e Az,y,r Street Address/State Road/Lot#(s) 9,7/5/ 4,V,,,,;
1L C/11/ State'& ZIP.2 TY&T /.)'z , ✓ e
'ql ')63-3—,'? L Fax#( ) Subdivision Rt vP,i./9 7
ed Agent City 6 $h l ZIP21%2
❑CW urEW ❑PTA ❑ES C?'PTS Phone# ( ) River Basin vm 11,
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body/149 C ( 4 1./ /\s v e'2 ,�lr
❑ PWS: ❑FC: , Sd
yes PNA yes / Crit.Hab. yes / no Closest Maj.Wtr. Body W�<<An,� t., P�
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distance offshore i F i I y T ,
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ig permit may be required by:ga,,„J[-l//,C (C ti -1 y, See note on back regarding River Basin n

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1':0005 2 L75949031I'044 L6

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORT
Name Of Individual Applying For Permit : 34CK iBONNtCC
Address Of Property : q7/ T 1? VgV. 5,4-4-e D2t✓E 451\ Arc
974
�t9 Ay(z t J7n Nic /-1 s 1. PtJC- &LA
(Lot or Street F , Street or Road , City & Cou
I hereby certify that I own property adjacent to-- -.the ab
referenced property . The individual applying for this permit
described to me as shown on the attached drawing the develop
they are proposing . A description or drawing, with dimensi
should be provided with this letter .
I have no objections to this proposal .
If You have objections to what is be_na proposed, please write
Division of Coastal Manaaement , 127 Cardinal Drive Extens:
Wilmington , North Carolina , 28405 or call 910 395-3900 withir
days of receipt of this notice . No response is considered the
as no objection if you have been notified by Certified Mail
It II
WAIVER SECTION
I understand that a pier, dock , mooring pilings , breakwater, b
house , lift or sandbags must be set back a minimum distance of
from my area of riparian access unless waived by me . (If you w
to waive the setback, you must :: itial the appropriate bl
below. )
/ I do wish to waive the 15 ' setback requirement.
I do not wish to waive the 15 ' setback requirement .

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit : 3 cK ¢ & 1iNt C. PIO
Address Of Property : 6 7` I1$1l 'VC
(Lot or Street = , Street or Road , City & Cour
I hereby certify that I own property adjacent to -.the abc
referenced property . The individua_ applying for this permit
described to me as shown on the attached drawing the developn
they are proposing . A description or drawing, with dimensic
should be provided with this letter .
I have no objections to this proposal .
If you have objections to what is be_na proposed , please write
Division of Coastal Manaaemen.t , 127 Cardinal Drive Extensi
Wilminaton , North Carolina , 28405 or call 910 395-3900 within
days of receipt of this notice . No response is considered the s
as no objection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock , mooring pilings , breakwater, b
house , lift or sandbags must be set tack a minimum distance of
from my area of riparian access unless waived by me. (If you w
to waive the setback , you must _: itial the appropriate bl
below. )
I do wish to waive the 15 ' setback requirement.
I do not wish to waive the 15 ' setback requirement .

•
DIVISION OF. COAST..L MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORE
Name Of Individual Applying For Per-:it : �( t< 4gNn/jC
Address Of Property : Q7/4 eQ(v'e .64T jPpi147,
ff y 9174 RA fti G*fc 1)2 As t4 ;A/c Bfiv
(Lot or Street F , Street or Road , City & Cou
I hereby certify that I own property adjacent to -the aid
referenced property . The individual applying for this permit
described to me as shown on the attached drawing the develop]
they are proposing. A description or drawing, with dimensi;
should be provided with this letter .
I have no objections to :his proposal .
If you have objections to what is being proposed , please write
Division of Coastal Management , 127 Cardinal Drive Extensi
Wilminaton , North Carolina , 28405 or call 910 395-3900 within
days of receipt of this notice . No response is considered the
as no objection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock , mooring pilings , breakwater, h
house , lift or sandbags must be set tack a minimum distance of
from my area of riparian access unless waived by me. (If you w
to waive the setback , you must initial the appropriate bl
below. )
I do wish to waive the 15 ' setback requirement.
I do not wish to waive the 15 ' setback requirement .

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