49161D - NC

i
I-CAMA/ Ryl'DREDGE & FILL L .
iEN ERAL PERMIT Previous permit#
}'flew ❑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 15A NCAC 7 H , I I O J
JRules attached.
t Name NC 134-j 57 ASSE(ti1$j_1--`gyp IZ f G ji L Project Location: County ejle(A N (A) l C4C.1
I CO C,rt,WQ,t, I,;SAC H (2O • Street Address/State Road/Lot#(s) 100 (Rj(,{, j
1(e- KLAN io State NC ZIP 2 4(ce5
(91h)) 27i1 gS0l Fax#( ) Subdivision
ed Agent °A I° L.LvyP City C(l K. 1SL 1-17\J 0 ZIP 2 P- (a
❑CW ❑EW ❑PTA QtS ❑PTS Phone# ( ) River Basin (Pot: r
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body ces - e (<\ at n
❑ PWS: ❑FC:
vt
yes / no PNA yes /& Crit.Hab. yes / no Closest Maj.Wtr. Body
Project/Activity aA Ll[,.HV A0 (V IN yL/ (ei/Y\M lag I R-L)
(Scale: la,- t C
:k)length
(s)
er(s)
i h
i
nber I -! -r
I/Riprap length GAO j ! t
distance offshore i {
c distance offshore
annel Nri W / LC IS1(N(. (Li Peke
to
-,--4.---,,,-
icyards �a ll 49`L° �' ` 57 -• , 'iV4° •IfY
41
p l"
m/Boatlift l I I
illdozing
-., I CO C(SwELA ►' 74c N +fir-_
Length > IOC 0
not sure o yes
i l - L -
: not sure yes ® I
r
im: n/a yes -&-
i
yes ;
ttached: yes I
g permit may be required by: LL MSW t(1‘.. ❑See note on back regarding River Basin ru

- 4670
NORTH CAROLINA BAPTIST ASSEMBLY 5j
100 CASWELL BEACH ROAD PH 910-278-9501 rr //
OAK SLAND, NC 28465 DATE L I / 7 66-30/53i
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www.firstcitizens.com f` t, t- `... _ \ ___ . . _ "P 111
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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION UN DELIVERY
• Complete items 1,2,and 3.Also complete 0 Agent
item 4 if Restricted Delivery is desired. WIEffir
Addressee
■ Print your name and address on the reverse
so that we can return the card to you. - -- eived b (-Tinted Name) C. Dab of Deliver)
• Attach this card to the back of the mailpiece, 1-(.1
or on the front if space permits.
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: If YES,enter deliverp pins iel7 206 0 No
to; 11;A rv� L. �4-s A e� 1
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3. Service Type
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I \ 31 iC D`t 0 Registered ❑Return Receipt for Merchandis
❑Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number 7005 3110 0000 0581 3330
(Transfer from service label)
PS Form 3811,February 2004 Domestic Return Receipt 1O2595-02-M-15

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U.S. Postal Service,.
CERTIFIED MAILTM RECEIPT
m (Domestic Mail Only;No Insurance Coverage Provided)
For delivery information visit our website at www.usps.com®
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Postage $ ,te,LD A _�
O Certified Fee M ' , \
/Postmark
O Return Receipt Fee
(Endorsement Required) `i Here
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Restricted Delivery Fee • I ,
(Endorsement Required) •
1-9
Total Postage&Fees pr1 J . ?
OSent To LL (Y\ � J •
Street,Ap7.'No.; A G Gc 'G$/1 e
or PO Box No. a L 5 _ �
City,State,ZIP+a _� I r) ' �c.��
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PS Form 3800,June 2002 See Reverse tor Instructions

North Carolina Baptist Assembly
100 Caswell Beach Road / Oak Island, NC 28465
William E. Rasher Trustee
2580 Creekstone Circle
Maryville TN 37804
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: North Carolina Baptist Assembly •
Address of Property: 100 Caswell Beach Road
(Lot or Street#, Street or Road)
Oak Island, NC 28465
(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 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 Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215
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
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.
Sign Name Date
T___-i 1.T_____ ���

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SENDER:COMPLETE THIS SECTION
COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete
A.Si i ure / 0 Agent
item 4 if Restricted Delivery is desired. ❑Addressee
• Print your name and address on the reverse X /, `(Print,.Name) C. Date of Delivery
sothat can return the card to you. B. '
• Attach this card to the back of the mailpiece,
or on the front if space permits. III
D. Is delivery address different from item 1? 0 Yes
1. Article Addressed to: • If YES,center delivery address below: 0 No
i ..
'----- iD S e- E. Se91-ii'll.
BGX 3. Serlf. Type
/J [1'Certified Mail 0 Express Mail
e ��/��� �� ,/S/ ❑Registered 0 Return Receipt for Merchandise
O `t 0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7005 3110 0000 0581 3323
(Transfer from service label) 102595 p2_M-1540
PS Form 3811,February 2004
Domestic Return Receipt

U.S. Postal Service,,,,
m CERTIFIED MAILTM RECEIPT
RI
m (Domestic Mail Only;No Insurance Coverage Provided)
M
For delivery information visit our website at www.usps.conv.
1:0 , , '''' ''-''' ! , • , ,„,A. ,',,'-',- r'..;
ui
0
Postage
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0 Certified Fee
CI -41 , Postmarte„ •
D Return Receipt Fee
(Endorsement Required) . C'' 7 Here \ '.
171 Restricted Delivery Fee
1-9 (Endorsement Required)
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m IIINILIIIMMID __ / ,•
Total Postage&Fees \„
I=1 Sent To
a Rd S-C. .Seq/4/ri.,
1-.— Street,Apt.No.; -
or PO Box No.
City,State,ZIP+4 L., ..(/1 c/ 1\,1 C
PS Form 3800,June 2002 See Reverse for instructions
•

-
elNorth Carolina Baptist Assembly
100 Caswell Beach Road / Oak Island, NC 28465
Rose E. Seguin
P.O. Box 780
Leland NC 28451

I,uD
L tL 5i A'8 O U 11,o-oy
E.G DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
North Carolina Baptist Assembly
Name of Individual Applying For Permit: •
Address of Property: 100 Caswell Beach Road
(Lot or Street#, Street or Road)
Oak Island, NC 28465
(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 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 Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215
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
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.
Sign Name Date
. _. AAA