48292D - Smith

id-AMA/ ❑DREDGE & FILL /
3 ERAL PERMIT V Previous permit#
1l Jew PModification -''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 7A • 42# '
©'Rules attached.
t Name i C- N N o Ai S m, n Project Location: County �jl„,..,S 4i/.c/C
6 i6 0 /9ujA Ps Soh/ /i Rd. N w Street Address/State Road/Lot#(s) ?2 y/ f f,i
7.,..r, StateGVC ZIP.2 T ..2D
•(910)2 L7'5/ 721 Fax# ( ) Subdivision
edAgent City Styr Li, ZIP 22 94
❑CW ❑EW [PTA 13'ES ❑PTS Phone# ( ) River Basin Cynj/j
❑OEA [1 HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body - /9/ S w (i' /r
❑PWS: ❑FC: _
yes /-� PNA Closest Maj.Wtr. Body /9/ W w
yes / Crit.Hab. yes / no
Project/Activity A/SIi9 I1 V 2 r ✓ i-f ec H it w — 1 c t X .J 71,"s Y• °2
:k length C t• 6V.I. QAif 1 G X.�' (Scale: 'I.,:-.,
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i/Riprap length
IC
distance offshore
x distance offshore ___ 1(
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Q�R r ('�sic yards L
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illdozing
x
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Length 6
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not sure yes no t
not sure yes no —
urn: n/a yes no or. i
((es noider
32aX ✓ -9162eA lr, ,2 t-
ttachedJ4 Y (yes no i-- _L i I I I , 1
'g permit may be required by: eQ 44" 5'✓/ C/1 w N.... See note on back regarding River Basin ru

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THIS NOTE IS LEGAL TENDER I• •' •
%l' >FOR
ALL DEBTS.PUBLIC AND PRIVATE _ x • A F 0
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THIS NOTE IS LEGALTENDER1 .�L
FOR ALL DEBTS.PUBLIC AND PRIVATE F ' 0 A F
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1996 P
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit: •ll /6 I
Address Of Property: 4 29..
.) (., / l ) 1c . Lr3r2U 4-c/2-
(Lot or ,Stredt IF , Street or Road, City & Count.ti
I hereby certify that I own property adjacent to the above
referenced property. The individual applying for this permit hE
described to me as shown on the attached drawing the developmer
they are proposing . A description or drawing, with dimensions
should be provided with this letter.
Mr I have no objections to this proposal .
If you have objections to what is being proposed , please write t1'
Division of Coastal Management , 127 Cardinal Drive Extensior
Wilmington, North Carolina , 28405 or call 910 395-3900 within ]
days of receipt of this notice . No response is considered the san
as no objection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings , breakwater, boa
house, lift or sandbags must be set back a minimum distance of l
from my area of riparian access unless waived by me. (If you wiE
to waive the setback, you must initial the appropriate blar
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 : / ��,,Z 5t
Address Of Property: 2-41�
�. 1 / : LL 0 -u-wvu�
t . : c �
(Lot or 1S�reet��# , Street or Road, City & Count'
I hereby certify that I own property adjacent to the above
referenced property. The individual applying for this permit h,
described to me as shown on the attached drawing the developme:
they are proposing . A description or drawing, with dimension:
should be provided with this letter.
I have no objections to this proposal .
If you have objections to what is being proposed, please write t}
Division of Coastal Management , 127 Cardinal Drive Extensior
Wilmington, North Carolina , 28405 or call 910 395-3900 within :
days of receipt of this notice . No response is considered the sar
as no objection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings , breakwater, boi
house, lift or sandbags must be set back a minimum distance of 1!
from my area of riparian access unless waived by me. (If you wi:
to waive the setback, you must initial the appropriate blar
below. )
) °r� I do wish to waive the 15 ' setback requirement.
I do not wish to waive the 15 ' setback requirement.

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