47588D - Willetts

/ • _ .
]LAMA/ ❑DREDGE & FILL 4
3ENERAL PERMIT Previous permit#
]New ❑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 ISA NCAC f r - 24D0
/ � �� //�
❑Rules attached.
t Name &iv 144�k 7 1 715 Project Location: County ,JGt-y vrp/�r i'
f 5 C-e4/ TS Street Address/State Road/Lot#(s)
)i hi;hf h StateM ZIP zi/Or 54 1,
(9/O) c2o. 2105 Fax#( ) Subdivision
ed Agent City / ZIP ,5e1417
❑CW I } PTA ❑ES ❑PTS Phone# ( ) s' Rivt�r Basin 6..lL
❑OEA ❑HHF ❑IH ❑UBA ❑N/A L c e04',f$. c-A+ nC /t
Adj.Wtr. ody ®/�' nat �F
❑PWS: ❑FC: Closest Maj.Wtr. Body ?O /�,�
yes' / no PNA ye / no Cntt..Hab. yes / no
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Project,/Activity yrt 544/�i%! O/1' 7 I (2) �7,/4s Gy/ 7e,A;
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I/Riprap length j I 1
distance offshore
x distance offshore t I ,
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iic yards At _40 L j ..,:s j 1 • /
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not sure n !Z,f %r�
urn: n/a yes 6 Ifile
_ cC Le -f1 �- / /es _f/ �,ttached: s no I I t 1 ' /�-4
ig permit may be required by: /4/, ���J. . ❑See note on back regarding River Basin IT/ //rf . I ,. - - - •

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2702
66-7172/2531 •
DATE
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LID BANKING
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30076 70 LH' 0 270 2

Jimmy North - CMC FAX NO. : 9102566357 Apr. 05 2007 10: 13AM P
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
me of Individual Applying For Permit: C.( 71 >
Address of Property: #S— —
(Lot or Street#, Street or Road)
�✓it—b101/6 fd rJ Art 4 l NE-4/��,q—�rry
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individi
applying for this permit has described to me as shown on the attached drawing the development tl-
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal. h O01-
If you have objections to what is being proposed, please write the Division of Coas
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7:
within 10 days of receipt of this notice. No response is considered the same as no objectioi
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
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If
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.
APR 0 9 ?on-)
(1/(e 1/4,(c
Sign Name a. Date
A ((
4Print Name
��
(1 . „ - A. _ .

COMPLETE THIS SECTION COMPLETE. THIS SECTION ON DELIVERY
to items 1,2,and 3.Also complete f Restricted Delivery is desired. ihiw
1 Agent
ur name and address on the reverse At _r: •ressee
we can return the card to you. Ir. - me Name) C. Date.f Delivery
:his card to the back of the mailpiece, liri r/Lj C1 1
le front if space permits. _
D. Is•eliverR.; . . • u.. it 1? ❑ es
ldressed to: If Btgr1t•r•trotkiltirirrNc❑No
APR 1 2 2007
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4114‘,Ijii / H4 ;1.1/7 O J ❑Certified Mail 0 Express Mail
❑ Registered ❑ Return Receipt for Merchandise
/� fp h S 0 Insured Mail 0 C.O.D.
r' `` 4. Restricted Delivery?(Extra Fee) 0 Yes
umber 7007 0220 0004 3502 4033
from service Labe°
811, February 2004 Domestic Return Receipt 102595-02-M-1540
U.S. Postal Service Tr,
CERTIFIED MAIL11, RECEIPT
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CD AZALEA STA
i t S` E WILMINGTON. Nortr Ina
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m Certified Fee11111.011 ��
Postmark Sales Re;e;r' ------
Return Receipt Fee Here Product Sale 'Jri:T. ,71
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(Endorsement Required) Description
Oty. Pr i; ;;r•
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D 7 WILMINGTGN r,: ��.;ry
fu Total Posta Postage G Firs0 Clan:
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Sent To 9 Z�(� Return Rc. - q
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