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3ENERAL PERMIT Previouspermit#
ZNew Li Modification JComplete Reissue Partial Reissue Date previous permit issued
,rized by the State of North Carolina, Department of Environment and Natural Resources �� , Z��
Zoastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
Xil Rules attached.
it Name \o NJ !% •\\"j Project Location: County ? 1J l). k-
(p(Dt ro Z IA— CR-6.4 r_ 4ek Street Address/State Road/Lot#(s)
fiveN P 91 t+-NT•A State 0 L ZIP 2$'-I y -S ) - 5. 1?S+a T L. )
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❑CW $EW PTA ❑ES ❑PTS Phone# ( ) River Basin 6.' rL
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❑ PWS: ❑FC:
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yes /�no� PNA es_. no Crit.Hab. yes / no Closest Maj.Wtr. Body ►� `IV
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(Scale: I ‘
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ise/Boatlift �,. ___�`
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Attached: es no r1
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Bank of America Advantage®
MARY E. BATTS 04-05 476
JOHN L. BATTS
910-329-1906 66-19/530 NC
660 MILL CREEK RD. 1 ^ 702
HAMPSTEAD,/\/ (
NC 28443-2976 Date -'(v 0 6 G.c,
Payt LJ, .L 1 �/ ' �� J $ 02-O D C L'
to th erof
_Dollars 8
Bank of America .
ACH R/T 053000196
,Memo PeA-4 r u.--x- / sr
1:053000L961: 0006514, 79211' 01, 76
e'er

DIVISION OF COASTAL MANAGEMENT.
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: . ) dA rl 0, ,p{, a) ak--b �Q44\1
Address of Property: . I 3 S / c3 pS a' / br—i /1 rc
(Lot or Street#, Street or Road)
I , 1\) ' C ' Pe. ncie.. _,
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indivi
applying for this permit has described to rn as shown on the attached drawing the development
are proposing. A description or drawing, with dimensions, should be provided with this lette
I have no objections to this proposal.
i_1©& (
If you have objections to what is being proposed, please write the Division of Coa
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-- %
within 10 days of receipt of this notice. No response is considered the same as no objectic
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mus
set bck a minimum distance of 15' from my area of riparian access- unless waived by me.
you wish to wai he setback, you must initial the appropriate blank below.)
4-do wish to waive the 15' setback requirement.
(
I do not wish to waive the 15' setback requirement.
' '.-- ,IfyiW(i7z/ Ol- /0 62
Sign 1Va e Dat
i"i
I,AJ / P21i'4 P Al A

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM.
4
Name of Individual Applying For Permit: Joh n �iy d. � a, c;,` '` ,
Address of Property: ,3 / 3 S. Th ac / v
(Lot or Street#, Street of Road)
stele c� �-y �v . c. r)ci
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indivii
applying for this permit has described to me as shown on the attached drawing the development I
are proposing. A description or drawing, with dimensions, should be provided with this lette]
kPLU I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coa
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910--7gtr,
within 10 days of receipt of this notice. No response is considered the same as no objectic
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mus
set bck a minimum distance of 15' from my area of riparian access-unless waived by me.
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.
lu i4eDe_aL c 'y•ir it Piceoo idutve ,
Sign Name Date
7-1--) -2 12_4114 LLIAi11 � Li/ A. .: rA

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