44852D - Cook

-cAMA/ DREDGE & FILL '
3ENERAL PERMIT Previous permit#
L.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 I5A NCAC 71/ /2 o'0
Mules attached.
it Nameagck'to. A.,,ai.# (4v,.,/< Project Location: County 34,,.rj wic
IS-/ Pin/ e .ST, Street Address/State Road/Lot#(s) ?IF 2 F (Yuen,
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imber
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ling permit may be required by: B/1 4r.S 4./ic k C/4 r1 j, . i See note on back regarding River Basin i

•
THE FACE OF THIS DOCUMENT HAS A MULTI-COLORED BACKGROUND•THIS PAPER CONTAINS FLUORESCENT FIBERS AND OTHER SECURITY FEATURES
Coastal Development& Realty Builders Branch Banking&Trust Company
131 OCEANBLVD W. SUPPLY,NC 28462
HOLDEN BEACH, NC 28462
66-112/531
[phone]
DATE CHECK NO. AMOUNT
March 21, 2006 29574 $********100.00
*******************************
Pay: ********* One hundred dollars and no cents
PAY NCDENR
TO THE 127 Cardinal Dr Ext.
ORDER OF
Wilmington, NC 28405 %�`-'
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i/02/20D6 TUB 17: 03 FAX [phone] COASTAL CONSTRUCTION ]002/D(
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: A' I i .h /. tv\r L a
Address of Property: $ 6 �.4.,, -1-ctyi V i. S.�� _o 4 . Z 3
. (- )
(Lot or Street#, Street or Road) '
(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 910-395-3900
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.)
________7z
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
2 1 : • - ....
Sign: alr Date rlicrfi^�
Ak K A ,,Itudb6ks AlugcsrA

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