44966D - Costen

'.CAMA / DREDGE & FILL _
;ENERAL PERMIT Previous permit#
New -Modification __1Complete Reissue Partial Reissue Date previous permit issued
-ized by the State of North Carolina, Department of Environment and Natural Resources �7
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / A/ /Z a
es attached.
t Name R/9 L y 4 C051 P,✓ Project Location: County 3R ydsw,(k
w/ ((fix/ �a Street Address/State Road/Lot#(s) /y 7 C.
i C Mew d State L ' ZIP..2.)22 9 5
(Vo5')S2) -292, Fax#( )
Subdivision
ed Agent /!d rt •cl9 (;,../5 /j City dCP0•J jf L' 9.1 `i ZIP 2 it
❑CW BiW CgPTA PTS Phone# ( ) River Basin L4Me4,
❑OEA ❑HHF ❑IH 1 UBA ❑WA ����!•✓U
❑PWS: ❑FC: Adj.Wtr. Bodyr/rINPL d (natl
ye 7 PNA yes Crit. Hab. yes / no Closest Maj.Wtr. Body w�✓
Project/Activity fig(v t.f t t e't./Z) c
(Scale:`/
:k)length 5" 5X S ' /Ql9rl, - — —
(s)
ier(s)
igth
'fiber C (7),.t p L. ""'"'------
1/Riprap length _
;distance offshore
x distance offshore
cannel
>ic yards
ip
se/Boatlift
illdozing
c/P# 14'x 7 '
Length 50I 1
not sure yes
not sure yes
1
um: n/a yes
yes (157
atached: yes �— fl 1. a!i • Z' 7 — 1 .....
ig permit may be required by:ae/9.-/ L e 13,49c4 Li See note on back regarding River Basin rt.
_ . . _ lI , _ . . ,— __ / - i.

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A&R CONSTRUCTION, LLC. 4 5 3 6
PH.910-755-6161
;, 621 DEERPARK DR.SW 66-112/531
SHALLOTTE,NC 28470 BRANCH 62201
"I �/ 3c"u L. DATE ly!
(70
PAY TOTHE I $ Ce) :ORDER
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lylli 6,i„L,� 4 //Qa_ DOLLARS 8 F..,,:.
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'� BRANCH BANKING AND TRUST COMPANY '!
1-800-BANKS BBai. / ,
11 &4
FOR /// fi7 so ... L ` '
1 1:053LOLL2L':00052L45L83L9004536! I .
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DIVISION OF
ASTAL
ADJACENT RIPARIAN PROPERTOY QWNERNAGEMENT
OTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: 44,4 c^05 f
Address of Property: /q 7 Sf
(Lot or Street#, Street or Road)
(City and Coun )
I hereby certify that I own property adjacent to the above-referenced.property. The indivi
applying for th i s permit has described to me as shown on the attached drawing the development
are proposing. A description or drawing, with dimensions, should be provided with this lette
x G t' I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coa
Managements 127 Cardinal Drive Extension, Wiltnington, NC 28405 or call 910-395-3
within 10 days of receipt of this notice. No response is considered the same as no objectia
you have been notified by Certified Mail.
WAIVER SECTION
[ understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
;et bck a minimum distance of 15' from my area of riparian access -unless waived by me.
Tou 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
ign Name Date
CIA'ouloi
rint Name Alifs�

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: �� r 1-med
4ddress of Property: /y 7 S�^
(Lot or Street #, Street or Road)
COJI,ti
(City and County) I
hereby certify that I own property adjacent to the above-referenced_property. The indivi+
ipplying for this permit has described to me as shown on the attached drawing the development 1
re proposing. A description or drawing, with dimensions, should be provided with this lettei
)( I have no objections to this proposal.
f you have objections to what is being proposed, please write the Division of Coa
fanagement,. 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3'
rithin 10 days of receipt of this notice. No response is considered the same as no objectio
ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
t bck a minimum distance of 15' from my area of riparian access-unless waived by me.
ru 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.
. 4 , 0
gn Name Date
ha te try-, ,,,) h. -+D.k AA