45927D - Deal

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J CAMA/ A DREDGE & FILL i.
�I.E N E RAL PERMIT Previous permit#
'New LiModification ❑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 I 5A NCAC '7 i- , I ( L. C.
[mules attached.
t Name ILA f2-Ky Ike A L. Project Location: County 154 LLN)SAJ i C 14.
40015 L .. Ni/RC N"(" OQ-. Street Address/State Road/Lot#(s)
A 151rA..i 0 State N(, ZIP Z Lj4
("t IJ) 2,01 -Lkj}j Fax#( ) Subdivision
ed Agent_C,f2..e 0 1-7YZ-l. A`tt-6 City 3A(v4 E ZIP Z5 4 to
NoCW 04W VOTA t?"tS ❑PTS Phone# ( ) A-(VLE River Basin CA)2E
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❑ PWS: ❑FC:
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yes / rr--) PNA C no Crit. Hab. yes / no
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distance offshore
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'' SHORELINE MARINE CONSTRUCTION
258000872
m W m a<' ~ I GREG PREVATTE s73 3234
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(� 3 o m y W e P.O. BOX 10671
�� w-^ 8 O vi— cn SOUTHPORT, NC 28461 DATE �� G
L m s y O y ?a PAY TO THE
3 C m zi p 0 €W ORDER OF
DOLLARS 8
li• Coastal Federal
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
ame of Individual Applying For Permit: 4/ ,1 22ii4L
ddress of Property: '/OQ 8 4-4Sj >-9CN7_ PA
(Lot or Street #, Street or Road)
0 9k /54/96 0, N G gIQ44/$r✓.�/( c.1)y,✓7
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individu
applying for this permit has described to me as shown on the attached drawing the development th(
are proposing. A description or drawing, with dimensions, should be provided with this letter.
a)sec.9 I have no objections to this proposal.
[f you have objections to what is being proposed, please write the Division of Coast:
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-390
xithin 10 days of receipt of this notice. No response is considered the same as no objection
✓ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must b
et bck a minimum distance of 15' from my area of riparian access - unless waived by me. ([
-ou 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.
� v L 7- zq- o 6.
i e
Date
-3—AwxEs -3—, ORDoG-- AE' A