43988D - Dombroski

CAMA / _I DREDGE & FILL
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 1 h • ) \OJ • - =>
Rules attached.
t Name I--;(...-N Th=ar--. �SCL�SvL Project Location: County .. +J vL
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❑CW i W ACM )4s ❑PTS Phone# ( ) River Basin C-H`'0 c
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Bod i P s rant. So—Id D LC�"'a`(at.•`r
❑ PWS: ❑FC:
yes /(.I PNA yes / o Crit.Hab. yes / no Closest Maj.Wtr. Body AS
Project/Activity S t•., -r ALL. v t w i . \\. ZI A/AN t,Lw o..c..b o f L)€ 1ST
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(Scale: �+1"
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er(s)
igth
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distance offshore 7.r
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im: n/a yes !i L
Yes
ttached: no
g permit may be required by: 17PS POL(_ F>E.A L tt . See note on back regarding River Basin ru

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��� 1758
ALLIED MARINE CONTRACTORS, LLC os os
910-367-2159 a
92 HAROLD'CT.
HAMPSTEAD, NC 28443 (�— (.. 66 19/530 NC
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DIVISION OF OASTAi tvratvarEMENT
ADM NT RIPARIAN PROPERTY OWNFR NOTIFICATION/WAIF FOR M
Name of Individual Applying For Permit: ) fv‘, j<
Address of Property: // / ( LC�i .t/�v e
(Lot or Street#, Street or Road) _ —
vF174. Pe,-,ems
(City and County)
hereby certify that I own property adjacent to the above-referenced ro e
P P rty• The individi
ipplying for this permit has described to me as shown on the attached drawing the development th
tre proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
f you have objections to what is being proposed, please write the Division of Const
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-491
(Rhin 10 days of receipt of this notice. No response is considered the same as no objection
op have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mus- t
l'bck a minimum distance of 15' from my area of riparian access- unless waived by me. (
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.
J
A) _44
Name Date
.IIIIW-Iw,mir

(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 91.0-395-3900
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.
WAIV LIEU 'ION ".`..�-- -.
I understand that a pier,dock, mooring pilings, breakwater, boat house or boat lift must be
set bak 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.)
do wish to waive the 15' setback requirement.
I do riot wish to waive the 15' setback requirement.
Name Date
3 di A Y__ t.t_4,t t r0e.it _ , •
Print Name
54i 04 7d NCDENR
2.3 V C"ROLINA Dersorrmorr r
E IVIIONMG'WT mut,Nana,RIDICYJA:Cy
Telephone Number with Area Code
S:\cama\sh el ls\riparianproperty.frm
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