45864D - Erida

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-CAMA/ ❑DREDGE & FILL
3ENERAL PERMIT Previous permit#
new LiModification LJComplete Reissue Partial Reissue Date previous permit issued
)rized by the State of North Carolina, Department of Environment and Natural Resources �� I�O a
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
IlRfles attached.
nt Name X t,j d e 4 L� a 1/AL Project Location: County in y.45 //Cat
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O. d X 2 2 y5 Street Address/State Road/Lot#(s) 2 y 6 p ualc�
4 AL Lv77'-' State /`k ZIP 2 Yyi 9
(9/9) Z 6 9-02)2 Fax#( ) Subdivision
zed Agent L 10 y 0/ Pi, ^ I, L. City OC1'4,. 2.e 3.'4 A ZIP 2 7Y!
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cw E3r. ❑PTS Phone# ( ) River Basin „.,
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body 614,0 L. d/f/I/Vol,6t/ (nat 4
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yes 'no PNA yes /..q Crit.Hab. yes / no Closest Maj.Wtr. Body 1J/W
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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired.
• Print your name and address on the reverse X ,I . i 6' ID Agent
so that we can return the card to you. l ❑.Addr= see
• Attach this card to the back of the mailpiece, B. Received by(Punted Name) C. Dat: . - very
or on the front if space permits. , I it,
1. Article Addressed to: D. Is delivery address different from item 1? M es
t If YES,enter delivery address below: 0 No
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Vame of Individual Applying For Permit: ito / 14K c/z ti/ �. IR_ /-1/2, 0
stddress of Property: v 6_ Ids I pf c SI
(Lot or Street #, Street or Road)
C. Al' T3 AL-C - /F0
(City and County)
hereby certify that I own property adjacent to the above-referenced property. The individu<
ipplying for this permit has described to me as shown on the attached drawing the development the
ire 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 Coast:
vIanagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-39C
within 10 days of receipt of this notice. No response is considered the same as no objection
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 s
bck a minimum distance of 15' from my area of riparian access -unless waived by me. (If yc
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.
234,
Sign N.Sf t Date