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► tANMA/ Ill DREDGE & FILL .
3EN ERAL PERMIT Previous permit#
New IIModification 1Complete Reissue iiPartial Reissue Date previous permit issued
prized by the State of North Carolina,Department of Environment and Natural Resources /�
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC /" /20C'
QRtit€s attached.
t Name,Le9cA rt / -,e),..) Project Location: County ,19 y'.•,Slaicle
D sr !/'* J4SLi4'z e 4/(5) Street Address/State Road/Lot#(s) yor/ 14,2,2
N-di'e f er'. `i State/✓C ZIP .2 Tye 7 G,/PS f-
g•(?/d).f 7' -''27e,Fax#( ) Subdivision
zed Agent /,j,M/ f9/t„pi,#4, City$y,JS€ 13•e6>Ch ZIP 2 T/,
I ❑CW SEW 412TA [9€S'- ❑PTS Phone# G
( ) River Basin C/M
❑OEA ❑HHF ❑IH ❑UBA El N/A Adj.Wtr. Body (',jr9,1r e/ /!j/s•�j/
PWS: ❑FC: /
yes no PNA yes no Crit. Hab. yes / no Closest Maj.Wtr. Body •Y/ i4'I
f Project/Activity 19 d /S >(12 ' G.9T Z/171 f ' G,/ s S,".- 2)C1cA
ri
, L A2 Cx rs1,,,f / 97144-, c} C )P,,.d £A,,,,y .v/iicx, y ' (Scale: )
)ck)length‘-'x 1s f,,.y ?nte cX / / /# 9e jam A,/ilh _re2/157 fie., p 1 soft �j oAfl./ .
n(s),C ,f/ r/ /Z/ ��/'a' �.^--� % i! —'— /9L,2' q T_.
)ier(s)
:ngth •.�� I amber TriLlif
flit
id/Riprap length t g distance offshore
ax distance offshoredot �� ...
hannel �.� �G o 1 U`t 9
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bic yards 5 . 41:4' • _ y_ 1_... y_.
Tip
i Boatlift /5'X I 1
iulldozing ' i ' A I
le Length d
not sure yes 0 _ 1
s: not sure yes 1 Cr ; 1 ...- r
urn n/a yes —{ _. _.._ I.
no a...... 41' A144#J 4 I i
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4ttached: 44031 no !�✓. I V i

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BRANCH BANKING AND TRUST COMPANY
w SUPPLY,NORTH CAROLINA
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: ,/'CGI&. ,F ,',AA(
Address of Property: yLt /A 7'-,( J oice. ti)Lr1/
(Lot or Street#, Street or Road)
c,MJ rf- 730vtis4 cow,
.4
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individ
applying for this permit has described to me as shown on the attached drawing the development tl
are proposing. A descri dot 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 Coa5.
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3!
within 10 days of receipt of this notice. No response is considered the same as no objectioi
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
bck a minimum distance of 15' from my area of riparian access-unless waived by me. (If)
wish to waive the setback, you must initial the appropriate blank below.)
r
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
4 , 4,2_, 0/0 6,
S i ann Name Date