43241D - Generation

I 9 ..
1CAMA/ DREDGE & FILL Lfr
IENERAL PERMIT Previous permit#
New _.Modification I 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 I 5A NCAC /211'
/ is -Rates attached.
t Name Ce/v e2 A 7's','+ Ow lei -gj Project Location: County s
1 91.99 f/a 2 /4,d )/t , Street Address/State Road/Lot#(s)2 y L A.i ,,,,
p StateNC ZIP 2 77/G L/.
( VI - O ?Sax#( ) Subdivision
ed Agent /1 cy a, 1, City62c.'9,i� I[ �p9c. ZIP Z i 9
cw CHEW Gofrfic 'erg- ❑PTS Phone# ( ) River Basin 441
OEA ❑HHF ❑IH ❑UBA N/A Adj.Wtr. Body CO✓A L a/"",e'/9 / l✓4'(bat/
PWS: ❑FC:
yes no PNA yes`�.:'% Crit.Hab. yes / no Closest Maj.Wtr. Body ��
Project/Activity fa,' fr 4-i { P p 't )G C
{/ (/ (Scale:/
:k)length
i/� 'C (�`/�/fc / i7
(s).
er(s)
,gth
nber
I/Riprap length
distance offshore
x distance offshore
annel
ric yards
ip (Iipr
se/Boatlift
slldozing
yLM7 ?
N `pet `c
Length c" y
not sure yes 7
not sure yes L y/://Z ,NDcd2 , f, Y, !
urn: n/a yes o;
yes
,ttached: yes ej
ig permit may be required by: O(',O A.✓ .L ( le / PAC.4 See note on back regarding River Basin r(
_ . . _ Ali , A I I 1 ,i . _ _ .

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GRIZZLY BEAR
t4t STEVEN T. FARMER s - >'�
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TRA COM SERVICES = } < �z f� fi 2 93
PFL ys1a754-2725 s' �` ' V " S1 ja
897 MIDDLEDAM RD SW -4 - t-J1 Q
7 •66-1I2/531
"" SHALLO1TE,NC 28470-5657 ` ➢'t' 62401
PARR ER OF �;vim; ' ,C -rur,Y-1 , 12e.VO-ems $ l►
• f, T v V1 UV%C 'hq2I� - — - /cam �`.
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/ y7+ '` �"A. JBH NGf BANKING AND tNusT CON► 4r ���.. �z 4� Y " h >. ^ y k s
' T CE N RTH CAROLJNA' �� • _
717
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1:053 /0L12LI: 52LL0660L811602993

RA-COM SERVICES beiA -1:101-1 �1 1 � � � 4
P.O. Box 1365 I,A-tom 614
>hallotte, NC 28459 O(pq.N a3/.a
1) 10-443-7 3
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r DUD �r

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: ., Gu4t ?Ai/4-j
Address of Property: Zer -� /Il//�i (
(Lot or Street #, Street or Road) )
(City and County)
I hereby certify that I own property adjacent to the above-referenced_property. The indiv
applying for this 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
yezzi I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Col-
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-;
within 10 days of receipt of this notice. No response is considered the same as no objecti(
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mus
set bck a minimum distance of 15' from my area of riparian access - unless waived by me.
you 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.
-/7 f
iign Name Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: (2_4715, C'z• `J -✓t�,l/
Address of Property: /4)/ C( 7/4e-fn4-7b-k, S 4)-L-
(Lot or Street #, Street or Road) /
Lel/kW Cam.
(City and County)
I hereby certify that I own property adjacent to the above-referenced_property. The indiv:
applying for this 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
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Cox
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395
within 10 days of receipt of this notice. No response is considered the same as no objectii
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mus
set bck a minimum distance of 15' from my area of riparian access - unless waived by me.
you 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.
ry.
;ign Name Date