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3ENERAL HERMIT .....—Previouspermit#
?Kew Modification 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 15A NCAC J/ //
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[ .RaIess attached.
t Name fill A 02. d 6f'/Z/z G s/-71 Project Location: County, g vb./sw/et
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ed Agent Li oy r /2)/ ,.i i z City S/rf i/d 741{ ZIP 2 F,V5
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67-7235/2532
COASTAL DOCKS & BULKHEADS 1 O 7 4
LIC. 2353846 355 3328
I, 2490 WHITEVILLE RD. NW ��/ Y�
h5. ASH, NC 28420-3224 DATE
i PAY TO THE I ) 11+ /Q I $ De, �d ii
i ORDER OF ���/// VVV f-fin AV (` �,
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Coastal Federal
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SHALLOTTE,N 28470
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: jy, , -
Address of Property: I (4 so it ;1 ( . k A„, e
(Lot or Street tt, Street or Road)
t9 ac_ tic: R A/c LA.1 k ,41 I die
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individua
applying for this permit has described to me as shown on the attached drawing the development the:
are proposing.. A description or drawing, with dimensions, should be provided with this letter.
1 I have no objections.to this proposal.
If you have objections to what is being proposed, please write the Division of Coasta
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3901
within 10 days of receipt of this notice. No response is considered the same as no objection i
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 se
bck a minimum distance of 15' from my area of riparian access -unless waived by me. (If yo
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.
st4e. Ldif,mcit,yv
Sign Named Date
/-` „ ) ('AI A h :�
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: rp
Address of Property: / 44 g-n )7\n"
1 ( )^ 4_z4,.
(Lot or Street
#, Street or Road)
( (V - AL \_
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individuz
applying for this permit has described to me as shown on the attached drawing.the development the
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 Coasts
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-390
within 10 days of receipt of this notice. No response is considered the same as no objection i
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 se
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If yo
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.
S• . ame Date
l ) 1 / U I - ..I