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iENERAL PERMIT Previous permit#
Vew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
zed by the State of North Carolina,Department of Environment and Natural Resources /,
)astal Resources Commission in an area of environmental concern pursuant to 15A NCAC ?h , /I P.Rades attached.
Name , /pit 0 LQ /2,f9/C 4,r✓ Project Location: County 5z 4.4,f c✓ic k
7 oy 611 ,.., T _ A Q Q . Street Address/State Road/Lot#(s) // S ^17`
5 ? f v, „I 7- State ,✓C- ZIP 272f ` c ,
( ) 212.-©JS y Fax#( ) Subdivision
ad Agent L.Ley, r/ 1 ,r I z.— City/90 L c/,J 6/.,*-4 ZIP Z F 96
❑CW ZIEW-• [ iaTiot._ O,i6-- ❑PTS Phone# ( ) River Basin L.4i- 6
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body C/9A✓/A L- O' `^�/I-4141(natC
❑PWS: ❑FC: Closest Maj.Wtr. Body G✓A✓
yes r no y PNA yes it Grit.Nab. yes / no
Project/Activity k ep L/�C e CSC”s I.,,•S R `,L/Cd " /9)
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ngth
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d(-Ftiprap length V — '
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distance offshore 2 ,.. __ �_ , i..... f..-.
ix distance offshore +
nannel
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bic yards 1 t - + + --
use/Boatlift t i
4 i
Bulldozing I } `
I 11" ' i /, _
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ne Length .A�
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not sure yes tf Ro �...
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gs: not sure yes I_ �_
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irium: n/a yes l._... —r • 1 { i... t_
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Attached: yes Q ,

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Coastal Federal nk 12 4 4
fl i : Coastal Docks & lkheads
Shaltotte,NC 70
h� ' Lic. 23538446 67-72 532
4/.�� Ash, C 284ille Rd NW /D ^//
L ,All
Ash, NC 28420 l
PAY TO THE
ORDER OF ye �--t(( O 0_ 8-� (I
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM •
lame of Individual Applying For Permit: / 2Y)/(/ Mar 4 hr)
•
.ddress of Property: l/1p SQf7IKCJ S/
(Lot or Street#, Street or Road)
1/0/a I m8eoh,, �e
(City and County)
hereby certify that I own property adjacent to the above-referenced property. The individual
pplying for this permit has described to me as shown on the attached drawing the development they
re proposing. A description or drawing, with dimensions, should be provided with this letter.
l� I have no objections.to this proposal.
f you have objections to what is being proposed, please write the Division of Coastal
4anagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-390C
vithin 10 days of receipt of this notice. No response is considered the same as no objection ii
you have been notified by Certified Mail.
WAIVER SECTION
'understand that a pier,dock,mooring pilings,breakwater,boat house or boat lift must be se
)ck a minimum distance of 15' from my area of riparian access-unless waived by me. (If yoi
Nish to waive the setback, you must initial the appropriate blank below.)
SC- I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
ei
Sign Name • D
r 11 • •

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER.FORM
fame of Individual Applying For Permit: �KO IC! mcoi\pin
•
.ddress of Property: / / CP �} �?T Gy d Sf
(Lot or Street#, Street or Road)
/7'O/(/ë Z2O cA /
(City and County)
hereby certify that I own property adjacent to the above-referenced property. The individual
pplying for this permit has described to me as shown on the attached drawing the development they
re proposing.. A descri lot 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 Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-390C
vithin 10 days of receipt of this notice. No response is considered the same as no objection is
rou have been notified by Certified Mail.
WAIVER SECTION
[understand that a pier,dock,mooring pilings,breakwater,boat house or boat lift must be se
Dck a minimum distance of 15' from my area of riparian access-unless waived by me. (Ifyoi
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.
OLP
i gn Name ate
��. \ c •