45885D - Millard

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J CAMA/ L DREDGE & FILL ,
3ENERAL PERMIT
PrevMew Modification ❑Complete Reissue ❑Partial Reissue Date
rious permit#
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 I 5A NCAC 7 4 _ //O 1
p Rules attached.
t Name L ) N /V)/ Lt...A-W-0 Project Location: County f ThJO 72
Po. 5q-.s- Street Address/State Road/Lot#(s) LC,-)T P3
;ELniti state/ C ZIP 2 7S7 7 (--,1 F71 l Uff7tS I)/2 .
t ►/?) 2 ci'/-.33/9 Fax#( ) Subdivision
:ed Agent M4t21 . C 4 M ENTS City ffrinp17E70 ZIP 2444,
❑CW ❑EW ❑PTA I S ❑PTS Phone# ( ) iihn c River Basin CA-14
FO OEA ❑HHF ❑IH ❑UBA ❑N/A
❑ PWS: ❑FC. Adj.Wtr. Body A (vvh/ (�a /r
yes / no PNA yes / Crit.Hab. yes / no Closest Maj.Wtr. Body f VI/i-v-
Project/Activity ("LAN c 7RUC T A A/Eh/ ad/ .40104 7
(Scale:/ %3(
:k)length
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er(s)
igth
nber
I/•Riprap length '
distance offshore T
(distance offshore j -
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is yards _...... _
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Length /.2.5 4. f..... cif _Lilt _ ... " ,. ...._ �..._
not sure yes (-ntp • ,. . !
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a' -� _not sure yes _ iim: n/a yesH+ IH
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aached: yes —f L II : :
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Clements ALlarine Construction 7963
910 270-9110,NCD.0 4356789
5771Ve Jfiyltway 210 U/ ZS o�
fiampstead,Ale 28443 Date 3oi365
�/ 365
OParderof to the /`/G e',f4 I $ —
Dollars 8
FIRST CITIZENS 365
BANKBANK F�ac�o-z«�e,2ar��,ecow„y
i� n,�,�.,e.H c.zeu�
www.firstcitizens.com
For ii SS�r`F, ear 7- a
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1:0 5 3 100 3001:003532 LL130311' • 7 9 6 3
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COASTAL VIEWS'

• ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/wAIv•
ER I UKM
Name of Individual Applying For Permit: `D p 3 inr c,c.,I'-1 i- D
Address of Property: Z. 2- 6,647 ()sg/c az t -e
(Lot or Street #, Street or Road)
!-�4/V_5 D A/C 08 y y 3
(Cit3/ and County)
I hereby certify that I own property adjacent to the-above-reference&property. The indi
applying for this permit has described to me as shown on the attached drawing the developmer
are proposing. A description or drawing, with dimensions, should be provided with this let
I.have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of CI
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 object
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat Iift mi
set bck a minimum distance of 15' from my area of riparian access-unless waived by m
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.
e ate
Ye, .70 AT:pr.
Print Name

• • ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
•
Name of Individual Applying For Permit: fc©dl/ / 2iG G,,Z.o
Address of Property: Z p j j 4,6-4
(Lot or Street #, Street or Road)
0
(City and County)
I hereby certify that I own property adjacent to the-above-reference Lproperty. The indi
applying for this permit has described to me as shown on the attached drawing the developmer
are proposing.. A description or drawing, with dimensions, should be provided with this let
I.have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of C(
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 objeci
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mi
set bck a minimum distance of 15' from my area of riparian access-unless waived by m
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
o � 1- zo -a 6
ign Name 19Date
•
Lin cJoo i TYo,' e 1 -�
Print Name

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