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GENERAL PERMIT Previous permit#
%New Modification UComplete Reissue ElPartial 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 15A NCAC kt - / — -� -
9kules attached.
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT FOR
CAMA MINOR PERMITS
I hereby certify that I own property adjacent to Dig TON L . Pow Fos
(Name of Property Owner)
property located at '3 S` ('N4 v LU(c k s'/i',1 es DR.
(Address, Lot, Block, Road, etc.)
on CH4D wick S/wo2Es , in SN EAos EiQa)/ ,t
(Waterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing at that location, and, I hav
objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
RE/01 ice cx;si,,oG .6 X /04 ' cox'e W4y ANd /2 x,24 vgn
Six d I2X A8 ` Cov6Rr/) 5o47 i °7
Signature �—
Print or Type Name 4L"

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT FOR
CAMA MINOR PERMITS
I hereby certify chat I own property adjacent to D,I7oAl / , Poo/,=,Q.'
(Name of Property Owner)
property located ;it 4 3 S (W/4O GO/c K S'14O/4Es' OA)
(Address, Lot,Block, Road, etc.)
on C1i0wlck _CP0,2E5 , in S,1/600s Pe ky , �
(Waterbody) (Town and/or County)
Ile has described to me as shown below, the development he is proposing at that location, and, I havr
objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(h be filled in by individual proposing development)
REo/,acE Ex'S //Nf 61X /OW WALkeog, 4Aid 12 'X241 Deck_
go;LD 01 X IR / CovE/ EO Dam T k/'7.
Si nature
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Print or Type Name
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LOT 673 Q/acK
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S3S C/ 1Owick claaR&;s DR.
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