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3ENERAL PERMIT Previous permit#
New Modification (Complete Reissue EPartial Reissue Date previous permit issued
>rized by the State of North Carolina,Department of Environment and Natural Resources Z 3 O
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Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
[ [Rules attached.
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Bank of America Advantage
KENDA A. RICHARDS 01-06
4972 NC HIGHWAY 210
SMITHFIELD,NC 27577-7903 Date 16.
Pay N C DN
to"the order of u,
hw^GliL-
BankofAmerica
ACH R/T 053000196
Memo r, tI54L9/i-Fs^ �ttel ifs '
1:053000 0006557 27 2040 3087

)4 06 01:47p p,1
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNERNOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: ba VI �e- j
Address of Property: Ld'( IL( f'1o/2k4,i5 GIel-C
(Lot or Street#, Street or Road)
Soz-c c A-L t .,,)C .
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indivi
applying ibr 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
7- I have no objections to this proposal.
I P
if you have objections to what is being proposed, please write the Division of Co.i
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-71elt
within 10 days of receipt of this notice. No response is considered the same as no objectic
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift nrus
set bck a niininntm 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.
Sign Name Date
��1ti1 /- 77ti1 mij �j1A
Print Name — _ -- ��7

7RO1`1 : Panasonic FAX SYSTEM PHONE NO. : Jul. 05 2006 07:19PM P1
PAGE 0'2
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DlY1510N O.E. QASTA1..M.A1i3GEWIT r
ADJACENT RIPARIAN,i10PER-a (DWI:FI&NOT'IF MAT ONLY]AI.VER FORM
pine of ltldivid+r<,.I Applying For Permit:_D4— 1.,:l —..-----•. ..�
A:iclmss of Property: Ifif-- d 0,24,105
(Lot or btre.,t ft,Street or Road)
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(City< id County)
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i i rtreby certify that I own property ttd;accnt to '.!le above-rc1brenced property. The hidivi5'.tal
:l r c Tying for this peruritEtot;described to me r..9.shown on the attached drawing the dcveloprnostt they
:,r:proposing. A description or drawing,with dimensions, should be provided with Lhis letter.
V.._ it ha'e tao Objections to this propoJa;.
If you Wive objections to wiutt: is being proposed, plenso write oho Division of Coastal
.s•1:tett<gurnent, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-7"fe3Co-1. tea
n'i:1hin lb (toys of receipt of this notice. No roponxe is considered the sante as no objection if
+•(?a have beeKi notified by Certified Mail.
WA IVI R SEC:I'JoN .
•
I to ndcrstantl that a pier,dock,mooring pilings,brenitwater, boat house or boot lift must be
;;r:t brit a ntihhicuanh cliststrnee of 15'front shy aro*of ripat'istn access-unless wnived by we. (if
:I.ni t wish to waive the setback,yet* must initial the scppropriate blank below.)
_ _ _—_ I do wish to w,livo the 15'se!back require:nett.
1 do riot wish to waive the IS setback r tr;rertlont.
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