45980D - Rogers

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JCAMA/ XDREDGE & FILL 1 4
3ENERAL PERMIT Previous permit#
A-New ['Modification El Complete Reissue —Partial Reissue Date previous permit issued
prized by the State of North Carolina,Department of Environment and Natural Resources � ff
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC >././ • 1�Lv
n ,Rules attached.
It Name Jot 1 L- G l 2 S Project Location: County b
( lei 6°(t') Y., Street Address/State Road/Lot#(s)
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t( ) Fax#( ) Subdivision
ted Agent b -(Nv'I C7 0111.1./ C rt_ City--rp SAS ' �t,ALA ZIP z..g 14
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❑PWS: ❑FC: � � /
n yes o PNA yes /, no Crit.Hab. yes / no Closest Maj.Wtr. Body fNT N/W
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ie Length 531 .
not sure yes no P _.__._--.,
Nygs: not sure yes (,IZF
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rium: n/a yes
Yes
Attached: yes no —_-

TOPSAIL OFFSHORE INC 2572
PH.910-328-2316 66-1220/531
743 COCKLE ST
SURF CITY,NC 28445 !///o
(P Date
Pa to th
Order ofe (6/C $ `/; °O
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Dollars 311
BANK OF`WILMINGTON
Hampstead,NC 28443
For v P -�oc�►-S l w
1:053LL2204i:00000E1656LII' 2572

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: Da ye Ca rc1/Jer- c t.. )2ocy
Address of Property: i l3UrY
(Lot or Street #, Street or Road)
7fsai1 Reach , Pc�, 'v,t.
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individu
applying for this permit has described to me as shown on the attached drawing the development th(
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 Coast
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-72:
within 10 days of receipt of this notice. No response is considered the same as no objection
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 s
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If y(
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
f/d /72 (17(
Print Name AA

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: Da Ve Ga rC ne✓- <i, 12j o ( o )1"
Address of Property: 1/7 �X 8 yk
(Lot or Street #, Street or Road)
T i/ Beach , Phcief-, N .
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individt
applying for this permit has described to me as shown on the attached drawing the development th
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 Coas
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-72
within 10 days of receipt of this notice. No response is considered the same as no objectior
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
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If y
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.
/4 /
Si' ame Date
jz,i4 C/oet