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IENERAL PERMIT Previous permit#
New Modification Complete Reissue Partial Reissue Date previous permit issued
sized by the State of North Carolina,Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ) N, I Z�
❑Rules attached.
t Name,��2�� 3 Project Location: County L►>1)c a—
t 0 I N t *.rT3 ti Street Address/State Road/Lot#(s)
►t,r5Tt.4,il State&L ZIP ZSt-1'Ig L% v ►7
(c Fax#( ) Subdivision
ed Agent City PS ZIP 7 L'i
CW �EW NS,TA _-ES PTS Phone# ( ) River Basin L a Pr:
❑OEA ❑HHF IH _UBA -N/A
❑ PWS: ❑Fc: Adj.Wtr. Body 6 r /r
yes �� PNA yes /� Crit. Hab. yes / no
Closest Maj.Wtr. Body o P S-01L
Project/Activity 5 i +' L (O X 0-1 i t r1 �^> J I S x g L- H t;a> �' x
f L a- S c a L.L 5 (Scale:
:k)length (o X C,
1(s) $ F L o Az C rt. diuk 5
ier(s)
igth
n 2 0
ber
i/Riprap length
;distance offshore j1
x distance offshore
cannel
sic yards
ip I
se/Boatlift
illdozing
Length O d J
not sure yes
not sure yes
urn: n/a yes
yes Cno"
attached: yes
ig permit may be required by:y PS F-NL t See note on back regarding River Basin rt
•
.(- FRED SESSIONS NCDL 7584013 �,
BARBARA SESSIONS 899 t
910-270-2905 66 30/531
101 NEWTON ROAD / Q C
HAMPSTEAD, NC 28443 Date 365
P Yro I $ J D
corder of-
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(�'l✓c �v/.J -� �t- col �i-r�- Dollars 8 7:47
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0, FIRST CITIZENS 365
BANK First.Cilaans Bank 8 Trust Company
BANK
Hampstpatl.N C.28443
www.firstcitizens.com
For f '`i� U �=w� -
1:053L00300i:0035369363790 00899
WDCC
- FBI ULSNER/BAYNES � ��
JOB: /G I Z ci4✓ �-.��
&ASSOCIATES, INC.
Asheville,NC Columbia,SC Hickory, NC SHEET NO.: / pS k-- C
(704)254-3218 (803)739-1750 (704)326-8980
_CALCULATED BY: DATE:
Charleston,SC Greensboro,NC Raleigh, NC L(D�� 2 '7 d- Z o S
(803)884-3554 (910)299-3006 (919)781-8840 j 5 L c — /Z 7 5 DATE��2�
Charlotte,NC Greenville,SC Wilmington,NC
(704)527-5134 (864)232-7796 (910)251-9155 SAS: + r c-= P Lye (`t
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l'ERT1FIED MAIL—RETURN RECULE R) OI.:ESI'H:D
DItiISICNY OF COAS'i Al.MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER
FORM
Nance of individual appiving for the permit: FRk 2 - }AR t1r4R.4 ..5'k.1.0
Address of property;_ lei l L CAA' t ./24 /?L vD
«t.tr street*,street of rer!)
--••it:ItyRC�utADf
I hereby certifs.the I own property adjacent to the above referenced property. The
individual applying for this permit has described to me(as shown on the attached
drawing)the development they are proposing. A description or drawing.with
dimensions,should be provided whit this letter.
I lt0ve no olhcctions to this proposal
I )ori ht,ve objoctiout to what Is being proposed,please write the Division of Coastal
Management,400 Commerce Ave..Morrhend City.NC 28557 or call(252)Sots-2tioR
within 10 days of receipt of the,notice. No response is considered the same as nil
objt•rlinn if you hare been notified by Certified Mail.
Waiver Section
I understand that a pier,dock,atouring pilings.breakwater,boathouse,lift or
sandbags must be sct back a minimum distance of 15' From my area of riparian
t.crrrts aaleas waived by one. (If yciu wish to waive the setback,you must initial the
appropriate blank bctow.►
rf I do wish to wtti'e tllc I'i• s:t.back requirement'4 1 110 not wish to waive the 15"•,elbncIc rcquirementzz
Signature )7 ttr
edetx /7d 2.,Je4
Print Nattlt;
(9/y' 7,F/ 2.4�.
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER
FORM
Name of individual applying for the permit: -0 ' 2 C/Z-^ �S/7 o M
Address of property: f . f Z �j9,2�s ur✓� ��-�p
'(Lot or street#,street of road)
/CMS e— Cr=.�y}�� l�1. e. z
(City&County)
I hereby certify the I own property adjacent to the above referenced property. The
Individual applying for this permit has described to me(as shown on the attached
drawing) the development they are proposing. A description or drawing,with
dimen 'ons, should be provided whit this letter.
I have no objections to this proposal
If you have objections to what is being proposed,please write the Division of Coastal
Management,400 Commerce Ave.,Morehead City,NC 28557 or call (252) 808-2808
within 10 days of receipt of the notice. No response is considered the same as no
objection if you have been notified by Certified Mail.
Waiver Section
I understand that a pier, dock,mooring pilings,breakwater,boathouse,lift or
sandbags must be set back a minimum distance of 15' From my area of riparian
access unless waived by me. (If you wish to waive the setback,you must initial the
appropriate blank below.)
�
I do wish to waive the 15' setback requirement
/ I L do not wish to waive the 15" setback requirements
Sig a Date