43993D - Shepard

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:CAMA/ <DREDGE & FILL
3ENERAL PERMIT Previous permit#
New -Modification 'Complete Reissue -Partial Reissue Date previous permit issued
-ized by the State of North Carolina,Department of Environment and Natural Resources __ I ,y
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC ) r t • ) 1', 1 Z''�
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[Rules attached.
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ig permit may be required by: Q3'St-Z1...) � . n See note on back regarding River Basin ri

CARL E. SHEPARD 66-7404/531 2735 r
MARTHA S. SHEPARD 1040000760
PH. 910-340-4441 .S • 1"
11,
e P.O. BOX 353 DATE. /r� �G G
SNEADS FERRY, NORTH CAROLINA 28460
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., Jacksonville,NC i `• / i,
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� 33 68

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
ie of Individual Applying For Permit: l�/ S- a 7-I
ress of Property: S-3/ lT0 •e,- ,i'.?f v? /`p�' ' 9% f
y
(Lot or Street#, Street or o l/ad) /
5/2ea s /-t-'ri fie-- &��Z1D
(City and County)
reby certify that I own property adjacent to the above-referenced property. The individual
ying for this permit has described to me as shown on the attached drawing the development they
Droposing. A des ription or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
a
ou have objections to what is being proposed, please write the Division of Coastal
nagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215
lin 10 days of receipt of this notice. No response is considered the same as no objection if
have been notified by Certified Mail.
WAIVER SECTION
iderstand that a pier, dock, mooring pilings,breakwater, boat house or boat lift must be set
a minimum distance of 15' from my area of riparian access - unless waived by me. (If you
h 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.
2P/be'j3 Z—2- -°-1)
a Name Date
A {, A al n �eNA,t NnniaATTTA

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
tme of Individual Applying For Permit / _S' c-7
'dress of Property: ��/ ��i e` i‘,,T sSg, ,��� / v/A,,/4
(Lot or Street#, Street r Road)
ee'a d ' 1/ -77 � - a�-'7/o
(City and County)
lereby certify that I own property adjacent to the above-referenced property. The individual
plying for this permit has described to me as shown on the attached drawing the development they
e proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
y
you have objections to what is being proposed, please write the Division of Coastal
;anagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215
ithin 10 days of receipt of this notice. No response is considered the same as no objection if
)u have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings,breakwater, boat house or boat lift must be set
ck a minimum distance of 15' from my area of riparian access - unless waived by me. (If you
ish 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.
.We/ �, d • ,_;1 z//74 6
ign Name Date
"/"Ai TM/ Gv. 6 ?
rint Name AA7