42883D - Smith

'CAMA/ ! I DREDGE & FILL
4 v
3ENERAL PERMIT Previous permit#
+New Modification I 'Complete Reissue Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 711, I24
ules attached.
t Name /11#71 S/11, L)i Project Location: County ,4itG(P(./ (0.
/'7 l i li,f15 La K)/t 04 - Street Address/State Road/Lot#(s)
H M p 5,1-eaA State,vC ZIP 7 u/ ``;(t is
('1/O)27O—5361/ Fax# ( ) Subdivision -
ed Agent // City ZIP
Cw [P.‘ hPTA PES ❑PTS Phone# ( ) • River Basin (),,ip
OEA ❑HHF ❑IH ❑UBA ❑WA Adj.Wtr. Body / /14) (nat di
PWS: ❑FC:
1:e / no PNA es / no Crit. Hab. esi(fi no Closest Maj.Wtr. Body Ql!a.1
Project!Activity too op.(„,"II )2/4 442 s iYt Y-- 4d4- ,'y /d//t/d/L
(Scale: /
:k)length
i(s) /Od)c01- ,'j
ier(s) A �t/"
ngth
Tiber
1/Riprap length
distance offshore
x distance offshore
cannel
)ic yards
ip
se/Boatlift /d•Xi5
7O'y G 1- 0.04,
SP4Mty
g�Ildozing ' / � 1�� � 1 t 0-e'sr}6aL,E
e,14,-- 20 y le
:Length co' IStt-I t i,r,(7h t im41,,
not sure yes fl 1I
not sure yes 63,
um: n/a yes
yes no
attached: yes o
ig permit may be required by: A /L' P/ 4 See note on back regarding River Basin rt

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' NAT AND BONNIE SMITH 26241.
PH 910-270-5364
1130 MALLARD BAY DR / �o v/X ` 66-30/531
HAMPSTEAD, NC 28443 Date ` v 365
Pay to the °O
I Order of j $
•
Dollars 6
FYRSI CITIZENS 165
11 I ANI( ms.d NBCk2:TMist Company
www.firstcitizens.com
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V VJ VJ• J Ir JGVI� J\.1111C J1 V-G I V-JJVL r•
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: //" 4 ( — S 7Si
Address of Property: ( Q '1l 1i 64.160r-iv Ack
(Lot or Street#, Street or Road)
( l et rh PsS ,./V G e ry
(City and County)
hereby certify that 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
ire proposing. A description or drawing, with dimensions, should be provided with this letter.
K.-4c I have no objections to this proposal.
:f you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
within 10 days of receipt of this notice. No response is considered the same as no objection if
rou have been notified by Certified Mail.
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WAIVER SECTION
understand that a pier,dock, mooring pilings, breakwater,boat house or boat lift must be set
Ick a minimum distance of 15' from my area of riparian access-unless waived by me. (If you
vish 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.
er�c
C . //-2,-�5
'gn Name Date
A4 7' Cann-ek-
Tint Name •
/�
At
a.A it fA �.G1 r ��

o10 05 03: 57p Jack Stone 910-270-9962 p. 1
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: 47/9 r 3 .S.-
Address of Property: / a ( /t 7'48 s' 4a �ee;`,_1. e04
(Lot or Street#, Street or Road)
//a te e r
(City and Coufity)
I hereby certify that 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 with this letter.
B O I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
within 10 days of receipt of this 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,boat house or boat lift must be set
bck 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.)
CC I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
9.4/0 Ji / //2/1 —
Sign Name Date
che.„,b5 /rev't
Print Name ©'a s