44062D - Walters

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'±'CAMA/ DREDGE & FILL
3ENERAL PERMIT Previous permit#
New __Modification Complete Reissue Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources // /ZG�
Zoastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
Rules attached.
t Name 1:49/z torn WW L 4ri7 f _ _--- Project Location: County l ter,c f'
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:ed Agent Ac i e ��/L/Yj e2 City Oc e,9r..Z /e C', C 4 ZIP 2 7/4
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❑OEA HHF IH UBA N/A Adj.Wtr. BodyL Ca et* (5)/
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ise/Boatlift -Z,�f - I
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not sure yes 49
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-ium: n/a yes
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Attached: yes g —_-- d /�---- _-- �_.—
ing permit may be required by: DCe9,' JTcLe (�J e..9C See note on back regarding River Basin r

.GRIZZLY REAR,
STEVEN T. FARMER
TRA COM SERVICES 3072
PH. 910-754-2725 897 MIDDLEDAM RD SW Z.ei 7 Z— 4)4 66-112/531
SHALLOTTE,NC 28470-5657 62401
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BRANCH BANIONG AND TRUST COMPANY
SHALLOTTE,NORTH CARIOLINA
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
04
Tame of Individual Applying For Permit: 7 ' a,
cc)ddress of Property: I 1 r c n Vct '^��b Ahlr-/e.7 Si
(Lot or Street #, Street or Road)
( �C cc0 l N C, Yui \Siv-
(City and County)
aereby certify that I own property adjacent to the above-referenced__property. The indivic
plying for this permit has described to me as shown on the attached drawing the development
proposing. A description or drawing, with dimensions, should be provided with this letter
I have no objections to this proposal.
you have objections to what is being proposed, please write the Division of Coa5
1nagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3
thin 10 days of receipt of this notice. No response is considered the same as no objectioi
i have been notified by Certified Mail.
WAIVER SECTION
aderstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
bck a minimum distance of 15' from my area of riparian access - unless waived by me.
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.
komx.r.s th,
Name Date
av �c� M 8� 1 � A AA

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2571 B008 01/13/2002
GUI Ownership & Location Information
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Current Owner: FORTKORT THOMAS & DEANNA TRUSTEES
Mailing Address: 10210 TAMERACK DR
VIENNA VA 22182

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2571B010 01/13/2002
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Ownership & Location Information
Current Owner: HILL DAVID M ET STACY M
Mailing Address: 730 GREENVILLE BLVD
GREENVILLE NC 27858
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