42810D - Andrews

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AMA/ L/ISREDGE & FILL
;EN ERAL PERMIT Previous permit#
?New _I Modification (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 I5A NCAC 7 11_ /f OU
[files attached.
it Name Mrbfr,4 tIP.tw' Project Location: County A` ►0sw/uL
A n/644w f� ,7 Street Address/State Road/Lot#(s) 13;
/ ic? ,/ve
////"I!"'rrrr"'' State ZIP �0`1-(pl`x �i. �
E I(J Fax# eU Subdivision 4 U 2
:ed Agent 6/ef(' 40 49A/ City r.' b,'Uu,/ ZIP 'CI
❑CW 4t 1 A Vter ❑PTS Phone# ( ) River Basin
❑OEA ❑HHF ❑IH ❑UBA El N/A Adj.Wtr. Body C�'4 Oric A,/fA/f(nate
❑P S: ❑FC:
yes / no PNA yes I Crit.Hab. yes / no Closest Maj.Wtr. Body 4 0�
•
f Project/Activity /g 1k aA0 ` `+Yr�pf((fry,va L4 tk/2 AID 14 /rj4r G)
t.
(Scale: f
ck)length
1(s)
iier(s)
:ngth
mber
d/Riprap length
3� i i
g distance offshore 0
ax distance offshore g jtt/,
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bic yards ..__1►v' __
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ie Length ,A 4 l
not sure yes n
s: not sure yes n /I/
^ium: n/a yes no I7 3 (�
yes
Attached: yes n - —
ing permit may be required by: Millre .(AL li See note on back regarding River Basin r

24/2005 10:51 9103233555 PAGE
Z002/t
2005 10;32 FAX [phone]
CHM BEACE1
DIVISSON OF CQAST NT
,CENT RIPARIAN PX.OPERTY 4WNER NO II ll /WAIVER —0
Name or Individual App1yirg For permit: 'lZ43144 !��ln'p s
Address of Property: 13 i 0 ? of
(Lot or Street#,Street or Road)
4/d.at
(City and County)
Ibereby 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 arc proposing.A description or drawing,with dimensions,should
be provided with this letter.
L?; I have no objections to this proposal.
IC you have objections to what is being proposed,please Jim Gregson with the
Division of Coastal Management,127 Cardinal Drive Extension,Wilmington,NC
28405 or call 910-796-7215 within 10 days of the receipt of this notice.No response is
considered the same ns no objection if yen have been notified by Certified Mail,
WAIVER SECTION
I understand that a pier,dock-,mooring pilings,breakwater,boat loose or boat lift
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.)
�L6 I do wish to waive the 15' setback requirement
I do not wish to waive the 15' setback requirement.
r/ 01 ge4 0/ay1°S�
Sign Nrne Date
vf o :I L u.rrcc 123
Print
(g1(.4") gr7-7- 73/o
Telephone Number with Area Code
S:\carna\shclls\ripariatiproperty.frm

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40100
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Hovaa ygiD TOt tZ1780t6 XV4 ZE:OT SOOZ
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24/2005 11:32 8628006 JOHNSON LAW FIRM PAGE
'8/24/2005 11:02 FAX [phone] CHM BEACH 1 002/
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: l2'4 I /4/V0f 1
Address of Property: 1' (i1 /07 iY
(Lot or 'Street#, Street or Road)
/A)/4h bR h`f /tie> ,AiA
(City and County)
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 thawing
the development they 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 Jim Gregson with the
Division of Coastal Management,127 Cardinal Drive Extension,Wilmington,NC
28405 or call 910-796-7215 within 10 days of the 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,moorings pilings,breakwater, boat house or boat lift
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.)
1 do wish to waive the 15' setback requirement.
I do got wish to waive the 15'setback requirement.
UflA\61€'
Sign Name Date
[-JAI t , d—wA-- ec IL . ,�-

24/2005 11:32 8628006 JOHNSON LAW FIRM PAGE E
3/24/2005 11.:03, FAX [phone] CHM BEACH Z 003/I
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