41481D - Andrews

eAMA/ DREDGE & FILL N9 4
^
IENERAL 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
oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 71/, /Z)
'ules rached.
Name 44v. it e I/e,A)3 Project Location: County 0,7 P."
6/7 GQo bot/ g, Le /, Street Address/State Road/Lot#(s)
ft of ps7oa, -_State/fir ZIP 2I Y5.1) 5 ..�
( ) ‘7 0-1 coc Fax#( ) Subdivision
:d Agent A4,-A ri.e e f s City - ZIP
❑CW CHEW y PTA ❑ES ❑PTS Phone# ( ) River Basin C 4/4
❑OEA ❑HHF IH ❑UBA N/A
Adj.Wtr. Body ��1� (nat /it
❑ PWS: --FC:
'es / PNA yes /6g Crit. Hab. yes / . Closest Maj.Wtr. Body e:::;ll-Ar
Project/Activity /7s y/d g-el ,/4 71 4,,, d r ex,5Ti ii f fir'o✓.
(Scale: /
k)length
s) x /1 ift/ N
br(s) K /L
gth t3G/40510)
iber r
T e
/Riprap length 1 0 0
distance offshore /(i fZ-
:distance offshore x ��i }C —� 4Y y71 ~
tnnel 11 L i
1 ,41`11 v 0
is yards
e/Boatlift
ciX
Ildozing
jib,
Length /Z.0 1 ` 7 WO Rw1 G L e e Z2 ,
not sure yes n
not sure yes n
im: n/a yes no
yes no
cached: yes no
g permit may be required by: /194/6/ (es I See note on back regarding River Basin ru

L1 V iOiyiv yr LL)AS 1 AL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: /Y2, 61/1/-/Jf74.i5
Address of Property: /� l;/IVY/a& /2� 16 //)C- 7W
(Lot or Street#, Street or Road)
,,f(/
(City and County)
I hereby certify that I own property adjacent to the above-referenced_property. The indivic
applying for this permit has described to me as shown on the attached drawing the development t
are proposing. A description or drawing,with dimensions, should be provided with this letter
VI.have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3!
within 10 days of receipt of this notice. No response is considered the same as no objectio:
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
set bck a minimum distance of 15' from my area of riparian access-unless waived by me.
you wish to waive the setback,you must initial the-appropriate blank below.)
I do wish to waive the 15' setback requirement.
do t wish to waive the 15' setback requirement.
ign N e ate
. Al WA

UI VISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: 02, /14, /i '
Address of Property: £% /,c ,% ✓_*1. ,;, 41/C - 5 v
(Lot or Street#, Street or Road) Kr/Z-i
(City and County)
I hereby certify that I own property adjacent to the-above-referenced.property. The indivic
applying for this permit has described to me as shown on the attached drawing the development t
are proposing. A description or drawing, with dimensions, should be provided with this letter
VI have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3!
within 10 days of receipt of this notice. No response is considered the same as no objectio:
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
set bck a minimum distance of 15' from my area of riparian access-unless waived by me.
you 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.
OS
Name Date
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