40476D - Berne

`CAMA / DREDGE & FILL N9 4
;ENERAL PERMIT Previous permit#
' Jew 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 7/1,
Li miles attached.
:Name Aeid 6f48 Project Location: County 44).1 s'ir/4-/�
30 Z /2j flee 0. _ Street Address/State Road/Lot#(s)
>v*11 pod." State / ZIP age/
(/0) '. 30Z1 Fax#( ) Subdivision
Me
:d Agent City ZIP
CW PTA t-ES PTS Phone# ( ) River Basin
OEA C HHF IH _UBA N/A Adj.Wtr. Body C/9t ✓' (nat
❑ PWS: i 1 FC:
yes / 6 PNA yes / 6 Crit.Nab. yes / Closest Maj.Wtr. Body__ -_ e:A;k -et
Project/Activity 40,l14 l/( /' Av/I ies
(Scale: /p
:k)length
(s)
er(s)
61/9, k r ✓e✓
Igth
nber
iprap length 110
distance offshore
x distance offshore
annel
iic yards
�.�wow-�..����.�..r����►...�� ..i► :fir
/DO'
se/Boatlift /-4/
illdozing J
30 Z Ave, ,Pv1
Length 21"
not sure yes finot sure yes o
urn: n/a yes no
yes ' no
1tached: yes `�+
ig permit may be required by: Sp,,Ar? See note on back regarding River Basin n

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit )0r at-6 ,BE,e,.)e:
Address Of Property: s42 Rtv 2)
_5ou PD,e7 JJC, &Pwosw.rc:4--
(Lot or Street#, Street or Road, City&County)
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described tome as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
1iYQ- I have no objections to this proposal.
le(
Jf you have objections to what is being proposed please write the Division of Coastal
Manaoemnnt 177 Nr►rti, [`��-r{ina� j}�Ne Wi]mino�tnn North !`ar..t; �
1900 within 10 days of receipt of this nonce No the same
na sno bje do
if you have been notified by Certified Mail
rnncidered same as no objection
WAIVER SECTION
I understand that a pier,dock, mooring pilings,breakwater, boat house, lift or sandbags
set back a minimum distance of 15' from myarea ofmust u
riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
J/k iY\ I do wish to waive the 15' setback requirement.
I da.not wish to waive the 15' setback requirement.
zAmi4.. /a, j 3.-/Lf 0 ,3
A„,,A
SignatureA
n _ .

DIVISION OF COASTAI.MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIN-R FORM
Name Of Individual Applying For Permit: AA1t1b
Address Of Property: Se.2
(Lot or Street#, Street or Road, City &County)
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described toitie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter. D�c�
(?.., 0/I have no objections to this proposal.
if ynii have objections to what is being prnpnsert please write the Division of Coastal
Mana rmrttt, 127 North Cardinal Drive Wilmin on. North Carolina 7R4f 5_or call 91(1 395-
'1900 within 10 days of receipt of this nnrice No rrspnnse_Ls .. seri the same as no nhjertinn
if you have he'n notified by Certified Mail
WAIVER SECTION
I understand that a pier,dock, mooring pilings, breakwater, boat house, lift or sandbags
set back a minimum distance of 15'from myarea ofmust u
riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
(f A " I&not wish to waive the 15' setback requirement.
. . 2
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re Date -

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