41529D - Braswell

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"CAlVIA / "J DREDGE & FILL N:g 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 7f9. /10a
161Cles attached.
Name Zvn /J-�F 4,Pp// Project Location: County - 6j�J,{S�,'Gk
000$ d f Street Address/State Road/Lot#(s)
1 /Isz, State /tic. ZIP 284
(f/I) t/-fin 5 Fax#( ) Subdivision
:d Agent City _ - ZIP
d Cw ii iv el5TAf$ PTS Phone# ( ) River Basin 4/0
❑OEA ❑HHF ❑IH C UBA N/A Adj.Wtr. Body (nat k
❑PWS: ❑FC:
hot
'es /d) PNA yes / Crit. Hab. yes / Closest Maj.Wtr. Body 44el
Project/Activity ,4d#'
(Scale: efi/,�'
:k)length
(s) //!'
er(s)
igth
nber j
Riprap length I/O _ I
distance offshore """
c distance offshore /^! _�.
�f(/ -
annel / _
ac yes
�p
Boadift 2•01
�Ildozing i ZOO' /di 141 A
Length -_ 40
not sure yes o
not sure yes no
um: n/a yes no
yes n
ttached: yes n
ig permit may be re ired by: AA j0L/ ,1 _ See note on back regarding River Basin ri

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
me of Individual Applying For Permit: ken B«.51,A)
(dress of Property: (GY g W `mb�
(Lot or Street #, Street or Road)
6151k /40^) ttEdk
(City and County)' i
� A2 .04
;ereby certify that I own property adjacent to the above-referenced property. The individua
plying for this permit has described to me as shown on the attached drawing the development the
proposing. A description or drawing, with dimensions, should be provided with this letter.
c_ I have no objections to is r osal.
P P
you have objections to what is being proposed, please write the Division of Coasta
anagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3901
thin 10 days of receipt of this notice. No response is considered the same as no objection i
u have been notified by Certified Mail.
WAIVER SECTION
inderstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must bi
:bck a minimum distance of 15' from my area of riparian access - unless waived by me. (I
u 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.
c77127. 5
m ame Date
i

.,
•
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
me of Individual Applying For Permit: kik 81dsl4C1______-____ _________
(dress of Property: 0246 1 W. y0 - --- __
(Lot or Street #, Street or Road)
Oak 115/Al &uJwfJ _ •_ __ _
(City and County)
tereby certify that I own property adjacent to the above-referenced property, The individua
plying for this permit has described to me as shown on the attached drawing the development the:
proposing. A description or drawing,with dimensions, should be provided with this letter.
q_.,2''
,e-; I have no objections to this proposal.
P P
you have objections to what is being proposed, please write the Division of Coasts
anagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3901
thin 10 days of receipt of this notice. No response is considered the same as no objection i
u have been notified by Certified Mail.
WAIVER SECTION
inderstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must bi
t bek a minimum distance of 15' from my area of riparian access - unless waived by me. (I
u 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.
37 - L_ 6" / VtA_i_../ 7 - / T - O
gn Name Date

DATE /1/Li/O,
PAY
TO THE
�,' ORDER OF �C hi?) $ /00
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DOLLARS
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