40403D - Bluestone

rCAMA / DREDGE & FILL ` N? 4
V
GENERAL 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 /i
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 6/ , /2t /
1Rules attached.
t Name JCna i , i Ae 0i IM, Project Location: County //7 C"
1-4a S f ei lc(4 (-rye4 /COS . Street Address/State Road/Lot#(s)
4//nh/ir6i 7Ph State /PG ZIP 2 Ty// /92S- ,G l4t4 2? E 4#
(I/V) ✓0 tlo • 140/Fax#( ) Subdivision
ed Agent ef44 ,k/'lDCity It?/d1?/ 7"i ZIP 28 5
❑CW ❑EW A ES ❑PTS Phone# ( ) $.toss ' River Basin C�-/AVe
❑OEA ❑HHF ❑IH ❑UBA D N/A
Adj.Wtr. Body �/-e,f4 eei t /r
❑ PWS: ❑FC: ITiJi"f" �' #$11"
yes /p PNA 0/ no Crit. Hab. yes / no Closest Maj.Wtr. Body l
Project/Activity /cj-7 i ' ,O Yi'S f/%j T" 14%/`,, ) ,C � I
14 tt�/'Gpar,� ,,,sfq// , MY - ��'j////�/ (Scale:/'=
:k)length
(s) t 40 i .
er(s) '_ _ + F, /1 l 4 �/"e'e°
igth \
nber L -' 1
I/Riprap length;distance offshore _ Pri yeSe 1 rr4 <" r n
r#7
x distance offshore / •Y
annel r/ /i'IL�I?'i7 an /7rw'
— d4eVi,4717,- \
iic yards
oatlift �2 X�y ,s )0S 7/i7 /',r
illdozing yOn/' / 44
\ \
a Length /41 /�
not sure yes (pd , 1
not sure yes 4 '�L.t-.. /'um: n/a yes d //4 / C
._xes f Q/u�s7',sh, �/• ,-/ . et_
1ttached: yes eo
ig permit may be required by: //l 4 S e . . See note on back regarding River Basin ri

F'4, 10/2 )0` 20:3C 9106664452 BROADFOOT PUB CO PAGE 07
DI VISION OF COASTAL MANAGEMENT
SAD-ACENT RIPARIAN PROPERTY OXkll g_NQTIFrcAI IoN/1 VA1V ER
IQEm
N2.ine of I.idividual Applying For Permit: \..• 01 A k) £3?L J-___ '0_4 1
4c dress o:'Property: 7 1 4'--L JLE K (?
- (Lot or Street#, Street or Road)
'd 10i) C- 2 (41S
(City and County)
is n'eby ci rtify that I own property adjacent to the above-referenced--pro,erty_ The indiv du:I
ppiying fc r this permit has described to me as shown on the attached drawing;the development the I
re proposi lg. A aescLiption or drawing, with dimensions, should be provided with this lett(r.
I have no objections ons to this proposal. +r-
f you hag e objections to what is being proposed, please write the Division of Co:sta 1
faaagemc at, 127 Cardinal Drive Extension, Wilmington, NC 28405 )r call 910-395-: 901
4t_rin 10 d ays of receipt of this notice. No response is considered the same as no objectid n i
311 have b!en notified by Certified:Mail.
WAIVER SECTION ~` ——
I anderstar d that a pier,dock,mooring pilings, breakwater, boat boast or boat lift mus ;be
s t t ck a mi aimum distance of 15'from my area of riparian access-unless waived by me. (Ii
p is wish to waive the setback,you must initial the appropriate bIa.nk b(low.)
I do wish to waive the 15'setback requirement
/ I do not wish to waive the IS setback requirement ✓
....�
Si n Name • Date
Pr: rt Name .- _�.r.
APIA
2)C:: _ � � NC;DENR
-4. f�•r ..�Ow..n.mor.r

DIVISION OF COASTAL. MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORD
Name of Individual Applying For Permit: jDJJj'tA)JFLU_51p1'
Address of Property:
(Lot or Street#, Street or Road)
t hh Mid k c 2.6 ij
(City and County)
I hereby certify that I own property adjacent to the above-referenced--property. The ind
applying for this permit has described to me as shown on the attached drawing the developme
are proposing. A description or drawing, with dimensions, should be provided with this le
I have no objections to this proposal. t/
If you have objections to what is being proposed, please write the Division of C
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-39:
within 10 days of receipt of this notice. No response is considered the same as no objec
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift m
set bck a minimum distance of 15' from my area of riparian access - unless waived by n
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. t�
4405-
Sign Name Date ,
Ito g fA4/7'

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Pay to the 0
Order of I $ 100
jj\i„ N.4274,y,
Dollars 6 �..
Bank ofAmerica
ACH R11053000196 s
For C5 �V
1:05 3000 L961: 000 L800_L 7.5�3 5ii 5 L SI sa i,.ra z.!
OOa.Me Amnkan OUARUTANA SAFETY BLUE WBl
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