41522D - Breamer

ICAMA/ [6REDGE & FILL N? 4
aiNERAL PERMIT Previous permit#
New Modification Complete Reissue Partial Reissu Date previous permit issued
sized by the State of North Carolina, Department of Environment and Nat Resources //OU
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC •
❑Rules attached.
:Name 1;-:40 t Ire•ML f -_ Project Location: County .(/C w /44•70`ri
I7 03 .f 'm --,/�ZW7 Street Ad` i�dress/State Road/Lot#(s) Q G7/ 0
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(?) 956.32 7 Fax#( ) Subdivision s 5 %'
ed Agent 2/fel City Ii1///� �
+, +J,„,//7$i-" ZIP 2 8+CW 31W (#S ❑PTS Phone# ( ) T' t.i. River Basin CG�t
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ier(s)
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distance offshore S F�rieeK ' 1/x distance offshore o
cannel / 4, Cm HI4/9
)ic yards L e'
ip fil <1--f-e9
se/Boatlift11-''
Creed Zt‘f//t 414 4/ i Pi... .......___
ulldozing
4 7/�4/risk /1>h/
e Length 5,6:�/ft,e•-/-- /2
not sure yes 46
s: not sure yes a
ium: n/a yes !la a,„)V, //f // 7
yes Ce , 1-
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ng permit may be required by: /�/ C/ , See note on back regarding River Basin r

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DIVISION OF COASTAL MANACEMNT-
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION &WAIVER FORM
Name of individual applying for permit lie1u2N,
Address of property �` aL J it ;m . �2 } r1r4,;f
I hereby certify that 1 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 are proposing. A description or drawing, with
dimensions should be provided with this letter of notification.
Please initial below if you have no objectionsts '117NfrIrx
_ I have no objections to this proposal. / O!% CIA 41,44 4c,
If you have objections to what is being proposed, please write the Division of Coastal
Management. 127 Cardinal Drive Extension. Wilmington, N. C. 28+405 or call 910-
395 3900 within 10 days of receipt of this notice. No response is considered the
same as no ob action if ou have been notified b Certed Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakweter,boat house,titt or
sandbags must beset back a minimum of 15' from my area of riparian access
unless waived by me.(lf you wish to waive the setback, you must Initial the
appropriate blank below.)
I•
DO wish to waive the 15' setback requirement..
- '.769 /
100 NOT
wish to waive the 15' setback requirement. "
7.
Signature & Date

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION &WAIVER FORM
Name of individual applying for permit 4It'�i'! L 1�'° "�1'' Imo°
/ �,., j� /��Q� / � � �l
Address of property A 3 3 5ML?YL /2, �0'' 'y'r y /k1
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
drawing the development they are proposing. A description or drawing, with
dimensions should be provided with this letter of notification.
/m, Please initial below if you have no objections l 7
I have no objections to this proposal. i yitt►,0 okoo ,
If you have objections to what is being proposed, please write the Division of Coa I
Management, 127 Cardinal Drive Extension, Wilmington, N. C. 28405 or call 910-
395 3900 within 10 days of 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, mooring pilings, breakwater,boat house,lift or
sandbags must be set back a minimum 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.)
I DO wish to waive the 15' setback requirement.
I DO NOT wish to waive the 15' setback requirement.
Cl0,6(2-K
Signature & Date
-DGlu; a KtJfeL , RdiiiitiS nt Name

i
CAPT. ED FLYNP
Piers, Floe
/�
igtt Uiv ✓ 3J /1/�m Boat t
P.O. Box 668
Wrightsville Beact
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