43220D - Bradshaw

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'CAMA/ DREDGE & FILL
;ENERAL 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 'l
:oastal Resources Commission in an area of environmental cppcern pursuant to I 5A NCAC 7/ , .7 7„2t
''//"� f� f� /e /tits H7t/f DrRules attached.
:Name Jdl`f N/4 K S A tJ '�M4v.".a� 1 Project Location: County /,irig/
2 (J r ,44/f � 4 . J Street Address/State Road/Lot#(s)
'el, State . 16-ZIP zfe// /,te-
( 7 l)6g6—C 'f 'Fax#( ) Subdivision
ed Agent City ZIP
❑CW E EW `ETA 1 •ES ❑PTS Phone# ( - ) River Basin
❑OEA ❑HHF ❑IH ❑UBA ❑N/A /
❑PWS: ❑FC: Adj.Wtr. Body 111/A14') (nat,411
yes / o PNA yes / r6 Grit. Hab. yes / o� Closest Maj.Wtr. Body
P/roject/Activity �O�'101,,,,,, ��G`T .1S �d "eon bdG f�,�/t i!r 4,...�r
G� " k?� fin /HITS C r'Olivl P.,' AT 44+41,--' (Scale: /A—
:k)length
(s)
er(s)
igth
nber ,
I/Riprap length
distance offshore
K distance offshore
annel - - --
is yards 73 0 (
ip
;e/Boatlift 1 pt1100-e t
#14 r9fPi' I
illdozing
Length bi-
not sure yes (19
f 4,nd
not sure yes n
urn: n/a yes
yes
ttached: yes n .
ig permit may be required by: __ See note on back regarding River Basin rL
- - - - -- - / i. // . _ i _ D ! , Z

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: 5G pJ,�,-rt �, Aem/,t//4
Address of Property: 2<70 S c;oJ FL u
(Lot or Street #, Street or Road) 1/
ILA L. I u L. Lg`f F ( 1)(1...s # -
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individu
applying for this permit has described to me as shown on the attached drawing the development thf
are proposing. A description or drawing, with dimensions, should be provided with this letter.
X I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coast
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-39(
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
•
I understand that a pier. dock, mooring pilings,breakwater, boat house or boat lift must be s
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If y(
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.
az. ,(
Ia- 5 0
Sign Name D to

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: . Cam" S A4 Z_L- 1144
Address of Property: 2 <-7 6 s� h`-L. 2, £</
(Lot or Street #, Street or Road)
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individi
applying for this permit has described to me as shown on the attached drawing the development tl
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coas
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-393-39
within 10 days of receipt of this notice. No response is considered the same as no objectior
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
bck a minimum distance of 15' from my area of riparian access -unless waived by me. (If y
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.
Sign Nail( Date

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