41600D - Bumgardner

V Oter •
(CAMA/ - DREDGE & FILL ADO 4
aENERAL 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 I SA NCAe -1 i-1. 1 tiQQ
Rules attached.
t Name �LC I ,..--r, A(L. J r Project Location: County 00 4,L-.Th✓
III- WI Z 1 O Street Address/State Road/Lot#(s)
^-Abs g a.t.y State ► 4-- ZIP 2,3-1 . 2_..43-) NA)4PCT t✓&..-) Al 1�
( ) Fax#( ) Subdivision
edAgent City SiDc.AOS FJa. L4 ZIP L3N(0
❑Cw &W [PTA ❑ES E PTS Phone# ( ) River Basin NtlitZTL
❑OEA ❑HHF (IIH ❑UBA ❑N/A
Adj.Wtr. Body .N/YV (nat•
❑ PWS: ❑FC:
es Crit.Hab. yes / no Closest Maj.Wtr. Body 5 i v► rYN P ' A Z %.)
no PNA yes /C
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:k)length(,., X 2..L/
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er(s) t X �I 9 S W Y V
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nber
I/Riprap length
distance offshore I 5'
x distance offshore ---~ q '
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urn: n/a yes "RiV0
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ttached: yes ,-t.®
ig permit may be required by: 0 IJS L J c.-/ Ga ✓i1 1 . See note on back regarding River Basin rt

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PILINGS AND MORE
JOHN CASSIDY 3871
PH: [phone]
107 KATHY ST Date C�`f�/ -1 66-30/531
SNEADS FERRY,NC 28460457
8 order oe / I $:/b 0 ,G
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0�C '� '��`� � J Dollars 8
eFIRST CITIZENS 457
BAD/�NK Firt t®rrs Banc 8 Trust Company
1` Srwads Farry,N.C.28160
For `, wwwG`�/''rs >ls.comfu'd /. FA.--- -----
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t1:053L003001:00457L3270 306 03137L
• oClarke a....nan WI/CC
•

I pYzsxoN or COASTAL mammals=
$DJAC11T RIP,RIAN PROP ARTY OWNER NOIEFICATIOl f WAS F
gym
Name Of Individu41 Applying For Permit : ,li �J���/_/f�
G7".�y'
Address Of Prope*ty: ° / ����� At/ c
ab ) J,^' -11 if.sY /y r, 79 yy,
(Lot or Street #, Street or Road, City & County)
I hereby certif that I own property adjacent to the above-
referenced grope ty. The individual applying for this permit has
described to me a shown on the attached drawing the development
they are proposi g. A description or drawing, with dimensions
should be provi d with this letter.
I
(:i----) I haNte no objections to this proposal .
If you eve Qbj - •
ions to what is being proposed: please write th
Division of Manaaement- 127 Cardinal Drive Extension,
W 11ui aton. : • caLplina, 2,§405 or call 910 195-3900 within 1
days of jeceipt •. Chip not i.ce. No _response is considered the sam
j pp ob j ect icW f .;,voti jaave been not i.f ied by Ce:rt i f jed _Mail
, -', ..
L
.,
IGLIVillt @$poi
I understand that a pier, dock, mooring pilings, breakwater, boa
house, lift or egs must be set back a minimum distance of 1!
from my area of riparian access unless waived by me . (If you wi:
to waive the seltback, you must initial the appropriate blar
below. )
I Ito wish to waive the 15' setback requirement .
I do'Lnot wish to waive the 15' setback requirement .
i
1(kOSNs:
n ematur� w w _ .. Date `�Cn

1-11JJI`il,GIN 1 rurtirufuv rKUrLK I Y U W NtK N O 1 IFTCATION/WAIVER FORM
Name of Individual Applying For Permit: 4/C1C 5,., r ch t pr ,
407
Address of Property: y
(Lot or Street #, eet or Road)
itOl�., c gIy`O
(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 the
are proposing. A description or drawing, with dimensions, should be provided with this letter.
.7 .21 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 910-395-390
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
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WAIVER SECTION
[understand that a pier, dock, mooring pilings,breakwater, boat house or boat lift must be s(
)ck a minimum distance of 15' from my area of riparian access -unless waived by me. (If yo
vish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
• .21Y3'i I do not wish to waive the 15' setback requirement.
441
►ign Name Date
'rint Name
AVM
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