42064D - Floyd

CAMA/ 'DREDGE & FILL /)0
1W° L
;EN E__RAL 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 )1T• I I O
Rules attached.
:Name C (It a Noy i"" Project Location: County 0 NA-)L.(..J
Z'Z G-►lA2LE5 La_eak Street Address/State Road/Lot#(s)
ie. F C 9A- State 0L ZIP 2.. Li iC) 7 . C4A¢.Lts 62 GCS 12�
( ) Fax#( ) Subdivision
BdAgent A,,,,Tr N o0.T IV\AeI.JF L-05I city Sn)t►l.m r`_.22y _ ZIP agLiC
❑CW ❑EW ❑PTA VS PTS Phone# ( ) River Basin VY 1kTTE
❑OEA ❑HHF ❑IH ❑UBA ❑N/A �
Adj.Wtr. Body 0J�1 NULL Gy Litz a l'- 44/r
❑PWS: ❑FC: /
no yes / PNA @/ no Crit. Hab. yes / no Closest Maj.Wtr. Body AT Nl 'Y
Ole:QLIBC.} ,
Project/Activity -1—ki5t'A1 L, +{Li O . 1- 15N LIL N D "Z,� 1 rJb CJo9.ri fa
j L- J11S (.E)C5 1--Ai (,- ls( 1 LILI-4L 1,ep (1)rit„)_m+j7—A T ; 't •- \ (Scale: I ": ,
:k)length JJJ___
(S) Al C.Am A 57.411—t S Th
er(s) _
igth QL Yyl 1a T h, L' r..`►"T L 76 a -f-S
nber
C..DmPrr6rg
I/Riprap length I leO
distance offshore
K distance offshore
annel —
iic yards
ip _
se/Boatlift
Cx `58 51A
illdozing
nA ..
I' \Length j 1 I ' F V
`INt sure yes no ,
o. J
not su yes t
urn: n/a yes �i
yes
1ttached: yes ® -__.—
1g permit may be required by: 0fJ' L�.J Gp..• ./ ry See note on back regarding River Basin n

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
me of Individual Applying For Permit C A 2 4 FL-0 y
ECEIVE
dress of Property: 2 0 /f E-5 c c E
(Lot or Street#, Street or Road) 2005
DIVISION OF
5 h(E-f4 S FC=ttu--•r C . ZQ' dAL MANAGFMENT
(City and County)
reby certify that I own property adjacent to the above-referenced property. The individual
lying for this permit has described to me as shown on the attached drawing the development they
proposing. A description or drawing,with dimensions, should be provided with this letter.
I have no objections to this proposal.
'ou have objections to what is being proposed, please write the Division of Coastal
nagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
vn 10 days of receipt of this notice. No response is considered-the same as no objection if
have been notified by Certified Mail.
WAIVER SECTION
derstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
ick a minimum distance of 15'from my area of riparian access-unless waived by me. (If
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.
21
Name % ` Date
n AA .�_•

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