42833D - Generation

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7C MA/ DREDGE & FILL
3MIERAL PERMIT
Previous permit#
Kew Modification ❑Complete Reissue ! Partial Reissue Date previous permit issued
rized by the State of North Carolina,Department of Environment and Natural Resources ^� /��d
2oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC f ,
IPICucs attached.
it Nam p,/Per/71i .,/ ,E..i' Cc/O�' Project Location: County
i3 Z 7,9 21 e f d..' D 2 . Street Address/State Road/Lot#(s)[.I; /
941 2id, 4 State A/C ZIP Z 73/4 3; Cr/tit 14 te4) 51
( ax#( ) Subdivision
:ed Agent l2 ACy cga eh 02 City Cc P,p,./ r-J t 8do ,4j ZIP 2 pyd
❑CW ,or- y•PTA dlS" ❑PTS Phone# ( ) - River Basin Cd/iy,
❑OEA ❑HHF E IH ❑UBA ❑N/A Adj.Wtr. Body CAI/91 d lq 6/ 41/G.) (nat,(
❑PWS: ❑FC: �j
yes / o PNA Closest Maj.Wtr. Body-
yes / o Grit. Hab. yes / no
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ier(s)
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ngth
tuber
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x distance offshore
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attached: es no 3 5 Lit)Li, ,4 N2_,
ig permit may be required by: Qrp,c:r/ IS/e ReR c A . See note on back regarding River Basin rt
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: 2 �
Address of Property: 7/ j/ G fr/ei
(Lot or Street #, Street or Road)
A)-'9g1 S.e:1/1",3e
(City and County)
I hereby certify that I own property adjacent to the above-referencecLproperty. The indivi
applying for this permit has described to me as shown on the attached drawing the development
are proposing. A description or drawing, with dimensions, should be provided with this lette
471 I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Cos
Management,. 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-2.
within 10 days of receipt of this notice. No response is considered the same as no objectic
you have been notified by Certified Mail. :ft4
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mus
set bck a minimum distance of 15' from my area of riparian access - unless waived by me.
you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement. 1 D I rpm, s rpc0
I do not wish to waive the 15' setback requirement.
ea,fek/ra t/GZ z d.+"
sign Name Date
-�Qr;69ra /a rve// A'EA

TRA-COM SERVICES � Et��°i'� .� -1 Ic, 1 C515 q 4-M
P.O. Box'1365 4A bL�
Shallotte, NC 28459 0�� ��
110
fl
i31 -1 r7
04/44 ?eviCei4 1 I "gat'te.:0 [Z)i' I
r I
�1CNbr
'Dec le_ 1131

• DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: �' i✓��� ip 4P,'/0&;es
Address of Property: bet:o,Att&2 - /..e3T eC
(Lot or Street #, Street or Road)
8ertc-/ &/(4exct-tes'
(City and County)
I hereby certify that I own property adjacent to the above-referenced_property. The indivi
applying for this permit has described to me as shown on the attached drawing the development
are proposing. A description or drawing, with dimensions, should be provided with this lette
Pe-- I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Cox
Management,. 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395
within 10 days of receipt of this notice. No response is considered the same as no objectic
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mus
set bck a minimum distance of 15' from my area of riparian access - unless waived by me.
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.
/.- 7-6
Sign Name Date
L /lEitfLE Cr i� /t/s Al �