41466D - Grimsley

C:AMA/ DREDGE & FILL N9 4
;ENERAL PERMIT Previous permit#
;New Modification Complete Reissue r '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 NCAC 7Nr )Z do
1 les ttached
:Name /2k ) S. 64 nt5ky -_ Project Location: County eats U/
137c 4'-Lis 6 nifrsy Aft Street Address/State Road/Lot#(s)
rein idOe4 4 state Ne ZIP N4ti3 5;1714
( )_al—ILK Fax#( ) Subdivision
ed Agent A 14 J 101rs'f City ZIP
❑CW LAW L}lPTA Es ❑PTS Phone# ( ) River Basin .141 it)
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body /9iw10 (nat .
❑ PWS: ❑FC: -' el
/9 PNA yes / ® Crit. Hab. yes /6 Closest Maj.Wtr. Body
Project/Activity //i/) 6f/l *71 /A DR lv,'6fi`•.r7 la P✓,
(Scale: /X?
:k)length _
(s) ,4, Me
er(s)
Igth < < J f 0 O
nber / t prima 61c16 `�
I/Riprap length 460 l T(✓
distance offshore O ey;4 /4f'4
K distance offshore Co
annel
is yards
ip
13Y 13 / "
lidozing i ?2$ X 11 1 r
ey;v-1 iv,1 I
Length ' ' K
not sure yes
ti
: not sure yes no / V� S P��
um: n/a yes no .7-reed ft J 4e✓
yes no /J7C 'trill to llhi M
ttached: yes
ig permit may be required by: nft iOr See note on back regarding River Basin ru

:T,01-2004 11:20 From: To:19102703380 P.1/1
L ION OF COASTAL MANAGEMENT
ADJACENT RIPA_RTAN PROP.,,1ZTY OWNER NOTIFICATIQN[WAIVER FORM
Name of Individual Applying For Permit: Pik-)L S. C A r - r
Address of Property: 1?-) 9-5 k< r N G-s
(Lot or Street#, Street or Road) �""•"
P SZ-fk� N C cete
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The i.ndividuf
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.
(-JI P I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coasta
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3901
within 10 days of receipt of this notice. No response is considered the same as no objection is
you have been notified by Certified Mail.
WAIVEk SECNOW
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
set bck a minimum distance of 15' Iron, my area of riparian access- unless waived by me. (if
you wish to waive the setback, you must initial the appropriate blank below.)
COCA)" I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
g. z r ©s
Sign Name ate

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f-01-2004 11:20 From: To:19102703380 P.1/1
DIVISIO OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROP STY OWNER NOT IFICATION/WAWER €Q •M
Name of Individual Applying For Permit: //1'L S. GR//1-t S L t r
Address of Property: /31 s /<ifJ S il ,I DI�G-- t
(Lot or Street#, Street or Road)
-c PSr 7 , NC 2? k/4/3
(City and County)
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.
\Q‘.t.1) I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 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 SE tole
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
set bck a minimum distance 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.
/7
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Si
pia Date

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