42852D - Hertzberg

tc,AMA / DREDGE & FILL `Ne" r
3ENERAL PERMIT Previous permit#
Blew Modification iComplete Reissue -Partial Reissue Date previous permit issued
rized by the State of North Carolina,Department of Environment and Natural Resources
2oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC --) H . 2 0—
Rules attached.
t Name(i i c+ld AL 1-\-k 4,-1 Z„(fir ItCr Project Location: County()„,Lp L.J
.S(.ZO Lqr• 66-1-+1 Street ress/State Road/Lot#(s)
-71-11-Sb i> StateMb ZIP 1081 k) Sa al Lin&Vi
( ) Fax#( ) Subdivision p _IdS L ta N 1)
ed Agent City�• j o L �jr.yac H ZIP
cw ,4w TA ES -PTS Phone# ( River Basin
OEA HHR ,:f]ikl UBA 1 N/A Adj.Wtr. Body ,'4LLZ(7 A'TJ),- 131I y I
PWS:
` ,_ ❑FC:
yes no PNA ` no Crit. Hab. yes / no Closest Maj.Wtr. Body A-1 14/11✓
'Project/Activity 1.t J A IL ir X Z$ .. 1)1 C. sC L)/ 1 t x Ito ` - HE__ D
Z.X I Z, L + (Scale: I ��= y
:k)length (O X z.Y+$
(s) 1 2A I - (mot-17i-v l 0 lg. 9-1-11 —
ier(s)
ngth e
nber
i/Riprap length •
���
;distance offshore
x distance offshore
annel
iic yards
ip
IZy1Z ��,
illdozing
Length �. 11 ,1 t/ lI
not sur yes no N Oki
•
not sure yes qQ p
urn: n/a yes tZ, L I
?Yes fP
,ttached: yes ____._.__ _
ig permit may be required by: N..-\''pQ 3 11 \-7e -\\ See note on back regarding River Basin ri

MICHAEL A. HERTZBERG 7837
PATRICIA O. HERTZBERG
5620 LAMBETH RD. Date9/z t3/ c D t5-3/54o
BETHESDA,MD 20814 t400s
Pay to the A)
Order of C� /]�/ �C)
(�c — Dollars 8
6-6
RIGGS Riggs Bank N.A. `g
www.riggsbank.com J �j , Lip 4)
for -k �-/1t9� kJ'7Tv(l-�fi'\ �a -- —
! , 1 �
1.0 5 40000 30I. L54524720 7837

O
S kn
\);,Ficc
: •
S, bX > ri <
(
Pei
.A0C).0 0} no\ 7 --}D)---\

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIANPROPERTY OWNER NOTIFICATION/WAIVER FOR/
(�e Por--+ry 5
Name of Individual Applying For Permit M I r:na.P. et �kz�e�c� +- _Oatmc 0
Address of Property: 3z1 Say kv 1/4-Cw OR\rc
(Lot or Street#, Street or Road)
N�`�-H►s c, k Rtaci.,, C. s R-,,-
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indi
applying for this permit has described to me as shown on the attached drawing the developme
are proposing. A description or drawing,with dimensions, should be provided with this le
I have no objections to this proposal
If you have objections to what is being proposed, please write the Division of C
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-391
within 10 days of receipt of this notice. No response Is considered-the same as no objec
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a-pier,dock,mooring paings,breakwater,boat house or boat lift mi
set bck a minimum distance of 15'from my area of riparian access-unless waived by m
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.
•
s�g�Name'

• ' :: ' a ; ., j ,I, . ,ir /Ai' •,
• 1 .• ' 1 ifir . . , , , .. _ . ..
,` ; _`.. •• _ •t . . • r „
- ..=',A-.- . . . • : I.
I Ci, s M! js1r,oo1C**Osaq Oi', 4 •-
, 'i s ie!!nu!+ -is? nictlikaptiritteiltatog
�,�,r�,,�s p totioll
i'POW' • .•
.`. fgo.°°r0'° r :! 'm , • 111 :,
�' _• "
ap
' us d,2 0a : , •
r. 'a b
.. - . POI ) :. . •
•
7. .ry .t -i T :.e e Ir
t r`..:r'e ;e i�" at'.i 4 =_- r r, ro,- • r..-sE •F ••�a - i, . r. !r.• asc_ . -Fu. •••• ,. ,,
' ;•::.,: -.:sin . t4ri.:%6Ang:::..�_:.I' z� L,441.0zt.9.,.z:.:44, �'.
: •,..E ry•�:.�)9ti1 'ONIL.. ::.; - . 1� Nan1s-,\3:�M0H- VdZti S.UU 9Z d3S .•