38947D - Hawkins

CAMA/ ❑[SREDGE & FILL
IENERAL PERMIT Previous permit#
New Modification Complete Reissue ❑Partial Reiss a Date previous permit issued
zed by the State of North Carolina, Department of Environment and Na ural Resources
I �Zov
)astal Resources Commission in an area of environmental concern pursuant to 15A NCAC_
T - L ❑Rules attached.
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Name ' s ,Lr4", 'w �s 4 '4 Project Location: County - / tt Hdj .,
/g ss- /jam&/r, /a• Street Address/State Road/Lot#(s)
///�ri y7fr.07 State/T/e" ZIP 7c{'/Daj' /g$5 /L -)6i-,e J/
( # ) 5Q•236,/ Fax#( ) Subdivision
id Agent a"/"#j j,�7, City 11"//Hi, i?or ZIP 2g`/d
D CW uyew hA ❑ES ❑PTS Phone# ( ) -4" River Basin C
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body 4t/4'f/y' (flat A
rt
❑PWS: ❑FC: �A ,yy //��
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�9 / no PNA ,yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body r, //4 &Y y
Project/Activity ("Go-s-,s f/-<., f al
,/e",•--- / / 7%, fr." �� �Cie 7/% /. • -lS � , t �i (Sl /
k)length 6iX 200
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ii 04/ I I
gth _ r-- •_ ,
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/Riprap length t •--_
distance offshore ._,. i —_ -— r �— � _ .-._..
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c distance offshore 'T {
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is yards r + Y'
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not sure yes I I
not sure yes rid : } I _I- } .0 r.. _..
urn: n/a yes 4 ( ! I } : I i I
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ig permit may be required by: Cd • . ❑See note on back regarding River Basin rt
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ar 31 05 12: 56p D & D Hawkins (910) 799-6191 p. 1
R3-27-2004 0E056 MS. ROPNIE H. WILLIAMS 252-4A2-3953 PAGE:2
CERTIFIED MAD, RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER�NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: L`Q`/5 `leAt 4)4 i')S
I � I
Address of Property: t45 fiP k.lrk grj•- �
(I.ot or Street#.Street or Road.City&County)
I hereby certify that I own property adjacent to the above referenced property. The individst
applying for this permit has described to me as shown on the attached drawing the developrnlit
they are proposing. A description or drawing, with dimensions, should be provided with t►a
letter.
()#'' x I have no objections to this proposal. _I have objections to this proposal.
`rI
`�' If you have objections to what is being proposed, please write the Division of Coasail ,
Management, 1367 US 17 South, Elizabeth City, NC, 27109 or call(252)264.3901 within 0
days of receipt of this nodes. No response is considered the same as no objection if you he e
bete notif ed by Certified dot.
WAIVER SECTION -7 Cc, -
}
I understand that a pier,dock,mooring pilings,breakwater.boat house,or IA must be set back
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.
X. I do not wish to waive the 15'setback requirement
n i. . 1 - 15-o5
l�r'y e:ri +cc l!- - ^ o y
Si atur r Date
Pn Marne z ��
R3/ o) 711-
Telephone Number With Area Code

ar 31 05 1.2: 56p D t D Hawkins (910r 799-6191 p. 2
09-2r-2 004 08:56 MS. ROINIE H 1.JILLIRMS 252-482-3953 . PAGE:2
li
t
CERTIFIED MAIL RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: w3 tS
Address of Property: S ��-441/02
'
{l� f - Jam- 244o7
(La or Street I. Street or Road.City&County) (�
I hereby certify that I owa property adjacent to the above referenced property. The individael
applying for this permit has described to are as shown on the attached drawing the devcloptntit I
they are proposing. A description or drawing, with dimensions, should be provided with this
gner.
have no objections to this proposal. 1 have objections to this proposal.
If you have objections to what its being proposed, please write the Division of Coaseil
Management, 1367 US 17 South, Elizabeth City, NC, 17909 or call(232)164.3901 within 0
days of receipt of this notice. No response is considered the same as no objection if you hcOe
been notified by Certified Mail.
WAWER SECTION - DCx to\fRz
I understand that a pier,dock,mooring pilings,breakwater,boat house,or lie,must be set back
minimum distance of 15'from my arca of riparian access unless waived by me. (II you wish to
waive the setback,you mist initial the appropriate blank below.)
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
Signature Date •
Cjt,tt G ` ,fr1V '-.--
Pr;nt Name /G _ 7 . g 4
/ V
Telephone Number With.Area Code

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