40420D - Jordan

.LAMA/ DREDGE & FILL N9 4
3ENERAL PERMIT Previous permit#
New .Modification - Complete Reissue _Partial Reissue Date previous permit issued
sized by the State of North Carolina,Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to I5A NCAC 17 i14 . 1 1 00 , -) j-4 • I Z-
/ E Rules attached.
t Name 4 L- rJ .
b J o„c.IN A IQ Project Location: County flt.).sLo.o m/
(o I LC) 61." S-T— Street Address/State Road/Lot#(s)
4 Q,F GIT`-1 StateP L ZIP 13'455-- bI lo Gar"‘ 4,1- .
(91 a )31-1- 34 1 s Fax#( ) Subdivision
ed Agent ST E✓C A WI L ti°R2 City 5NQ.G —iT -( ZIP LA b y
❑CW 'MEW $PTA tilIES ❑PTS Phone# (' 1° )311- 3c("7 5 River Basin4/HN G
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body CA,.) A 1--- (nat(j
❑PWS: ❑FC: /
yes no PNA ye / no Crit.Hab. yes / no Closest Maj.Wtr. Body PZ V✓ Vs/
'Project/Activity RE Q L-VLE 5-5.' 0 g u Lk_'E W) ) 10) x 14° Love (LC-3) -E -1L ,
' y. b' V✓Ai_le_v✓A►-' , Le x II' F13J(3iC PI CZ- t•)Pyr To EYI sr;+` (Scale: I';NC
:k)length 1'ICI' X 0 gO VT e-ta "
(s) 1 Li' X ("La
ier(s) L ' x 15°'
ngth •
/ in �..—
1/Riprap length cS' ,
distance offshore 0' I Z-1 s I
x distance offshore 0' j,.- /
lannel
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>ic yards T T�(.T �40
se/Boatlift coo . T
P < (47e r
illdozing C0
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a Length illOr I 4"5'
not sure yes L(
not sure yes Q. Nr ,�, 1'
urn: n/a 61/3,ituP goA* 2A,r
yes ty$
xtached: ye no y
ig permit may be required by: S N Q.r CZ T -/ t See note on back regarding River Basin rt

: COMPLETE THIS SECTION COMPLI.TF THIS SECTION ON DELIVERY
:te items 1,2,and 3.Also complete
if Restricted Delivery is desired, Bliiiir
❑Agent
)ur name and address on the reverse ❑Addressee
we can return the card to you. B. •i ecib (Printe. C. Date of elive
this card to the back of the mailpiece, /I\ C, •
Y CDC 01-
le front if space permits. �� �� A — 'J
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/� Q if YES,enter delivery address below: ElNo
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4. Restricted Delivery?(Extra Fee) ❑ Yes s i c
umber 7004 1,350 0002 2100 8728 r
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1811,August 2001 Domestic Return Receipt 2ACPRI-03-Z-0985 u,r
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-18 05 10:32 FROM:MAC JONES CONSTRUCT. 9199750337 TO:19103273475 PAGE:01
14 04 12: 53p P. 3
DIVISION QF COASTA vjANAGEMENT
ADJACENT RIP} IAN.PROPERTY OWNER NQTIFICATION!WAIVER FORM
une of Individual Applying For Permit: -e-Ne.- �✓
Xas
[dress of Property: W! - S
(Lot or Street#, Street or Road)
v7F--
(City and County)
Hereby certify that I own property adjacent to the above-referenced property. The individual
plying 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.
40X_ J I have no objections to this proposal.
you have objections to what is being proposed, please write the Division of Coastal
anagement, 127 Cardinal Drive Extension, Wilmington, NC 284e5 or call 910-395-3900
thin 10 days of receipt of this notice. No response is considered the same as no objection if
u have been notified by Certified Mail.
WAIVTR SECTION
Inderstand that a pier,dock, mooring pilings, breakwater, boat house or boat lift must be
bek a minimum distance of 15' from my area of riparian access-unless waived by me_ (If
u wish to waive the setback, you must initial the appropriate blank below.)
#1,) I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
0441 J )9,161.7'.
m Name Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NO 1 ItICATION/WAIVER FORM
Line of Individual Applying For Permit: -e i-e_ 1a..)C� 14A4/
ldress of Property: 6Q 1 W S/
(Lot or Street#, Street or Road)
F CiVy .
(City and County)
ereby 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.
t CV� '�� I have no objections to this proposal.
you have objections to what is being proposed, please write the Division of Coastal
Lnagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
hin 10 days of receipt of this notice. No response is considered the same as no objection if
t have been notified by Certified Mail.
WAIVER SECTION
nderstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
bck a minimum distance of 15' from my area of riparian access-unless waived by me. (If
i ' ' h 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.
It f X f fli.E?n,Name D
I ,,