42021D - Johnson

AMA/ DREDGE & FILL l �'
j IP 1 r n
3ENERAL PERMIT Previous permit#
Dlew _Modification Complete Reissue Partial Reissue Date previous permit issued
,rized by the State of North Carolina,Department of Environment and Natural Resources:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC ~• / H. I L-0,_:'
D
zirRules attached.
it Name 1 p iJ'- �oH t.>S�r✓ Project Location: County 15 LAt..----)
-1 0 2 3 f 4 . ) Street Address/State Road/Lot#(s)
0‘n*t f G,L-`1 State 0 C- ZIP 2$q`4 oZ s --111-+ s /
( ) Fax#( ) Subdivision 01._ SST LE.4.5 iSE+Q
ted Agent l i 9-_3iYItz PA A(LS Ni S City' ,-./ 4. tfri ZIP z-a y
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A E ES ❑PTS Phone# ( ) River Basin
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❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body 0,4 U L 15.1% '^''Q So 1^"di(nat l
❑ PWS: ❑FC:
yes /(', PNA yes / t• Crit.Hab. yes / no Closest Maj.Wtr. Body 1 ��J
,
f Project/Activity J t--i. AL . j LL � 1. F T I Z �[ /Zt
(Scale: 1 =i
)ck)length
n(s)
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ingth .-- _ Ci-\,,kii-AL.....amb
er �- ... . ..
id/Riprap length
g distance offshore
ax distance offshore
hannel
ibic yards E.'..' %
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usc�Boatliftt ' 7
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tulldozing di ....---~
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ie Length Ss / I. 6I.IL k t4p p
yes no
;s: not sure yes e
rium: n/a yes •tiD
yes �io
Attached: yes tiT+��
ing permit may be required by: S' c c La 7 See note on back regarding River Basin r

DIVISION OF COASTAL MANAGEMENT \)0
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: TO()nU L . n sQ r
Address of Property: 7c 3 7e - J
(Lot or Street #, Street or Road)
&:6tA n nisk6d
(City and C unty)
I hereby certify that I own property adjacent to the above-referenced property. The individ
applying for this permit has described to me as shown on the attached drawing the development tl
are proposing. A description or drawing, with dimensions, should be provided with this letter.
�-O I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coas
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910- 1c16+--
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
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.
- Az4 I7- 0
Sign Name Date
i,J.a lit cr4 C r Ac%

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: DO n nyJ L ,Tp kr or
Address of Property: '7O 3
(Lot or Street #, Street or Road)
6 LA-4 Cil--); )ne" ) ,DnsloiA) C_o ,
(City and Co y)
I hereby certify that I own property adjacent to the above-referenced property. The individ
applying for this permit has described to me as shown on the attached drawing the development tI
are proposing. A description or drawing, with dimensions, should be provided with this letter.
,_,CI have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coas
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910--7 c -"
within 10 days of receipt of this notice. No response is considered the same as no objectioi
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must
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.
E.,..V, A,,..a._ \
6—/Ae2r
Sign ame Date
l..keic lAc T '►10 :.Ai; 4 %

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