42053D - Lewis

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CAMA / I DREDGE & FILL N9 LI:
;ENERAL PERMIT Previous permit#
t w 'Modification !Complete Reissue -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 15A NCAC 7 NO
ule attached..
:Name �jr/�gn yi Lee/Ji3 Project Location: County �jr ','�G i�,
'C' etJ,6 6 Street Address/State Road/Lot#(s)
/ o
7,toNl/0�A/t State,l� ZIP 22 //4'3 _ �/y1L.,
(?/O) — Fax#( ) Subdivision
ad Agent City ZIP
Cw L A 't< ❑PTS Phone# ( ) River Basin 440/
OEA ❑HHF ❑IH ❑UBA ❑N/A II
PWS: ❑FC: Adj.Wtr. Body /1W4Ay �� (nat t
ye ,'/ no PNA yes /� Crit.Hab. yes /aio Closest Maj.Wtr. Body �iC�4
--
Project/Activity 14;Q"0 5 B1 fre✓ 1- Z 46 4 ri oel /Z 744,Iier s
��y (Scale:/d:
J %
IC:k)length 4 X '
er(s) 711 W&
igth
nber
I/Riprap length I
distance offshore
K distance offshore
annel `' ._._____
T
is yards .
ip
ie/Boatlift
Ildozing I t <
�sde' 53(2.0
fz'
I t — r/0 —4
Length !/O
not sure yes not sure yes ( j Z•nCl)/ '7 N
urn: n/a yes
yes
ttached: yes iii
�
ig permit may be required by: An IP CO, . See note on back regarding River Basin ru

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER _NOTIFICATION/wAIV B- POI
Name Of Individual Applying For Permit:
Address Of Property: ,�j f' 1 ' "
3--g 7 C f U
(Lot or Street I, Street or Road, City & Cc
I hereby certify ' that I own property adjacent to the
referenced property. The individual applying for this perm]
described to me as shown on the attached drawing the develc
they are proposing. A description or drawing, with dimens
should be provided with this letter.
I have no objections to this proposal
If you eve objections to what is being proposed, please writ
pivision of Coastal Manaaementl 127 Cardinal Drive Exter
Wilmington. North Carolina , 28405 or call 910 395-3900 with
days of receipt of this notice. No response is considered the
as no objection if you have been notified by Certified Mail
WAIVER §ECTIQN
I understand that a pier, dock, mooring pilings, breakwater,
house, lift or sandbags must be set back a minimum distance c
from my area of riparian access unless waived by me. (If yoti
to waive the setback, you rust initial the appropriate
below. )
I do wish to waive the 15'setback requirement
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NQTIEICAT19N/WaiINIR- FOR
Name Of Individual Applying For Permit:
'
Address Of Property: (6IY
Q AritIZA04
(Lot or Street 0, Street or Road, City fi Co
I hereby certify ' that I own property adjacent to the a
referenced property. The individual applying for this permi
described to me as shown on the attached drawing the develo
they are proposing. A description or drawing, with dimens
should be provided with this letter. .
I have no objections to this proposal
If yog _have object one to what is being pr000sed , please writ
Division of Coastal Management. 127 CardiDA Drive Exten
Wi minc 011. _North, Carolina. 2J4O5 or .4ll 910 395-3900 with
days of receipt of this notice. No response is considered the
As no objection if you have beer_ notified by Certified Mail
WAIVER wTION
I understand that a pier, dock, mooring pilings, breakwater,
house, lift or sandbags must be set back a minimum distance o
from my area of riparian access unless waived by me. (If you
to waive the setback, you must initial the appropriate
below. )
90i do wish to waive the 25'setback requirement.
-

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G►coio Lewis

II GLENN LEWIS 2668
PH.270-2542
IE HAMPSTEAD, NC 28443 Date / 66-30/531
365
Pay to the I $ OG' OO w
a Or�dq'e�r of �, � ,
(//�Pi / /�G Dollars 8 0...,.....'
I
FIRST CITIZENS 365
. ICFirst-C,,zans bank 8 Trust Company
Hampstead,N C.28443
.pFS� IIE.CgII • '
For j, ,,,, +�' "°
':053 L003001:000000 L45 L5511' 0 2668 '
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WClarke Rmeriron
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