39730D - Lucas

,'CAMA/ ❑DREDGE & FILL
3EN E RAL PERMIT Previous permit#
1NewModification Complete Reissue EPartial 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 i�'// Z)`�
QQ L`TRu1 attached.
t Name J�TT 'y Amy L,tt CG�j Project Location: County /�..Q/7 141-"''
60 I I T(G�i e o kpoi Street Add ress/State Road/Lot#(s)
7n,too 4eAA State ZIP Z' 3 /,/�
) & 5Cp -OM° Fax#( ) Subdivision
:ed Agent City ZIP
❑CW Z.EW ,n.PTA ,p ES ❑PTS Phone# ( ) River Basin
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
❑PWS: ❑FC: Adj.Wtr. Body ��� �r«� (nat d
yes / no PNA yes /6f 2 Crit.Hab. yes KAo '
Closest Maj.Wtr. Body �� �
r Project/Activity . .f✓ Gdi,/ij I - APa't v- S, ,4 p4 4,-fe-t--
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(Scale: I
ck)length C 3
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1(s) it)( /4' ;ier(s) i j
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ngth f I I
mbar }
d/Riprap length i ......; � _ _ l ' _... �� __.-__--
distance offshore ' _
ix distance offshore { �' " {.* �..__ L_ .......__ ( _ . . ._ ......
i
cannel !"±:{ '1 q r i
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sic yards I
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np �t-_.—"�'1o_--- - '^-l—! ..4 _- --_L.4.--
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'se/Boatlift • r
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er I !� I
ulldozing 54 tjek ! I /.
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1 ii___"44,....:,,,e4,7_ i _ve_tj ,
e Length ,/31 ( _ /i 1 t,1 1-1t.ife51 ieo...ii I L
not sure yes o
s: not sure yes o i .+ -- — i
wm' n/a yes no + :� i _ ,
yes o _ i ! +—,..—_ ._{_ .. _....
\ttached: yes 11 t t
ng permit may be required by: 4/710, /;:,, ❑See note on back regarding River Basin ri
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GENERAL PERMIT coivreurER FORM
y Lucy
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ACTION ECPaATIO
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CA-M-?MAJOR DE:v-?REQUTIZ=:

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: Gt/A_Ca ,r, a,
Address of Property: (:s I 1 141)(r J4 ES 12-041-0
(Lot or Street#, Street or Road)
fli P AI D E(1_
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individu
applying for this permit has described to me as shown on the attached drawing the development till
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have o jections to what is being proposed, please write the Division of Coast
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-39(
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 be si
bck a minimum distance of 15' from my area of riparian access-unless waived by me. (If yo
wish to waiv 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.
an ame Da
t\) n .��A

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: f1L% �� 1m,,.„
Address of Property: (CII Hu HA-Es k o po
(Lot or Street #, Street or Road)
V\AolesITAo . Faio
(City and County) i
I hereby certify that I own property adjacent to the above-referenced property. The individi
applying for this permit has described to me as shown on the attached drawing the development th
are proposin
Avl escription or drawing, with dimensions, should be provided with this letter.
�'<"'shave no objections to this proposal.
P P
If you have objections to what is being proposed, please write the Division of Coasi
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-39'
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 be s
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (Ify(
wish to waive the setback, you must initial the appropriate blank below.)
X/1/t.) £41,4,_A do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
�liLi JL 6, /2, " /6 0 l
Sign Name Date
OU'fac_k P6Ntlamin/

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WACHOVIA.
Wachovia Bank,N.A.
wachovia.com
for
4/9 3g iao
i:o5 3 /016 261: 10100 254697700 13 3 L
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