42085D - Laviner

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ECAMA/ DREDGE & FILL .{`:1" ;'
;EN ERAL PERMIT Previous permit#
Jew Modification Complete Reissue -Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources /I�1
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7k. 1 7. of
❑Rules attached.
t Name t-7r - L_AVI ►J E (L Project Location: County PG 0he a
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) s \ /E,r I t 6 G b Q- Street Address/State Road/Lot#(s)
,f(L.F G2?`f State(J4- ZIP Zro 4 45" / v✓g ,T 66C D g,
( ) Fax#( ) Subdivision SAIat n y K-1 D&(=-
edAgent City Sung GS-r\{ ZIP Z84i
❑CW 'Ew `FeTA 1 ES PTS Phone# (1_1 )4/")-'72 9')River Basir .APE
❑OEA ❑HHF ❑IH ❑UBA N/A r-
Adj.Wtr. Body �j; ALC, 'fib L.,v
❑PWS: ❑FC:
yes I PNA Cp no Crit.Hab. yes / no Closest Maj.Wtr. Body A.2
Project/Activity L L2 T A L L 8 )( 10 1)D C I(_, w l 4 x / 0 lA/A
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ier(s)
ngth
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1/Riprap length
distance offshore
x distance offshore
cannel \ \lf/
sic yards \ '
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se/Boatlift
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Length S Li ` ti'
oar yes no P LI
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ig permit may be required by: SM L I ` . See note on back regarding River Basin ri
1

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: R onh 49 6411/r v1 eR
Address of Property: ) v,,te4 R,c.y
(Lot or Street#, Street or Road)
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indivic
applying for this permit has described to me as shown on the attached drawing the development t
are proposing. A description or drawing, with dimensions, should be provided with this letter
0 -' I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Cox
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910- 19(
within 10 days of receipt of this notice. No response is considered the same as no objectio
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift musl
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.
Sign Name Date
-� _ AAA

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: RvvvAS' LA-✓, ,4-e/
Address of Property: t ci W k V.-1,_
(Lot or Street#, Street or Road)
6--f-c C't +II 1314Je K
(City and County) 1
I hereby certify that I own property adjacent to the above-referenced property. The indivic
applying for this permit has described to me as shown on the attached drawing the development t
are proposing. A description or drawing, with dimensions, should be provided with this letter
14I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coa:
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-1 Q(o
within 10 days of receipt of this notice. No response is considered the same as no objectio:
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.
. ;r—
I do not wish to waive the 15' setback requirement.
Sign Na is Date
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BAR6AQA (31C,v5 LAv1NER ,t ,
LOT 18 SANDY RIDGE �s
tcwd vF RF c,t1, PENDER C,O., AU. C.

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Pay to the IVCDEI $ /Onier of
bJel reel /1-7"cl
Dollars
State Employees' Credit Union
'11114111111V""""".""'"87urgaw,North Carolina
112
For 2.4 K
I: 253 L 7701491:0860 544 56 230 35 /9
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