42895D - Learner

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AMA/ --DREDGE & FILL 1',
3ENERAL PERMIT Previous permit#
New Modification ! 'Complete Reissue Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources /
2oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7/ .c7/V U
imemi it ttached.
t Name/OR, (I7//�, e'V' ' /6/7,-ivto/Z__ Project Location: County kev5(Ai I U(
L y o .44-j MPr f LIA-y S E Street Address/State Road/Lot#(s) t{, Y 3 ? ,
)u 111°0 R f State Ate ZIP 7 81(6/ a 6 Y' rY -Ri�A r si-y Q/
`( )) 53.. '?T3)Fax#( ) Subdivision . � 7,l• L r14G S /w!/1
:ed Agent Cr` k1 145 c City 9a eOR aO 7 I - ZIP
❑CW 10L4 V,,F'f'A ❑ES ❑PTS Phone# ( ) • River Basin L u N
Li OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body k /w 4101/i
❑ PWS: ❑FC: A( �
yes / no PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body f�"
I Project/Activity ry4,/QS/f E,dhel,,, cnAe,.,f- agC01KLV4-7
(Scale: /
ck)length
i(s) ^('� � ��
ier(s) / V"
ngth
mber
d/Riprap length
distance offshore
u(distance offshore t Sr• P ". c-h
1N.
cannel it, "'!? a 1 6 c) c> ' d cr . 1..) e) --
v
)ic yards
np
se/Boatlift >O AP meN,
1Y�"ulldozing / ; C A-`v(t. --P.,
VEA-Kk41T - 100
e Length /0/
l: 6 4. 3'7
not sure yes no
s: not sure yes o
ium: n/a yes o
yes
kttached: yes no
ng permit may be required by: iggioittSka i( Ca • i See note on back regarding River Basin n

/ \
FAXON W LEARNER& 232
DONNA A LEARNER&
2640 MARINERS WAY / j� 31 615
SOUTHPORT, NC 28461-8512 lo/r /
1
079 lc , $ 16 o
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Edward Jones 5770335 0
PNC BANK,D e AWA'
E Serving Individual Investors Since 187i WILMINGTON,.ELAWA'E
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• 1:03LLOOL5 ?h: L883 ? 12232" 0232

CArGt(An > > / y•7
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: Fib jt to /V Z Z 4-ANT
Address of Property: Z(P 1/0 in a. Y 1)1-e if bl CoT 37
(Lot or Street#, Street or Road) I
(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 the
are p • ,osing. A de:cription or drawing, with dimensions, should be provided with this letter.
r /
I have no objectio
ns to this proposal.
If you have 6 • • ions 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
[ understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must t
;et bck a minimum distance of 15' from my area of riparian access- unless waived by me. (:
V%u wish to waive the setback, you must initial the appropriate blank below.)
1 4 I do wish to waive the 15' setback requirement.
VI do not wish15'to waive the setback requirement.
a_L - (0
;ign Name n D to

!?'l, Fchell
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit:
�A� Az LEA-give-k,
Address of Property: 70 0 A( r WAT 7
(Lot or Street #, Street or Road)
(City and County)
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 proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
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 1
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.)
;ta/Y) I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
6,1,/-.AL,, rALT(4CUO 6/0 5
Sign Name Date