41464D - Moubry

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'LAMA/ -i DREDGE & FILL N® 4
WewN E RAL PERMITfi/ Previous permit#
,IModification ,Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina,Department of Environment and Natural Resources U
oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7 // ''�/D U �
[,RGles attached.
:Name L A iv"(ma._ Ai 0 H gR y _ Project Location: County 13/tw 5 LA,i(-K—
ilt( `j7� ' ( I Street Address/State Road/Lot#(s)- J /L( S7((
4/de„, 1-1 StateNe ZIP D K /4,„„)—
( ) yU --7/1/L Fax#( ) Subdivision (� ram,
.d Agent / City 1-4o/JJ� &at W _ ZIP Ja 7'
�CW PEW Q�A ❑ES -1 PTS Phone# ( ) River Basin Lfih.h
❑OEA ❑HHF ❑IH -UBA N/A
❑ PWS: ❑FC: Adj.Wtr. Body Sw S A !S� C /La/L &)/n
ies m es PNA / no Crit.Hab. yes / no
Closest Maj.Wtr. Body /r' W
Project/Activity
a (Scale:/r` 3
k)length 3 ' Y/(o j
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ar(s) 3 !` D'
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igth I,
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fiber f -__
/Riprap lengthe -,,,_---------
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distance offshore
c distance offshore r / l(
annel ,) Sf-. l C
is yards_
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oatlift f�s,P3
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Ildozing t ± 4 y
po4 y "X/b g 3
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Length ,,00 f=i. f/L
not sure yes "®� J
not sure yes 60� 11 ` r, ,
am: n/a yes 49) ! r f r d
yes ecached: yes
,
g permit may be required by: /-4410e1. 6eAC(' . See note on back regarding River Basin ru
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J1.114-01—O&M Ms C`r rrOm
Ana,MANNT
B1P DIYI PROPER y O O jC '1JI
sn3A�N7 ti}�jA� ATIQAI��
Name of Individual Applying For Permit)
Address of Property:..11
(Lot or Street M,Street or Rood)
(City and County)
I hereby certify that I own property adjacent to the above►referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development they
are proposing. A dese;iptior. or drawing,with dimensions,should he provided with this letter.
I have no objections to this proposal.
If you have objections to what Is being proposed, ple se write the Division of Coastal
HJtanagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910.395.3900
within 10 days of receipt of this notice. No response is considered the same as no objection if
you have been notined by Certified Mall.
WAIVER SECTION
I understand that a pier,dock,mooring pilings,breai•w tar,boat house or boat lift must be set
bcl:a minimuw distance of 15'from my area of riparian access•unless waived by me, (If you
wish to wniv a setback,you must initial the appropriate blank below.)
\ I do wish to waive the I.5'setback requirement,
I ealigt wish to waive the 15' setback requirement.
16MA\ Q1J
Slga Name '`` Date
3 \ hACrGc . r
Print Noma �a,R
1 ' hr. NC dra •

36/26/2005 •23:34 7045229004 5PEGTRLM ram nt
)6/25/2006 18:57 FAX [phone] UNITED TRANSPORT �001
*AA '1. a •. _ 71,.1c!�1
I. _ ♦� t. . . • t • ge,AZ14. • 4111.1 *0v..6... • i
MOS of Individual Applying For Permit Lrx i)IP.,1
Ararat of P►vpeRy:
(Lot or Strew S,Street tat Reed)
4(1 cdC—
(Cill/end Comm)
I hereby testi*toot I owe propaty adacent to the ebove•refeceneed property. The Individual
epplyhts for this perntlt hat described to me es ehowp On me oodalted drawing die development they
propoti:aP. A descripuoa or drawing,with dimensions,should be provided with this letter.
__AL I have no ob eetlism to this proposat.
If you bate ebjeedoes to what Il NMI praposed, Ids writ. the Division of Coastal
htasgenr%127 Cardiwal Drive Extension,Wiltalsvos,NC 25405 or call 910493-)I0O
within 10 dew of receipt of this ttatite, No reepowe Is awelder•d be same oo no objection if
you have Wee potltled by Certified MaIL
WAIVER SECTION
1 aedereteed!bat a pier,dock,mooring pains,breakwater,boat house or boat tilt mast be set
bet:a i,dalenuea dbnance oral from my area of riparian seals•soles wowed Q;►me. (area
wish to waive e setback,you must initial the upprapriste Meek below.)
I d0 wisb to waive the IS sstWok rogwtrwaeet,
•
COI with to waive the 15'setback requirement.
Sip Now
?dra Name
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BRANCH BANKING AND TRUST COMPANY BANKING
SUPPLY,NORTH CAROLINA
1:053 /01 1 2 LI: 5 1965 203 27100 15 13 9 "
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