40354D - Montogomery

':CAMA/ DREDGE & FILL -
ENERAL PERMIT Previous permit#
"New _Modification JComplete 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 I 5A NCAC 7// /M O/ 71/ /2000
I ❑Rules attached.
t Name RQ/t2'7 nNO�t/�"�Q/11- 2 y Project Location: County Q(li(/$Gt.)i G.�
3kf SI 0�f L 21 DFre. 4LA) ( Street Address/State Road/Lot#(s)
f 4714e(,O S State a ZIP 2idai ,KLz Yrq -T W4 7C�/ th
(7O1()M i i0 Fax#( ) Subdivision �
ed Agent f p /o/Ieii 60-v74c'r, 'RI-5 0-!v5/O City 110/. )64J 8SACtf ZIP 2g.
�Cw Ca,6N LKPTA lk5 ❑PTS Phone# ( ) River Basin L t
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body /-1(ww j` `71 /r
❑ PWS: ❑FC: /Ifs, / \ 6- .r
/ no PNA Closest Maj.Wtr. Body �/ !�-�
yesyes / no Crit.Hab. yes / no
Project/Activity pro P45e.0 f"(/2. to 7f/ /2 X/2` ,(� M 47ErQ ., �S'k '� 7 v,/4'' 9 , 4,61,
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I�Riprap length ,7 ( /5' /Z PcA-rFm IAA
distance offshore i/ AA ,, �'
K distance offshore /./ i'V_ brtakq
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is yards hit,i
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: not sure yes 6401,- e-0 / .7 t Fri9PoSe_9 ) w.
gym: n/a yes LO f 13U tie E)C — f
yes n ' r✓IOtirt beA4d c( I pi AA y to -4^4
ttached: yes n
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g permit may be required by: j.1,,(I/v6,gC D4 See note on back regarding River Basin ru

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07 05 09: 16p Greg Holden 8429806 p. 1
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PRO ZRTY, OWNZR NQTIFICATION/WIVER. FORM!
. Name Of Individual Applying For Permit: ?o 7 T/"Z./TZ,GvNeV
Address"Oi;' Property: /e.2 44-46r I''4Arcd
?7 .& r /Ta:1 cri,
(Lot 'or Street #, Street or Road, City & 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 description or drawing, with dimensions,
should be provided with this letter-_
I have no objections to this proposal.
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If you have objections to what is being proposed. please write the
Division of Coastal M n,aoement, 127 card,inaj. Drive- Extension.
Wilmi_noton. lTortt Carolina. 28405 or call 91.0 395-3900 within 10
days of receipt of this notice, No response is considered the same
as no opiection if you have,been notified by Certified Mail
W ,Zvt;x SECTION
T understand that a pier, dock, mooring pilings, breakwater, boat
house, lift must be set back a minimum distance of 15'
from my area of riparian access unless waived by me_ (If you wish
to waive the setback, you Dust initial the appropriate blank
below-)
l do wish to waive the 15/setback requirement.
I do pot wish to waive the 15'setback requirement.

1. 07 05 09: 1Gp Greg Holden 842980G p. 2
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07 05 09: 16p Greg Holden 8429806 p. 3
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