40474D - Martin

LAMA/ DREDGE & FILL
iEN E RAL PERMIT Previous permit#
Jew Modification --Complete Reissue 'Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources ��//
)astal Resources Commission in an area of environmental concern pursuant to I SA NCAC -Ms NOjo Rules attached.
Name 1,74141n Project Location: County Dew IS
2) 9 /t/✓A r Ir. _ Street Address/State Road/Lot#(s)
11.414(JDi I State Ale ZIP 21516 Si/ _
(q/O)279-30Z 7 Fax#( ) Subdivision
;d Agent City ZIP
❑CW £W r 1 TA S G'PTS Phone# ( ) River Basin 6lp /
❑OEA ❑HHF h IH C UBA ❑N/A Adj.Wtr. Body C /4i*✓ //(nat /C
❑ PWS: ❑FC: '�
h
yes / � PNA yes
,,//�9' Crit.Hab. yes / Closest Maj.Wtr. Body Le
Project/Activity Ai 71-0,'n!.l I LV*//
i
(Scale: /
:k)length
(s)ier(s) /
/7 E ei
ngth
-nber
PRiprap length /00
distance offshore
uc distance offshore
cannel
/POf
bic yards
np
Ise/Boatlift
iulldozing_ "'t/ 6r Ili' 1
ie Length
not sure yes
gs: not sure yes
rium: n/a yes
yes
Attached: yes •
ling permit may be required by: SUA lbr7 See note on back regarding River Basin I

JIiVISION OF CO M AN4A EMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIEWATION/WALIVER FORM
Name Of Individual Applying For Permit g/ M Ae
Address Of Property: a 3`/ APsw..e e
. 4/71 ,e7 i✓ $kAc^zs� ,r
(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 tome 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.
Jf you have objections to what is being propczs,M, _please mite the Division of Coastal
Management 127 North Cardinal Drive Wilmingt nn No h C�mii 7 wnc nail "iir 95
1900 within 10 days of rtmipt of this notices. No response is_consideaed the same as no objection
if you have been notified by C ertifiedl Mail
WAIVER SECTION
I understand that a pier,dock, mooring pilings, breakwater,boat house, lift or sandbags 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 must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement_
I dn.not wish to waive the 15' setback requirement.
/•,/ A711'111iiireawA
Signature u

•
DIVISION OF COASTAL MANAGEMENT
ADJA{'ENT RIP&RL4N PROPERTY OWISTI NOTiFICAfQN[WATVER FORM
•
Name Of Individual Applying l For Permit: C A y MAR
Address Of Property: c,73-/
(Lot or Street I, 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 tome as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
VI have no objections to this proposal.
If you have objections to what is being proposed, plea write she Division of C.nacral
Manes ement, 177 North Cardinal Drive, Wilmington North Carolina- 7S405_nr call 910 395-
1900 within 10 days of receipt of this notice No response is nnsidrwed the same as no objection
if von have been notified by Cry-title/1 Mail
WAIVER SECTION
I understand that a pier,dock, mooring pilings, breakwater,boat house, lift or sandbags 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 must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
✓ I dent wish to waive the 15' setback requirement.
icffo. /
4n9tre _ _n Date

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COASTAL FEDERAL BANK
I_ SOUTHPORT,NC 28461
1 MEMO /-L`t.t.: 40 %/i 144' 7.3i -- - - ---------------_M
I: 25327235SI:325E1000137211' 2 70 3
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