43262D - Mast

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'CAMA/ DREDGE & FILL
;ENERAL PERMIT Previous permit#
New Modification _'Complete Reissue Partial Reissue Date previous permit issued
lzed by the State of North Carolina, Department of Environment and Natural Resources AO,
Resources Commission in an area of environmental concern pursuant to ISA NCAC 'f
/' D Rules attached.
t Name (�'tt4f //last Project Location: County oi/ee, /90.,,✓r✓r
ST03 4 GG#,,,,,,c . Street Address/State Road/Lot#(s)
i'/' 4 /%o £'ci State 4t ZIP 2K Q ,sec i
(1/ ) 67/?• i1 Fax#( ) Subdivision r- /
ed Agent "`2/'/'!s7 Le City /4 P/fi s 67.// r eeife ZIP 2*e/
cw IMP�A/ ❑ES ❑PTS Phone# ( ) ogarne River Basin e4/94
OEA HHF C IH C UBA H N/A Adj.Wtr. Body 224404 / ` /(nat /r
PWS: ❑FC: �/Y �/1"41'7
yes 671 PNA yes /®' Crit. Hab. yes / no Closest Maj.Wtr. Body /�+�w�
Project/Activity ` /�C" 'fr ek--//9 / 47` ►- s is,� A S A..., G�
7/ 4 400•7 , _ /d 4 . (Scale: ///S
:k)length 1%/ ' • �`
(s) t g/x 2 t' Tt I i,1.�S
ier(s) I j �'L ,��:,�,,„II
igth
nber 1 fop05el,f lC e?
/
i/Riprap length 1,�/57/ ,%/ 'r^"•_"--_...r--
,distance offshore 4.-td 9 el _e- ✓G
x distance offshore /4/OA7 -
annel 1
j i
''''''' - \
>ic yards
ip
se/
2.) 13 X/3'
illdozing f le— 1y
.Length !&:
not sure yes no'not
not sure yes no
urn: n/a yes no
yes i l I U 1
ttached: yes bi
/
1g permit may be required by: y/, • . See note on back regarding River Basin rt
r) - /- _ -.1 I a _ // i/ /i 1 f

, DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: lam"e-cs hq d6`t - C a h_ 1 aeY
Address of Property: 3 AA") 74 2 u n i4,/a.
(Lot or Street #, Street or Road)
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individu;
applying foc this permit has described to me as shown on the attached drawing the development the
are proposing.. A description or drawing. with dimensions, should be provided with this letter.
14„ =f/c wpm
I have no objections to this proposal. sod
P P t,.� p G iG.w
tvrd I qr.- Ay*SC
-� Mce dcU).-A
If you have objections to what is being proposed, please write the Division of Coast:
Management, 127 Cardinal Drive Extension, Wilmington, NC 23405 or call 910-395-390
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 be so
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If yo
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.
fr+15C'ea'u2rf
Sign Name Date
I �

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A Si. ature
item 4 if Restricted Delivery is desired. '`— P ' ❑Agent
• Print your name and address on the reverse X l /,1- �-Q-)"��-
so that we can return the card to you. 0 Addressee
B. Received by(Printed Name)• Attach this card to the back of the mailpiece, Dat= , Delivery
or on the front if space permits.
1. Article Addressed to: D. Is delivery address different from item 1? ❑ Yes
If YES,enter delivery address below: 0 No
j6 S{,1
2y� C 1/e7/;A✓c C7 r
leo,_4 ""to u 'x I AJC 3. Service Type
?Certified Mail 0 Express Mail
(2___70far r'3137 ❑ Registered 0 Return Receipt for Merchandise
❑ Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number
(Transfer from service/a6eq 7005 1160 0005 2172 0892
PS Form 3811,February 2004 Domestic Return Receipt
102595-02-M-1540
--
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
•
■ Complete items 1,2,and 3.Also complete A Sign uurre� r( ��`��
item 4 if Restricted Delivery is desired. X ^� ` ✓ � ❑Agent
• Print your name and address on the reverse (' 0 Addressee
so that we can return the card to you. B Rbceiv by(Prnted Na e+ C, to of Delivery
• Attach this card to the back of the mailpiece, / � i ��Jlr
or on the front if space permits. 1 I(-f``.f a T o5k5
1. Article Addressed to: D. Is delivery address different from item 1? ElYes
If YES,enter delivery address below: ❑ No
6.)///!3l,5adv j C I/ �3�c�c4
7/•A�l;;Cf ny/P 'Vd c.7/-e,r1 2
yj�G et'n /&e/•G/ � S 3. Service Type
/ G ertified Mail 0 Express Mail
t/`�` / / ~ 7 "o 4./ tti Registered 0 Return Receipt for Merchandise
2ir-Ce U ❑ Insured Mail ElC.O.D.

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4,..M CF 750!�0795 A [0�
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('PESER�E' I !f a _ .^ '�%/ , f6 ,. .,�♦q tt
TNIS NOTE IS LEGAL TEV OER 1 v}t'�+��'� $ �� A
FORA ERTS.PUBLIC ANO PRIVATE r 0, i` , -j i I�
Cr 75040795 A
:144:1 :1''''' 2001
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