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IENERAL PERMIT Previous permit#
New _Modification —Complete Reissue -_Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources
oatfal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7//. //Ud
+ 1 L Rt fes attached.
Name JOIL'1 A; 2 e Project Location: County /JHsu v'ck
21 27 f. I1ta n Street Address/State Road/Lot#(s)
I k Isla n et State 't4 ZIP N yr " S4,,
(qWO) Z79- 3OZ7 Fax#( ) Subdivision
td Agent City _ ZIP
❑CW CAW -['PTA =ES/ ❑PTS Phone# ( ) River Basin �{,//C J
❑OEA ❑HHF E IH -UBA ❑N/A A l9)
Adj.Wtr. Body inOn it,Om Pit 6'4 1' (Orr
❑ PWS: ❑FC:
,es / r62 PNA )6/ no Crit.Hab. 6, 1 no Closest Maj.Wtr. Body V(A)
Project/Activity P o/p$t 1 /b A,t f A .
(Scale:
l
k)length
s)
'-r(s)gth
fiber �/�
I Riprap length f` Y
distance offshore
IV
:distance offshore V V 0
innel il g
—_
�_ � _r
is yards / h
Jo/1'f'Prnemy a/4' fX
p
e/Boatlift g0, . --------
T l0/
Ildozing y
Length Sd
not sure yes
not sure yes •
im: n/a yes
yes
:tached: yes •g permit may be required by: A✓AS go JI, 6, I See note on back regarding River Basin ru

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9o' ,, PLACE
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11112SION OF('O&STAL MANAGEMENT
AD.IACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WA1WR FORM
Name Of Individual Applying For Permit L i z e
Address Of Property: 2- 9 2 2
)1' X SL,4 h d Ivy o rtio SL,,6h J
(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.
If you have nbjeciinns to what is heino pmposed _please write the Division of Coastal
Manag .ment 127 North Cardinal Drive Wilmine nn North Caroli a 2>4n5 or sass 91tt 395
1900 within 10 days of receipt of this notice No trcnnnse is m i '• Jed the same as no nhjerrinn
if you have Iron notified by Certified Mail
WAIVER SECTION
I understand rh.:t 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.)
NJ I do wish to waive the 15' setback requirement_
I daunt wish to waive the 15' setback requirement.
46117:11111211ruirA
e e

IIrVIS1o\ OF C'O&STAI.M AN&GEMENT
ADJA('ENT RTP4RIAN PROPERTY OWNER NOTiFIC'ATI(1 IW
Name Of Individual Applying For Permit f L i 2 e
Address Of Property: 92 2 ,i< ,;
C) 4-k S 1LAn,�1 l�/C (ijrun S )
(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.
6 lC l,{ I have,no objections to this proposal.
If you have ohjtctions In what is being
proposed_ please write the Division of Coastal
Mana_oement 127 North Cardinal Ikive Wilmine nn North C'arnli a 2R4� or i J vi0 a9,
390n within 10 days of receipt of this notice No rsponse is considered the same as no nhjerrinn
if you_have been notified by C'errifirri Mail
WAIVER SECTION
I understand tht:t 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.)
C- IC \. I do wish to waive the 15' setback requirement_
I do not wish to waive the 15' setback requirement.
63.1 12ty— . l - oSSi1�n� ae '/ te ' ISo Ku de/a I/�Y. 11.I.) Ll)11 L.

5 PAY TO THE C {{ �f I /p C�
i ORDER OF / / +120
D o e C h
o �Pi DOLLARS L'I;o
CoastalFedera/
—Bank
([([([ Or' SOUTHPORT,NC 28461
£i MEMO 377
,1,1
1: 2532723551: 3 258000137 211 837