42321D - Nixon

A/CAMA/ ��DREDGE & FILL \/ 1 Ni" 4
iEN E RAL 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
oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7#//D0 1' ZQ/Zee
E fires attached. //
Name ! ` /r'9A Atevi Project Location: County /3, ?n5Ga/f4 L'
OZ t/i[/�-f', Or, Street Address/State Road/Lot#(s)
pk 140A State,AC ZIP Ze6yG7 "itlfi�PG
) 279 - 5bZ7 Fax#( ) Subdivision
Agent City ZIP
❑CW 1111W ['EiS ❑PTS Phone# ( ) L - River Basin 6�Ae A
❑OEA ❑HHF ❑IH ❑UBA E N/A Adj.Wtr. Body it/h ' (nat
❑PWS: ❑FC:
ies /b PNA yes /6i ) Crit.Hab. yes / n1
Closest Maj.Wtr. Body Coen
Project/Activity ///f id �oi�✓ rf �v,`/�'4et A rerV t eihd?7'
(Scale: /p�
k)length 70 f C
;s) x/2
sr(s)
igth / X 1
iber
Riprap length Go
distance offshore
distance offshore
annel
is yards
/
;e/Boatlift
dldozing
< -_ r
Length 0
not sure yes ,(
not sure yes no IOZ A , /ad/ Ve
um: n/a yes no
yes n
ttached: yes j� _
ig permit may be required by: l/ ' /. f y See note on back regarding River Basin ru

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DrVISLON OF COASTAL,MAN&GEMF.11T
ARACF.NT RIPARIAN PROPERTY ORNFR NOTrFICATION/WAI1,TR FORM
Name Of Individual Applying For Permit: le,yAS'A l� t XO Yi
Address Of Property: g d'. (,jam y T
i sz/4n/ JVC C8r'✓y:S-(11;611 )
(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.
61 y. V I have no objections to this proposal.
If you have nhjrrtinnc to what is being pro/Inst./1, please, write the, Division of Coastal
Manatement, 177 North Cardinal Drive Wilmin,5on North Carolina 7R405 or call 910 395-
3900 within 10 days of receipt of this notice No response js_r0nsidered the same as no nhjertinn
if you have bran notified by Certified) 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 acres unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
U h 'X I do wish to waive the 15' setback requirement
I do not wish to waive the 15' setback requirement.
a- - TrigirA
Signature Date

DIVISION OF CO&STAL MAN&DEMENT
ADJACF.NT_RIp&RI&N PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit: / TLC S,4
Address Of Property: 0 L ( i v4.c r�
Q cy 11 SL/� 1 C� ( iJi )
(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.
1./ 'CZ I have no objections to this proposal.
If you have ohjertions to what is hying proposerI pleat write the (Division of Coastal
Manaoernenr 127 North Cardinal Dive, Wilming.on North
�9Of)within 10 days of trlr Carolina_ 284��call 910 395-
tpt of this notice_ No response is rot>sidered the same as no ohjrsrtion
if von have been notified by Certified Mail
WAIVER SECTION
I understand thur 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 arrpss 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 do not wish to waive the 15' setback requirement
0,1aolt
-7100S AT!�1'
Signatur Date

ORDER OF E LJ /4 N-1 4,_ I $. (3 0o, . L
t F71-e )1-7 U h cQ, .0O L I,,4.r$ DOLLARS 8
Coastal Federal
O—Bank
HM SOUTHPORT,NC 28461
MEMO t)- arc NP
_
1: 253 2 ? 23551: 3 2580008 ? 211 83 2