38548D - OPM

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AENERA ERMIT Previous permit#
]New 1Modification Complete Reissue Partial Reissue Date previous permit issued
rized 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 f1 / ? - 2
les attached.
t Name rpm / G 4//.5Moor ❑Ru
Project Location: County t/y-
t r''e'.4'1,` j ?.uq" /Ale S _ Street Address/State Roadd/Lot -(s)
L O/ / � 7I
A/ 622EState ZIP V6
()2) 3 7 , 1./
7( ) 247 — 2YI`j ax#( ) Subdivision
ed Agent City /1)j,-L '%/ ►Cjf-ZIP
____4
❑Cw pTA kES ❑PTS Phone # ( ) River Basin
❑OEA ❑HH ❑IH ElUBA ❑N/A Adj.Wtr. Body Tv
bhS // /I I (nat /i
❑ PWS: ❑FC: I f
yes / no PNA yes / no Crit. Hab. yes / no Closest Maj.Wtr. Body p / 74 '
'Project/Activity N (7!' t' 'T [j" c :Z ii f�%i"� �R /
...:-
/ (Scale: (
ck)lengt�6 Y' /
bi-
ier(s) YP4 ( ©t 4` 1 h 14 -
ngth IIIN,. j F { I -_1- [- ! I
f
mbar F { ____,�;____�� r • 7
diprap length �, r..._� _. j I i _ __ `} I _ .
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distance offshore
a distance offshore f..__...___ ; — 4 . ... j - t.._._
1 1 : I
cannel I
I I
I 1. *.H
sic yards i .f Iise/Boatlift � / . i . '
Ilia::
1 1 1 to �i ulldozing / 1--e Length
not sure yes no • 1 1
1 j
s: not sure yes no J�( rrr icfrt- _Pkg_kt —
wm: n/a yes no
yes �fo + i�_ Al
attached: id
�- � 1 ,yes 67o
ng permit may be required by: /- b L. ° A] . n See note on back regarding River Basin ri

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1

DIVISION OF COA STAL MANAGEMENT
• ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONiWAIVVER FORM
ame of Individual Applying For Permit: oP Y'' Ma)14 C.ill 4-y(�
.ddress of Property: ( a t S&l 5 i L V r S+. dt4 64 (4 .4 /v .( ,
(Lot or Street#, Street or RO d)
H00 LA litk(-11\ r„,,,
(City and County)
hereby certify that I own property adjacent to the above-referenced.property. The individual
pplying for this permit has described to me as shown on the attached drawing the development they
re proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
r you have objections to what is being proposed, please write the Division of Coastal
lanagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
rithin 10 days of receipt of this notice. No response is considered the same as no objection if
ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
bck a minimum distance of 15' from my area of riparian access- unless waived by me. (If
ou 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.
inn Name Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER,�^NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: 01 /v is N Q 4 M L 1/49
Address of Property: GI SA (a5 ( lO V✓ S-11
(Lot or Street#, Street or Road)
MAIO 130(C24 AJ' C . e&octgli
(City and 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.
If you have objections to what is being proposed, please Jim Gregson with the
Division of Coastal Management, 127 Cardinal Drive Extension,Wilmington, NC
28405 or call 910-796-7215 within 10 days of the receipt of this notice. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, moorings pilings, breakwater, boat house or boat 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 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.
h11/neotbrl e_r
--� _ I_

ru Postage $
g $1±.3
0
Certified Fee "3l
Return Receipt Fee $i.7!
(Endorsement Required)
O Restricted Delivery Fee $j l•Cu,
Q- (Endorsement Required)
m
O Total Postage&Fees $ $�'
O
Sent To
r- Street,Apt.No.;
or PO Box No.
City,State,ZIP+4
PS Form 3800,June 2002
got U.S. Postal ServiceT
m CERTIFIED MAIL
rl.l
(Domestic Mail Only;No Ins
IU For delivery information visit ou
•
Postage $
Certified Fee $=•Jl=
0
Return Receipt Fee t r
I (Endorsement Required)
p Restricted Delivery Fee
a-. (Endorsement Required) •
m
Total Postage&Fees $ $4.4 7
O
- t o
(� S`treet,Apt.No.;
or PO Box No.
City,State,ZIP+4
PS Form 3800,June 2002

State of North Carolina
Department of Environment and Natural Resources
Wilmington Regional Office
Michael F. Easley, Governor William G. Ross Jr., Secr€
FAX COVER SHEET
Date: g o S No. Of Pages: / t ` c
To: From: _DCM
CO: CO: Tip So A/
FAX #: 1072 3/s FAX#: [phone]
REMARKS: / r ('J /
re741-1.-CL-/ Al Cle r&1'c_Te
127 Cardinal Drive Extension,Wilmington,N.C.28405-3845 Telephone[phone] Fax[phone]k
An Equal Opportunity Affirmative Action Employer

CAMA / DREDGE & FILL
3ENERAL PERMIT Previous permit# -- -.
]New -Modification L-Complete Reissue --Partial Reissue Date previous permit issued —
rized by the State of North Carolina,Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to I5A NCAC ' / 1 e C.-'{?
/J // , p . ❑Rules attached.
t Name rim !if:,?, c� it r f/- !///r Pe Project Location: County /2y /4,y, S
7/5 (-7r '1"-- 14 / J ` ' '� C- Street ss/State Road/ Lot#(s)
/,7, f 7 , h
• �.�i /U "�L/ C State ^�" ZIP ,' � 2..- /2/;�� S v/7
( ) :4[.,7 — Zyc`tax#( ) Subdivisio
,ed Agent - City /fb j OgNi P;r/:- Cf'PZIP r C.
❑CW .NEW -PTA ES ❑Prs Phone# ( ) RRiver Basin ,
E.OEA ❑HHF ❑IH E UBA ❑N/A Adj.Wtr. Body ! '" hh< / /)/7 • (nat A
E PWS: ❑FC: /
yes!T no Th PNA yes n& Crit.Hab. yes / no Closest Maj. Wtr. Body AilsL
f Project/Activity Ufrj4 r i.t/f. p/ "fir/ /if -4/ rr,-z -1 -f r')�{. -�{
(Scale;
ck)length G �[ — _ i —_—�
i", 1 I I
'(s) ��'' _ OM
r:
,ier(s) j i .�' I rat?, y�l +s }_ r..
'n8th # •
i I
mber
�Riprap length I — I -A 1— j ---_ _
—t—-
1 - Ili _______,.or e,_
distance offshore , _
ix distance offshore —___ ._ T __. _ -- — — --
cannel I 1 i I r ----•- j
bic yards I - j♦
np ��
i t —
ise/Boatlift r -
i
I 1 4 •
ulldozing -rt— MN _i MM. • .411101 ' ■
L
n
i
e Length j — — tJT'E
—..._ IL
--1- -- -
not sure yes _�ryJ hi �l ,I�::.- ��% i
I;s: not sure yes ! 74 — 1 lid. A .../.� i 5 k I ', 1- -
ium: n/a yes ( J -— i ; _�� ---
yes � — F ' rig MA I _ it _ AP
Attached: yes C _:/ 1 -
ng permit may be required by: / '7'/. t7 /AJ j,✓r -lets . 11 See note on back regarding River Basin

i
OMP' •ETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
items 1,2,and 3.Also complete , I
Restricted Delivery is desired. ❑Agent
r name and address on the reverse L►� � � ❑Addressee
re can return the card to you. -.ceived by(Printed Name) •. • .ry '. ui,w s.: . P;" -ta . _7',
its card to the back of the mailpiece,
front if space permits.
D. Is delivery address different from item 1 1 °s OM
dressed to: If YES,enter delivery address below: 0 No 1 ��
l DOO
al& OH
mi
n -i/1 1 Y I`jc I J m
l v\ V�� a ��q 3. Service Type -1
0 Certified Mail 0 Express Mail P.i A 4 1 1\1 ,C,a75 0 Registered 0 Return Receipt for Merchandise
`� ❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes 1/4jv
amber �� D
amber 7005 0390 0000 2437 2309 F
From � r �-"
811,February 2004 Domestic Return Receipt 102595-02-M-1540 0 °C m
g ' IS L 0 Z
o
COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY l" 4,
e items 1,2,and 3.Also complete A Sigilgture O
Restricted Delivery is desired. X ll4±A 0 Agent
it name and address on the reverse ,///i y(ti
0 Addressee
ve can return the card to you. B. eiv'by(Printed Naar) A C. Date of Delivery LA
1isf card topathe backo the mailpiece, I �� �i / ,(Gg/,47
front ifs ace permits. L/k /=-
D. Is delive address different from item 1? 0 Yes a-
dressed to:
�A� If YES,enter delivery address below: El No C
R * Jkrt ;,� (�r'KI(
rI C
Ih ,C )? iS 3. Service Type
❑Certified Mail ❑ Express Mail
❑ Registered 0 Return Receipt for Merchandise �-
❑ Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes :_.(.,....._
'or. 7005 0390 0000 2437 2293
,
111,February 2004 Domestic Return Receipt 102595-02-M-1540
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