40471D - Phillips

rtAMA/ i DREDGE & FILL N9 4
;ENERAL PERMIT Previous permit#
Flew _.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 I5A NCAC 7i9, /2 2 2
/�J� Rules ttached.
/.Name 4 //Ir//l f)f Project Location: County Pam/ Q/
9D1 C'e, [ A)/, Street Address/State Road/Lot#(s)
lle inn feit A State /te ZIP 2 /4 , ,j�,N P
( ) 9/7-323 y Fax#( ) Subdivision
Bd Agent L City — ZIP
❑ PINY CJ CW PI PTA f S ❑PTS Phone# ( ) River Basin (9x
❑OEA ❑HHF ❑IH ElUBA ❑N/A Adj.Wtr. Body 4,e iy S Ada, (✓reek r
❑ PWS: ❑FC:
yes /(5) PNA Cam/ " Crit.Hab. es no Closest Maj.Wtr. Body Ati W
id
Project/Activity Arn el he K
(Scale: �1:k)length 3&yii _
(s) 4,'x /'
er(s) L►/Pq!�'
igth
nber ty
Y g
I/Riprap length
distance offshore
K distance offshore �t��— '' „--.✓
annel di {/,{36,
is yards Y
'p
;el Boatlift
Ildozing — ' i
Lk
Length Z 3 I
l V
not sure yes de
not sure yes • 4101
urn: tai
n/a yes /t��L
yes k /20' > f-----__ /���
ttached: yes '. i - y
ig permit may be required by: / ye,1p✓ 4, See note on back regarding River Basin ru

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: b ; ,p j
Address of Property: T 2 5f C v- e c (K
(Lot or Street #, Street or Road)
HcA_fry, fie c( vl J vi y 3 /9 Pt de it
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individt
applying for this permit has described to me as shown on the attached drawing the development th
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 write the Division of Coasi
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-391
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
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (Hy'
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.
_ 5,6AA44"__ 1/4- c
Sign Name Date
r��

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: B U 6 y P1 , LL . p
Address of Property: 1140 f C v e e. k f)r
(Lot or Street #, Street or Road)
Ha. kyi and57e u ct l� c 51�q 3 /1(City1hV-
County)
I hereby certify that I own property adjacent to the above-referenced property. The individu
applying for 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.
✓ I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coast
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 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 sl
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (Ifye
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.
— -,sow
Sim aline Date

/ )
-ro Sirvfr i,,
44 G 5 ru5 '--` iF
3
a` E#
harm ei- ' '�
� k � � ��
\ _ apc19t: 6 — ifr 41. '-' :' i
ti\ t, L. ik r ‘k , ,k,
_ ._ _ _0;),* ii, te iv --it ‘ 614'
lfr ‘l'
11' 141. lfr °cAll a.' je'' -
ill 11- \ ifr di/ 4 . i i
de ll' • i
g•L 1 1'
Ili 11 � It l
ir 4 v \ it
V I'
4
i.1 ifr 'el* li' ,At or , h ' ``
\ V.-
H
0! ,j/, Ye
p 11)OF

D�APRIL 06, ZOOS
Pay To The /
Order Of 1 ✓1 5' (" I O �t1 CO�4 L vria.Y1 45 2. $
**100.00**
**ONE HDNDRND DOLLARS AND 00 CENTS" Dollars
Not Valid Over$1000
Signalurc Uf I'ur r r(Drawer
•
rMn Bank of America is not liable for lost or stolen Money Orders.For your protection �v6 I r//,• 4 7'
against loss or theft,sign and complete this Money Order as soon as possible. Name Of purchaser(IJrawer)
Rank of America,N.A. 6070200 00022 000074795 C p Qe K Ole" //Awips f Qete-/ l�
San Antonio,Texas Address City.State,Zip
L 7
11.00 ?IL 79511' is L L40000 L91: 00 L64 L000613611'
�PIESORIGINAL DOCUMENT HAS REFLECTIVE WATERMARKON THE BACK •"'THE ORIGINAL DOCUMENTHAS REFLECTIVE-WATERMARK ON1
i
•
•
•
•
•