43210D - Pisano

CAMA / DREDGE & FILL '7' i---
.
EN ERAL PERMIT Previous permit#
'New Modification Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7f9/,40f A/240
/ ,�pp ' es attached.
nt Name Le ended 1"%SLt n D Project Location: County eerie/
fl� le C l e 0/, 5#(..*p-/ 4 Let 7 Street Address/State Road/Lot#(s)
/TiiMp S ieft, State dt ZIP Zls W/j a, ,,n e
# ) Fax#( ) Subdivision
ized Agent_ j fir. City ZIP
d Cw 5EW ` I "IqA £ES ❑PTS Phone# ( ) River Basin at
OEA ElHHF ❑IH ❑UBA ❑WA Adj.Wtr. Body f%/►/' A—e #0 t
• PWS: ❑FC:
(,ye�js / no PNA 63/ no Crit. Hab. it/kV)
Closest Maj.Wtr. Body it��
of Project/Activity /p/d0 eoe ,6v/A'`je..tA co--ftl
iii
lock)length rd.X lj w (Scale:
•m(s) /D'x"a` L
Eilfil
pier(s) c/totnn el s- i `D~f-
length /
r
w ber ,i(Cet
iprap length 0 •
•vg distance offshore 0 Gx j fr
nax distance offshore K f0
channel r --
. y ,, i
. I)
IY � 1_obit yards l l
amp
V r'y 704 l�
me/Boatlift -- /;"
4,1
Bulldozing
7
ne Length 60
not sure yes no
igs: not sure yes Q
>rium: n/a yes
yes do
Attached: yes C
ling permit may be required by: /Pill/ lP/ 60, . See note on back regarding River Basin
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION WAIVER. FORM
aq /
Name Of Individual Applying 7
ying For Permit: t
Address Of Property:
\ C L L
(Lot or Stre t #, Street or Road, City & County)
I hereby certify that I own ro er
p p tY 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 drawin
should be provided with this letter, g' with dimensions,
v have no objections to this proposal .
•
If you have objections to what is beina nr000=_ed , plc-G.= Wr '
Division of Coastal Management , 127 Cardna - lte the
i
Wilmington , North Carolina , �'_- Drive Extension
28405 or call 910 395-3900 within 10
days of 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, mooring pilings, breakwater, boat
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 toL waive the 15 setback requirement.
I do not wish to waive the 15 'setback back requirement.

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION WAIVER- FORM
C"), 7,6Pqmpio
Name Of Individual Applying For Permit: +
Address Of Property: C .,
(Lot or Stre t #, Street or Road, City & County)
I hereby certify that I own ro er
P P tY 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 drawin
should be provided with this 9, with dimensions,
letter.
I have no objections to this proposal .
•
If you have objections to what is beina proposed , p1c_ca write
Division of Coastal Manaoement , 127 Cardinal - - the
Wilmington . North Carolina . Drive Extension
28405 or call 910 395-3900 within 10
days of receipt of this notice. No response is considered the same
as no ob-iection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
must be set back a minimum distance of 15 '
from my area of riparian access unless waived b me.
to waive the setback Y (If you wish
below. ) you must initi al the appropriate blank
k4�' ✓ I do wish to waive the 15 'se c ,tba, k reaLzrem Ent.
I do not wish to waive the 15 'setback requirement.
/ , . /I /%4

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Deana Jae Pisano 08-05
Ncdl 25568988 10 66-46/531 117 i
00034894518
2222 Washington St. 910-431-1969 an -0 f
Wilmington, NC 28401-7128 5
/1 Date
Pay to the /-y- • '©� _�
odder of
B��
u d� \AA'S c, Tt-U
Dollars 8 "'
L.c S UST- ACH RT 061000104 .
For e` toe 32{0 D -
1:0 5 3 10046 Si: 10000 348 94 5 Lao° O 1 1 7