41541D - Roach

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LAMA/ '-DREDGE & FILLiW ,
il ERAL PERMIT Previous permit#
rNew JModification ___Complete Reissue Partial Reissue Date previous permit issued
•ized by the State of North Carolina, Department of Environment and Natural Resources '` V
.oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7�y ./�U
Lj Rdfes attached.
:Name LI\\`‘,/k-r" if �lo'N / UA{, 4- Project Location: County 60Z 46/ f,I
,.)i X 5 a:, 6 A N p/Ary lc LA-n/ Su Street Address/State Road/Lot#(s)_ 3"7/? S�
M p -Itate NC ZIP „7 b )-- u A r-
(itu) 451(019 31 Fax#( ) Subdivision sI-e. PO i tV
Bd Agent '14 City 5441/04 ZIP 4
❑CW ISICV I.P'fA ❑ES J PTS Phone# ( ) River Basin L 14 wJ
❑OEA ❑HHF ❑IH -UBA _N/A
Adj.Wtr. Body L '‘-k-i (se S lof}( nat
❑ PWS: ❑FC: �
yes /��noJ PNA es no Crit.Hab. yes / no Closest Maj.Wtr. BodyS llai'` Rieet
Project/Activity 4W;74 U'v D/' g f it- ) r/041-1 N& oc-/c E.g Ski^-9 P-ea_
(Scale:/ ; y
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er(s) rO ©� c�i
p �� #'� +f�' ti
lgth
nber i= ! f e d
1/Riprap length J I
distance offshore I
x distance offshore
cannel
CAC
>ic yards 1
e , f/k i-
P
se/Boatlift
illdozing
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Length $0
not sure yes
>: not sure yes n t1
ium: n/a yes (3o
\ttached: ye no i tat 12C
rig permit may be required by: 6Rntv5vv(C _ co. See note on back regarding River Basin r

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: Wo /1,..I 4 + 7-e t- 5. D c c
Address of Property: /y e! 1 14 I tit R d
(Lot or Street n, Street or Road)
S6., i1_Q € irwjc2
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individi
applying for this permit has described to me as shown on the attached drawing the development tl-
are proposing. A description or drawing, with dimensions, should be provided with this letter.
this have no to
�7�� objections proposal.
osal.
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 910-395-39
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. (Ify,
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to w i - -air e the 1�' setback requirement.
I do not wish to waive the 15' setback requirement.
S', N e Date
t� ,

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: 4), i li CZ W� t 6.R o c.J
Address of Property: 3 ri / 9 s'he_. ' ✓ j
(Lot or Street #, Street or Road)
SAG-a) - fe_ r tc..�v
(City and County)
[ 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 thf
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
Ef you have objections to what is being proposed, please write the Division of Coast.
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-39C
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
[understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be s
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If yc
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.
x2'
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sign Name Date

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WACCAMAW v. ,9 REGAL ADVANTAGE
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