41459D - Sayers

•CAMA / 1 DREDGE & FILL \/
3ENERAL 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 SA NCAC 7 N . /L O U
IL3'I(ules attached.
:Name A/-v; Al $4 y?'R 5 Project Location: County /3/NN W 'C IL
3/ (,8 3 G R 7,9vEN RCN Street Address/State Road/Lot#(s) 1(I D4R E.
�S�k t, State ZIP /99 3 5
0).) '3,)-t45T Fax#( ) Subdivision
.dAgent j?�.N .Tr' SSt c City 0(474n, . 5/`e ;7'4(11 ZIP —)b y6
CW L / ❑ TA ❑ES ❑PTS Phone# ( ) River Basin L U wk 6
❑OEA ❑HHF =IH ❑UBA ❑N/A
El PWS: ❑FC: Adj.Wtr. Body(4N4 L 0 I- 4L-(.J IA) (nat6
Closest Ma Wtr. BodyA'rt" kJ
(es / n/ PNA yes / no0 Crit. Nab. yes / no I'
Project/Activity 3o41 1 ley /4-, .r,74cl r-- G c it, S-6N& >oCK
(Scale: / - ...:
k)length
Is)
er(s)
�,.., D NA I— ��
igth
fiber GC\I-
/Riprap length '11N U
distance offshore - 06 5
c distance offshore
annel _ ; ,Jr II / , ( ( fQ r
is yards , -�'� C r�'� C i f 7 r
p 1
.e/OPID 0)
I
Ildozing
e `Length
77
not sure yes (no) r
t. J
: not sure yes o)
im: n/a yes r 4 /t( -MAT 5T
yes ', d>
ttached:C2l o c no
g permit may be required by: W ru or O(F4 v =-Ir RPM+-(N See note on back regarding River Basin ru

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11' 16' 1. 124 8.,� 10
0
Floating Dock
co
Boat Lift
0
3'=
Ramp
24' 23'
Top of Bulkhead
1.:Dire St.
50'

TG'+ON OR C17+4T� Amo 1Jt1sT, ,r*, —
ATVTAr MT_P.;apR i xN PROPERTY DWNFR NOT FTrfiTT
_OIiJKP_7777R TID_RM
Name Of Individual Applying For Permit : kC_V l r\ Sa
Address Of Property: QQS "n`r" L
/ jr u SW I C , Ce)(jr17k
(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 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.
t5V I have no objections to this proposal .
` you hsvt. oIPit.4t ions to what iP h in T tyrpnocpd l t. t.
p as writs ht.
Division of Coastal Wanag ,mt.nt, 127 -('ard;nal
W; lm;ngron, North Carolina, 2R40'; or rail 9 nriv� Fxt-onG; cn
days of rt.c� A
��t of this nnr�r _ 1-(� �4�-�q(l(l w;r},;n � �
No �-Psn0nse is coTisi dProd t-ha saint.
?c no ohjt.rtioi if you riav? bt.t.n no�t-iii�d byrPr
tirit.d Ma; 1
WIIVxR, SECTION
understand that
a pier, dock, :mooring pilings, breakwater, boat
house boat lift must be set back a minimum distance of 15 '
from
my area of riparian access - unless waived by me. (Ifyou wisho
the setback, you m„ t initial l the so .)
.-n-.�zz- �ppropriat=_ .blare i- below. )
A cr7 I do wish to waive the 15 ' e-
5 �.ria.,k ream rnmeTlt .
7 do not wish to waive the 1S ' setback re ,ire
ql- mnt

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
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Name Of Individual Applying For Permit : < C'�/I►'1 �ae Ems$
Address Of Property: H f ICcr€
-111-61,---( JICIC-, Ca
(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 to me as shown on the attached drawing the development
they are proposing. A description or drawing,
should be provided with this letter. with dimensions,
W0,4 I have no objections to this proposal .
' fin what
,_I� i Pa�P writes t-ha
bTi 1 mi nat-on Nprth C'arnl i na �stan�
nr call Q� �qr, w� th,n
G T10r'1 C`P Nn rc l (�
fiamr�
HAMER SF�TTO
I understand that a pier,, dock, mooring pilings, breakwater, boat
house or boat lift must be set back a minimum distance of 15 ' from
my area of riparian access - unless waived byme.
waive the setback, you (If you wish to
mus_t initial the appropriate blank below. )
__ I do wish to waive the 15 setback requirement .
I do not- wish to waive the 15 ' setback requirement .

[phone] 67-7235/2532 / �/e sJ
TO THE ¢ /V/�
ORDER OF IY -.- `I' 0 .
_ AUTHORIZ IGNATURE
MEMO 1 T l�F 6 y-j
0L372So 1: 2532723551: L25700L46Le
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