42878D - Smith

'CAMA/ - DREDGE & FILL 1� •
3ENERAL PERMIT Previous permit#
'New Modification LJComplete 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 SA NCAC �/��/`/_
/ C Rules attached.
t Name 4L ',4 J h Project Location: County Z - ' c
J ylt .4 j0o1-I lji4 Street Address/State Road/Lot#(s)
..i64,1 State/tie ZIP Zic‘/6.5
( ) Fax#( ) Subdivision
ed Agent City ZIP ��^
CW SEW '4-PiA DES ❑PTS Phone# ( ) • River Basin CG�G
OEA ❑HHF IH UBA ❑N/A Adj.Wtr. Body (flat�I
❑ PWS: CPC:
yes / r ) PNA 6;2/ no Crit.Hab. 6)/ no Closest Maj.Wtr. Body fit*
Project/Activity 1,KOM.l (114./AA',¢I
(Scale: /
:k)length
i(s)
ier(s)
ngth
nber
3�yRiprap length //U
distance offshore
x distance offshore
cannel
sic yards V y S
ip
se/Boatlift
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poh PAy'
Length /e10
not sure yes a
not sure yes
urn: n/a yes
yes g,ttached: yes
ig permit may be required by: /j/ibIr1 Wit CK (gyp, See note on back regarding River Basin r�

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DIVISION OF CO&STAL M aN 4GEMENT
AMACF.NT RIP&RIAN PROPFRTY OWNER NOTTFICATIONFWAT F.R FORM
Name Of Individual Applying For Permit
Address Of Property: 5/)491 c,J WRY
ORK 1-.S.L0S.Diat 84/6 Bkua v,u,C'
(Lot or Street I, 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 tome 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 vnu av� nhirv-rin„r t0 W at tc hrin nmrx�.v� {mac �.��
g 1hr tliyxn !` i
M_ a^a.° .mint 177 Nnrtit (���-i{� aI nrrvr„ Wilm�ne nn, T�nrrh C'�mlins 7�r►�„r,.,lt
39m within 10 days of errant of thic notice No
response it sbnsidrrli the same as no nhjrrrion�
if von have been notified by Certified Mail
WAIVF_tt SEC'TI N1I
I understand th a a pier,dock, mooring pilings, breakwater, boat house, lift or o
be
set back a minimum distance of 15' from myarea of waivedabybags must you
riparian access unless 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.
1 do not wish to waive the 15' setback requirement.
Fit /144)-i %/- —C� � •
ignature J a Date •

a
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: et,8 E7 .(ira-7 /
Address of Property: S 9A1IPesA/ LOA1/
(Lot or Street ', Street or Road)
OAk 2S1,9 'A, A✓c agyG.,z Rev A,sL,Arc,r
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individua
annlvina for this permit has described to me as shown on the attached drawing_the development the:
are proposing. A d4es-ription 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 Coasta
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3901
within 10 days of receipt of this Notice. No response is considered the same as no objection i
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 se
bck a minimum distance of 15' from my area of riparian-access-unless waived by me. (Ifyoi
wish to waive the setback, you must initial the appropriate blank below.)
ri---- V I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(:,6a S ,fit /i- 8-vs
Sign Name Date
,Z.isa_ Skp
Print Name • A

•
SHORELINE MARINE CONSTRUCTION s'7�2255332 2 9 2 6
GREG PREVATTE
P.O. BOX 10671 ///�S�o
SOUTHPORT, NC 28461 DATE J
PAYORDER TO OF THE ^ /r , $/�
•
(�✓l € cc-. I2 L/ 4-I j DOLLARS 8
Coastal Federal
ocow—Bank
p n E
MEMO G� 0SSOTMA (5/4' a7)74 ) ./Lv�� NP �.
1: 2532723551: 3251300013720 926