42848D - 17th (Seventeenth)

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'CAMA/ DREDGE & FILL i. - 4
3ENERAL 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 �� , //QO ,/Z
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
� S/ .�- ❑Rules attached.
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t Name L L.C Project Location: County X°l-Y ,%
( 7Iif(h/47 2, ILA Address/State Road/Lot#(s)
�ji/AV/'/1i/ ekiI State ZIP -7e//g . 4/ tilt'L
•(D) c2CC. V442Fax#( ) Subdivision
ed Agent G' ��iy/, City 4///fib/s/Y�'e!/ 4"e4�P c7 Se
cw yFW ;r PIA ❑PTS Phone# ( � ) .....coiliwe River Basin C-' ,14,
OEA HHF IH ❑UBA N/A Adj.Wtr. Body e1 / (nat 4
PWS: FC: /�
yes / no PNA yes /� Crit.Hab. yes / no Closest Maj.Wtr. Body 6/7ceroi/W .5 4i
7rojct/Activity C/' 4 e 7" /it t, �,y/€P Gl` cId // Ore
e � O�'/ ht('f rek01STi"GC 1 41 br S/�C11� (Scale: /�i
:k)length G/ X 3 / /
i(s) i y%/9/ —— Z
ier(s)
ngth11�• /
TiberPffr fT L,:-./
7/Riprap length , wf / — `__
distance offshore 0. I'4 �l�` �7
x distance offshore
cannel
1
sic yards _ dit"0;454,illdozing,11 ,4)Oira'
X 7/4-,0,..--- -0
/ n�7/i X
I
Length TO " ./'
�Ji 64. e/ e.4%. J47-
X .
not sure yes 659
1 r i , / 1
n 4'.�il
>: not sure yes ev r
ium: n/a yes e w 1, iy A siv LL e /0/ 6i/ /,
yes ` v 49/ e".4//.tom' 4•1 X . /
1tached: yes g / 41(..,,,7 e��i
ig permit may be required by: A'"p / 2 '4 s _ . _ See note on back regarding River Basin n
1 . /. - ..n . / 1♦I. . . ./ /.. 1..1/

no Milne VonTracTors, Inc
Complete Marine Construction Servi
For Over 27 Years
CAPT. ED FLYNN '•� - DURWOC
Piers, Floating Docks, Pilings, Bulkhei
Dit.. Boat Lifts, House Pilings, Repairs
r,y_lie? , i f/ P.O. Box 868 Phone/Fax: (910)
!Y( Wrightsville Beach,N.C.28480 email:efly
501
.Aittitidknkb102,
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION &WAIVER FORM
Name Of individual applyirrp for Pirniit
Address of Pr, , VsY cowj itAtairvefiiiites ei
l hereby certify that I own property adjacent to the above referenced property. The
individual applying for thIs p °t P a 'r!_ �!its me.A! Sh, :. on ti att ;I'ed
drawing tha da lopment they are proposing. A description or drawing,with
dimensions should be provided.with this letter of notificatio .
Please.l ,belowif yo4havrenoobJectiorIS / ,
�r •tt�jY,,, + ��� ; ` , i rti�: � 1)./4d
��G�S•c r` t'._
`biliv
..� If�1a�°b nsto is. ', 1 _Dti f.�.
Management, 127 Cardinal Drive Extens€on,�W7i mington, N. C. 28405 or call 9t1tf-.
2n- ?000 within IC days on rc oipt of this note*. No response is dared the
same as no objection if you have been notified by Certifieed Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater.boat:house,kft or
�,�ou,.iu s must beset back a minimum of 15'from my area of rtparian access
unless waived by me.(tf you wish to waive the setback, you must Initial the
appropriate blank below.)
I DO wish to waive the 15' setback requirement
N 16 I DO NOT wish to waive the 15'setback requirement
a„vdtepy Y/ilo5lC -.
G� o�, p_, Signre &Date ,A-- (27L___
4a1ho i 4) OQ cse_ {�A fZKtl2
N�4NesX L. Bo RA SC Print Name f1 tcM E',LE 6 .
• T6t' P F Eic-.
n I A ^I e—I 'rf/s I Minnhone Number w/Area Code

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION &WAIVER FORM
'ndividual for it -S:= Lr L-6,
Name of i applying perm
Address of property VP! Ob J /1444/11 31/1 Vera) /VL
I hereby certify that I own property adjacent to the above referenced property. The
individual applying for this permit has desc^d to me as shown ^" the .?_Ittarhed
drawing the development they are proposing. A description or drawing, with
dimensions should be provided with this letter of notificati
- Pjeaseinitiatimiow if you---have no-objections. 1, -
ihkokisiAif
- Management127 Cardinal wive-Extension,-Wilmington, Pt C.'2 6=or-i -9111-
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 house,lift or
sandbags must beset back a minimum 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 to waive the 15' setback requirement.
I DO NOT wish to waive the 15' setback requirement.
141'7-11
Signature & Date
i,/; i1� Print Name

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