41580D - Smith

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CAMA/ ,'DREDGE & FILL 1 T 9 4
;EN L PERMIT Previous permit# yisa-2.
y44ew gotrodification L (Complete Reissue ❑Partial Reissue Date previous permit issued S1X=
•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 5A NCAC .9 6 . MeV
A/ El Rules attached.
t Name �+JC.5Di7 -S / Project Location: County /vl Al- t 6'' ve,
' Cp �H /C t 14?kv 2>r. Street Address/State Road/Lot#(s)
1///Osi, h State Ne ZIP 2 gyt SOS' 1H 4 r i/,re. - ,. /' .
(9i0)6/9,35e / Fax#(9/D) 9//. 45/y Subdivision ��- 4/;7,7 Li./eta,
ed Agent !p,4,rr+ CenNsf f f City GJ///n1/),tH ZIP 2 88%
❑CW IlfW ! rITA ❑PTS Phone# ( ) .SlNv, River Basin 4.01."
ElOEA ❑HHF ❑IH ITUBA N/A Adj.Wtr. Body - F1'//n p (/fe.e (nat �f
❑PWS: ❑FC:
yes / ") PNA yes / Crit.Hab. yes / no Closest Maj.Wtr. Body�tfrnt///// 5®ti'f1/4✓
7Pr ject/Activity r7 <Y/'6✓!7$ h/00-s- /9/"/ , 7;4 vA6� �-v6
�r,71/sue ,.l�� - (Scale: /...:k)length 6 'fZy/
(s) 81x 32 ' 4'xZ'I
er(s) A
igth i 1JC if
nber
i/Riprap length
tk
distance offshore _
x distance offshore •annel
-( ///cw //4«, ! inn
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ric yards
1p
4,,/:)y i9-7,i, 7• 1l/
se/Boatlift .,L,LIN„), r/�Lc�Y'/�i LseL /Ci
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illdozing
/fit/ter
Length /jr, ~ . / (G"
not sure yes (no {
not sure yes y/ 1�f„el
urn: n/a yes f
gel•j is,, !/+ ,/'�/ .„-x-,- /'
yes
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atached: yes ///
ig permit may be required by: ,(T ('+e", / /./74j , I I See note on back regarding River Basin r

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DIVISION OF COASTAL MANAGEMENT
JACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
(.61ct --I.
ne of Individual Applying For Permit: �/N S 0.A L �,,�,
dress of Property: < 0% L,.\A \j ;�,,,,) .� C,
(Lot or Street#, Street or Road)
(City and County)
:reby certify that I own property adjacent to the above-referenced property. The individual
lying for this permit has described to me as shown on the attached drawing the development they
proposing. A description or drawing, with dimensions, should be provided with this letter.
_AZ I have no objections to this proposal.
Tou have objections to what is being proposed, please write the Division of Coastal
nagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
gin 10 days of receipt of this notice. No response is considered the same as no objection if
have been notified by Certified Mail.
WAIVER SECTION
.derstand that a pier,dock, mooring pilings, breakwater, boat house or boat lift must be set
a minimum distance of 15' from my area of riparian access - unless waived by me. (If you
li to waive the setback, you must initial the appropriate blank below.)
,i/A I do wish to waive the 15' setback requirement.
`/.a I do not wish to waive the 15' setback requirement.
`'T-4 Y A ✓T in lam"¢)
(.- f • .Tr-iiiiti-,_ /in,N pf-ilinnaplihev< z---/--4- 40,5--
i Name Date

DIVISION OF COASTAL MANAGEMENT
----ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: P\s C,N v�
Address of Property: ?o \`
(Lot or Street #, Street or Road)
�..) vti�.�. �-o.� New wno �r
(City and County)
hereby certify that I own property adjacent to the above-referenced property. The individual
.pplving for this permit has described to me as shown on the attached drawing the development they
re proposing. A description or drawing, with dimensions, should be provided with this letter.
VI have no objections to this ro osal.
P P
f you have objections to what is being proposed, please write the Division of Coastal
lanagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
'ithin 10 days of receipt of this notice. No response is considered the same as no objection if
ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set
ck a minimum distance of 15' from my area of riparian access - unless waived by me. (If you
ish to waive the setback, you must initial the appropriate blank below.)
_ I do wish to waive the 15' setback requirement.
fA I do not wish to waive the 15' setback requirement.
Name Date
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