41484D - Siewers

CAMA/ DREDGE & FILL N9 4
iENERAL PERMIT Previous permit#
ICIew -Modification Complete Reissue _Partial Reissue Date previous permit issued
ized by the State of North Carolina,Department of Environment and Natural Resources /9
oastal Resources Commission in an area of environmental concern pursuant to ISA NCAC 7hi. 1"
ules attached.
Name Chy;S7Lh 5I0w•er.7 Project Location: County /Si v,.fn4,1eX 71
03G A�a4 WWI Af,4e4i Aii. Street Address/State Road/Lot#(s)
4SIJP/ /JroGi State,& ZIPZS►S'/lis ,c._
( ) t�f-3o?1 Fax#( ) Subdivision
Bd Agent 6?'.e, , 4H74 City _ ZIP
❑CW (4k-PTA S-ES ❑PTS Phone# ( ) River Basin apt
E OEA ❑HHF 7 IH 7 UBA ❑N/A
❑PWS: ❑FC: Adj.Wtr. Body /ft/414.'1 (nat g
res /el PNA yes / r� Crit.Hab. yes /e6 Closest Maj.Wtr. Body �t��
Project/Activity 1 //e)/oW,e, �'�A4.*r
(Scale: /
k)length
(s) }f j
er(s)
igth itk
nber '
V Riprap length I/ 1� `/
distance offshore / V
(distance offshore Y
annel sm�snsondl. .i11..�IIII...,AP i Ayr,.s m....ora.Amvs Air..dor s OW
/ .' 1"
is yards ��
' 1
i
,e/Boatlift /`
ildozing 1 63 ( 14)`//
4 t7eA 14 41
Length r/ 11
not sure yes • 0'
. not sure yes
Jm: n/a yes
yes
ttached: yes /
g permit may be required by: �/��fji,�!!�(lL G/bi See note on back regarding River Basin ru

DIVISIO\ OF CO ACTA L M AN AOEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIF'ICAT1ONIWAIV R FORM
Name Of Individual Applying For Permit C/ RzS An/ t,EG�E,Qs
Address Of Property: 4 34 G'AS,oELL &&AC/./ ,ed
(],t viz L Q -"Apt, /_A/C Qlt toy t_9rCe
(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 ide 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 you have ohjerrions to what is being proposer! please write the, Division of Coastal
Management 127 North Cardinal Dive, Wilming on North Carolina_ 28405_or call 910 395-
"i900 within 10 days of rerript of this notice No response icronsidered the same as no objertion
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 be
set back a minimum distance 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.
Al1;41•191A
Signature tvx, Date

DIVISION OF COASTAI.VIAN&GEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATTON/WAIVF.R FORM
•
Name Of Individual Applying For Permit L ils/A1,5 j�,/ ,jl‘,,,,,e S
Address Of Property: 6.34, C44S6.,ELL Bel e/-/ ,eb
(f4S4,2: 1L ReAC//,, A/C- U4INSI-)— A(
(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 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 you have nhjrrtionc to what is being proposed, please write the Division of Coastal
Manaorment, 127 North Cardinal Drive Wilmin Ir)n North Carolina; 78405_or call 910 395-
3900 within 10 days of receipt of this mike_ N�rrspo__ s 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 be
set back a minimum distance of 15' from my area of riparian arress unless waived by me. (If you
wish to waive the setback, you mutt initial the appropriate blank below.)
I do wish to waive the 15' setback requirement
I do not wish to waive the 15' setback requirement.
afA______
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