41543D - Spear

'LAMA/ J DREDGE & FILL N® 4
IENERAL PERMIT Previous permit#
<ewModification -.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 15A NCAC 7 //. f-i) U c1
ules attached.
Name / 4-, ,4 i?/= 7 O. j f r4 R Project Location: County 3R ti 5W i (I.
j/ /t-, 02104, '1 sf. Street Address/State Road/Lot#(s) 5 ' /--.4,,Pry',
r X State/VC ZIP 7 (/Sy S -f .
(70?)S b 3 e,/Fax#( ) Subdivision
:d Agent Teff2y 3-o J�= c City (CEF 'V ss-/E ZIP •DVS
w PEW rA E ES ❑PTS Phone# ( ) River Basin 11.4 ill
OEA ❑HHF ❑IH ❑UBA N/A
Adj.Wtr. Body C 41\1
4 I Or -Z. A11.✓ (nat
PWS: ❑FC:
res / no PNA yes / n Crit.Hab. yes / no Closest Maj.Wtr. Body �'r��^'/
Project/Activity kat/q-Z,v.r7P-v'f b r x/ I<
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k)length / /.�V �1-__/� �� �p
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/Riprap length
distance offshore
distance offshore ZS
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Ildozing 1L. i
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Length T,5D_
not sure yes 0 e
: not sure yes o 1 1I
gym: n/a yes
yes 8ttached: yes —�
g permit may be required by: O(, d'i- . _.e (F I-3E C4 1 i See note on back regarding River Basin ru

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DJV15I0N OF COASTAL MANAGEMENT
a,a ACENT RI AWN PROPERTYQWNER NO lajCATIONrWAIVER FORM
Name of Individual Applying For Permit: 10,�„� P S''�. c
Address of Property: - ��-l{�•1 �� �`
(Lo: or Street#, Street or Road)
(City and 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
arc proposing. A description or drawing,with dimensions, should be provided with this letter.
•
I have no objections to this proposal.
If you have olrections to what is being proposed, please write the Division of Coastal
Mao,azemeut, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
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 or boat lift must be
set bck 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 bIank below.)
I do wish to waive the 15' setback requirement,
0\ I do not wish to waive the 15'setback requirement.
Si *dame Date
"14. 14- YU- (47'2-IV)! A
Print Name - '- -
■��1111111. .—

• DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: `i/l - .0o-e yt
Address of Property: ,-57 �/�/2rh .v7 S�
(Lot or Street #, Street or Road)
(,ce oA.,„A„,
‘-‘/,d
(City and County)
I hereby certify that I own property adjacent to the above-referenced.property. The indi,
applying for this permit has described to me as shown on the attached drawing the developmer
are proposing. A description or drawing, with dimensions, should be provided with this let?
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Cc
Management,. 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395.
within 10 days of receipt of this notice. No response is considered the same as no object
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift mu
set bck a minimum distance of 15' from my area of riparian access - unless waived by mi
you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
4(/ I do not wish to waive the 15' setback requirement.
Si ame Date
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