41586D - Savory

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yCAMA/ DREDGE & FILL ?
,EN ERAL PERMIT Previous permit#
New _.Modification Complete Reissue Partial Reissue Date previous permit issued
lzed by the State of North Carolina,Department of Environment and Natura sources '/
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 'J N -1.) 00
alRCfes attached.
:Name r'j1 SA o R,( Project Location: County Be IAN stAi,ckt
1-.1;n/ S o R k a. Street Address/State Road/Lot#(s) y// col-;
5j'`4;t'j State C ZIP 3 k°y _
(YA5c1S3- Lilo j Fax 416Q7 -),U °/` Subdivision
Bd Agent &' I t e Cows- ' City S LtNAG r -4.4eN ZIP AAA,
❑CW I4 cloPtA LIES ❑PTS Phone# ( ) River Basin L rY►^
❑OEA ❑HHF ❑IH ❑UBA ❑N/A !�
❑PWS: ❑FC: Adj.Wtr. Body �'/R.v4 (oH AL.17 ./ (nate
yes /� ye PNA / no Crit.Hab. yes / no
Closest Maj.Wtr. Body r"�
Project/Activity 16/Q; ufflp /9 f'4.
(Scale: /
:k)length
(s)
r.ber
I/Riprap length
distance offshore
(distance offshore /
annel
is yards
e/Boatlift
PYnv9
Ildozing
r/i)4t s)f del
/)
Length Zia 5 v V// 54,/1;5
not sure yes
not sure yes rt
Jm: n/a yes
[cached: tier
g permit ma be required by: 5t4 v5 T A3E-XCIL See note on back regarding River Basin ru

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DIVISION OF COASTAL. MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICA1••ION/WAIVEF;
Name of Individual Applying For Permit; 1�A), SR,N C`\ --
Address of Property: \\ 3C1.-AY1.0(.\
(Lot or Street it, Street or Road, City °, C..
I hereby certify tn<:at I own property adjacent to
referenced property. The individual applying for this perm; l
deiscri b.ed to me as shown on the attached drawing the develop
ire propossi.ng. A description ordrawing, with dimensions,
:provd • with this letter.
have no objectives to this proposal .
If you have objections to what 1. 5 being proposed, pl :se? ,•,,
Division of Coastal Management , 1.27 Gdrdina]. Drive Es:;' .e-sns_.i
Wilmington, NC E3405' or call 9107•-395-39OO within 10 days c i
this notice. No response is conssi. der•ed . the same as no oti] E.T: '-
you have been notified by certified mail .
WAIVER SECTION
6
I understand that a pier , dock, mooring pilings, breakwater ,
house, lift or sandbags must be sat back a minimum di stcanc. :.
from my area of riparian access unless waived by me. ( If yc
waive the setback, you must initial the appropriate hi nk
I do wish to waive the 15' setback requirement .
-----_----- I do not wish to waive the 15' setback regc_cl.,remew_ .

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:COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
Signature •'f.17�
ate items 1,2,and 3.Also complete A. Si g
if Restricted Delivery is desired. •
`G�,//� nt
our name and address on tha�reverse vN--� ressee
we can return the card toy6u. . Received by(Prin aNa •,-) C. D of elivery
this card to the back of the mailpiece, ',61
he front if space permits. HIAFDIAN®SAFE, OClarke Aneoran AN
D. Is delivery address different from itL 1 Yes . ..
\ddressed to: If YES,enter delivery address below: 0 No
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,,^^ 3. Service Type O ' D p�D /�
urV\V� <-t — II -1 Dm{ `
i�Certified Mail 0 Express Mail ..
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�C►�2 3 ❑ Registered return Receipt for Merchandise _ t rb - ;
❑ Insured Mail 0 C.O.D. 0
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4. Restricted Delivery?(Extra Fee) ❑Yes 0 It.; 0 t C
\lumber
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rr from servic 7003 1680 0004 9790 7465 Zo$ w
3811,August 2001 Domestic Return Receipt 102595-02-M-1540 _ y Z n
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