39801D - Henderson

1 CAMA/ I DREDGE & FILL I *
iENERAL PERMIT Previous permit#
New _,--Modification_,--Modification —Complete Reissue J w Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources !l
oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7 A • ' ,g-0�-•�
ies attached.
:Name V i' t i a Ns_ 1-4-. .. A, r.. d ti Project Location: County 0 1�S LULU
40 74 4 .S T. Street Address/State Road/Lot#(s) 9 04-'D.... I
u r F C State Nt ZIP Z.EA4S- Sr• )1M
(Ng ale, S-'7D121 Fax#( ) Subdivision ©L,4� S 1.'(`( LP r-s C.r
!d Agent r°r City Sa r F Cc. ,ZIP �-841
❑CW f W )$'PTA ❑ES ❑PTS Phone# ri to)328 River Basin
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body CA t1/4-)A L. (nat /r
❑PWS: ❑FC:
yer.5 PNA 0/ no Crit.Hab. yes / no Closest Maj.Wtr. Body SD
Project/Activity �l I i/`t r c, P( e f
r , jl T (Scale: ' l c
:k)length IA
(s)
er(s) X 3 1
igth
nber — — —
I/Riprap length tit-1-1.,_ —•"r` '
distance offshore
K distance offshore `` .. . .l . . . , j°i6 .-.-.a i _ t t ... .....
annel 1 41 3fi f f i
dC yards ( .. 1 + I....
s(13oatli i 1 •
j
il
i — \ �
illdozing ' I �' S (j
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fi
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Length �_ ' a,
not sure . yes _
4
not sure yes q Q y ,.I 1, �. T I k
{..-
um: n/a yes +v L , (p l�
J
1• no
1 y
Ltached: "fit ' i , - _
ig permit may be required by: SLIt2F C ( n/ See note on back regarding River Basin ri

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APPLICANT NA NE: i/l) ) 4e44.02jair
SoY�
ADDITIONAL NAMES:
AEC DESIG r --1N D '_ .OP"�P�4: ,i PROJ DESC:
(will OQSIVt.r�6-) twin°thyimi t 1)
WORK: �� j a,) (p EU 14
(wilt t, ,3 13 �3
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auly 4)Q -
IMP: (,J 5 ) "1
ACTION :XrIRATION
DPI &P31.1 REQUIRED •
CA AMAJORDEVT RfiQU : t2_"( ` `I

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: A4..`blit, /x,'zz / 'ic,
Address of Property: fa- 57.
(Lot or Street#, Street or Road)
, /- (,' ir/.c . .psi
(City and Coun )
I hereby certify that I own property adjacent to the above-referenced property. The individw
applying for this permit has described to me as shown on the attached drawing the development the
are proposing. A description or drawing, with dimensions, should be provided with this letter.
4eg_
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coast
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-390
within 10 days of receipt of this notice. No response is considered the same as no objection i
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 s(
bck a minimum distance of 15' from my area of riparian access-unless waived by me. (If yo
wish to w,)„Iaive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
Oi4-°-�
I do not wish to waive the 15' setback requirement.
_1/ ?4 c2WA "i(r
Si Name Date
ri'v/A V Grid 2- 4- 4- AAA

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: a/IL /A'N1 M- /6vDtrzsesA)
Address of Property: �� y.9 �'�` s- _
(Lot or Street#, Street or Road)
Si.,,e 'Ali, A) .c . 1v5L Cc).
(City and Cou tyl
I hereby certify that I own property adjacent to the above-referenced property. The individuh
applying for this permit has described to me as shown on the attached drawing the development the
are proposing. A description or drawing, with dimensions, should be provided with this letter.
> ,(‘ .' m
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coast.
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-390
within 10 days of receipt of this notice. No response is considered the same as no objection
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 sf
bck a minimum distance of 15' from my area of riparian access-unless waived by me. (If yo
wish to waive the setback, you must initial the appropriate blank below.)
:*. t_:7;?\(' I do wish to waive the 15' setback requirement. /
I do not wish to waive the 15' setback requirement.
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Pay to the r ,(
order of /�L /V _ $ `A'l/ /61%--
7 /
o�n� -
+ s Dollars 8
Bank of merica
ACH R/T 053000196
L ' /
For -- ` -_- -----•--- �
I:053000 L961: 000695487054v L L
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