39035D - Haebner

1CPMA/.❑DREDGE & FILL
3ENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized 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
❑Rules attached.
t Name /c = , a`-l": Im a✓' Project Location: County ,N2-0N5E,CJ/4/S
/ 4.4.1-r -7 =:= .71" Street Address/
// ri State Road/Lot#(s) /
' '{ � /�5, 1C i State 11/C ZIP q[ ` 1L
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'(9/u)5-7' 1, ,_-, / Fax#( ) Subdivision /
ed Agent /r rce. ('�er75Ttti r C 7L'vvi City OGC!kr l l c'. T{C�C/ ZIP .2 gi/(p
❑CW kEW L krA ❑ES ❑PTS Phone# ( ) River Basin LL i r r
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body `')ct.-r (nat (
❑ PWS: ❑FC:
yes / no PNA yes /''no) Crit.Nab. yes / no Closest Maj.Wtr. Body �«`w
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'Project/Activity 4 -./ r‘-:/C- /�:-, ,/..) y. is i c,G, O, t bC,C k...-
(Scale: /r
ck)length y x/j.
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ier(s)
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ngth
tuber
d/Riprap length I ± }.. —.... ... — _.,..- r
distance offshore
ix distance offshore I ,f 1
1
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cannel — I r"
1
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bic yards 1 {
i np - 0 +If I ._.._._ _a_
Ise/Boatlift 1 i
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ie Length 1
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not sure yes no i i 6- —4
not sure yes z no �, — j... —— r
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urn n/a yes '} ' f '
yes Cno1 ' 1 1 —
Attached: yes (no) • •
1ng permit may be required by: a66 G/.) See note on back regarding River Basin r

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: 7(C ka 146_e rya".
ADDITIONAL NAMES:
AEC DESIG: E h-) $' DEVELOP AREA: .G ( PROJ DESC: Y� -/--Z
(Will only take 6) — — (Will only take 1)
WORK: -I>(Z �F j/ (,
(Will only take 4)
T �) I �
MAINT:
(Will only take 4)
IMP:
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: q• IS-.o Z-15-• U
CAMA MAJOR DEVEL REQUIRED: IS. /Z"9 b4

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit:
�m
Address of Property: �0�
� ���-own��
�J
�
~�~ �-wN���� \�c
--------------------------------------v----
(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 me as shown on the attached drawing the development th
are proposing. A description or drawing, with dimensions, should b
provided with this letter.
__ I have no objectives to this proposal .
If you have objections to what is being proposed, pleas rite the
Division of Coastal Management, 127 Cardinal Drive Extension,
Wilmington, NC 28405 or call 910-395-3900 within 10 days of receipt
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, lift or sandbags must be sat back a minimum distance of 15'
from my area of riparian access unless waived by me. ( If you wish
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 requirempnt .
_
� .
_____________________________________________________________
____________________________________________________________

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: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
lete items 1,2,and 3.Also complete IVe < ,if Restricted Delivery is desired. ❑Agent .'our name and address on the reverse a41-" M Addressee
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i we Can return the Card to you. B. Received by(Pri to ed Name) / C. Date of Delivery osmium d sa y'/!//edo.,,^.'a,,,e;m�en'//'/•,
i this card to the back of the mailpiece, V ....ti.
the front if space permits. rff�i'././1/�`/%/-lfi''✓_7/'/J
D. Is delivery address different from item 1? ❑Yes `„:\\,\.�'\�'\\-‹.- \'�'�\� ��,,<,„
Addressed to: If YES,enter delivery address below: ❑ No �.rr./. /7/77,././f.//,Z.//7,/,%/
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4. Restricted Delivery?(Extra Fee) ❑ z Yes - i 1.11 z ttZ
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;Number In z
701H 1,680 0004 9790 6352 m 0
fer from service label) _ CC
13811,August 2001 Domestic Return Receipt 102595-o2-M-1540'� D c J .1- " �(
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':COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY n
A. Sig ature
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lete items 1,2,and 3.Also complete ❑Agent .. 6N
if Restricted Delivery is desired. Xx,Q _ Pa_�j,(ti [ addressee
it we name and address to the reverse B. Received by(Pr ted Name) C. Date of Delivery X
it this
can return the card you. �/el a 3 I 0 Y
1 this card to the back of the mailpiece, �j�N,P✓ a..�._ O
the front if space permits.
D. Is delivery address different from item 1? El No ru
Addressed to: If YES,enter delivery address below:
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VCertified Mail �❑ Express Mail
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Yes
4. Restricted Delivery?(Extra Fee) 0 ��- _ _ u
eNumber 3 ],680 0004 9790 6345 ,� C
sfer from service lab( 7003
102595-02-M-1540 �, , ,
m 3811,August 2001 Domestic Return Receipt { " r r�^, Efl. -
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