39771D - Langdon

itAMA/ V6REDGE & FILL
3ENERAL PERMIT Previous permit#
ew __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 15A NCAC 9/1 ,//00
/ ides attached.
t Name 3RA X-li Ai �4ti a D/1N �P Project Location: County nic1�Q
1 1 , W e I(en,S 5 J Street Address/State Road/Lot#(s) /.)s -f"Rott'
v‘A;-t\5:1 e(r-1 State NC. ZIP 77 55r/r/ it e
(f) j 3y-20011 Fax# ( ) Subdivision
.ed Agent (ANA4y PAA,Sic yy City V .i �Pk t f ZIP DgyLi
iw [❑CW # LEES ❑PTS Phone# ( ) River Basin C j0
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body (4 v#4/ (nat Qi
❑ PWS: ❑FC:
yes / no PNA yes no Crit. Hab. yes / no Closest Maj.Wtr. Body -it)PS4//cOgN4)
f Project/Activity .\I_AA€A P I CA v z° is
(Scale:J '
ck)length
iier(s) W
:ngth
Riprap length (00 R
U IA4c cu`Ak b
g distance offshore 1 c-,'
ax distance offshore 5
hannel 7 ..4..........-
\\
bic yards jrich
Top `A c\) o / _
) X/ I
Jse/BoatliftI+ Ad
f Act-.
41(
lulldozing L /_)5 1 0 64 t
1
1 1 p
t r
ie Length Co��
not sure yes no
gs: not sure yes no
rium: n/a yes no
yes no
Attached: yes no
ing permit may be required by: 7D(A.1 -46(,i4 I I See note on back regarding River Basin i

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: 1�01 11-'V LAI (t ti
ADDITIONAL NAMES: c'y rn 0 s I'ey
AEC DESIG: W 0T r` 5 DEVELOP AREA: O.O 3 PROJ DESC: - )
(Will only take 6) (Will only take 1)
WORK: 13\k b G>
(Will only take 4) 3 a J
MAINT:
(Will only take 4)
IMP: {- 0-00
(will only take 6)
S(3 \�-C�
ACTION EXPIRATION
DREDGE&FILL REQUIRED: j v( G3-0 7-0 S
CAMA MAJOR DEVEL REQUIRED: 1,)-0 7-0 0 �7 S�

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: f� ,),., �,.,,,J
Address of Property: 75 -641-
(Lot or Street#, Street or Road)
skit/ &AA /I/( 4r)
(City and County)
[ hereby certify that I own property adjacent to the above-referenced property. The individu
applying for this permit has described to me as shown on the attached drawing the development the
are proposing. A descripti or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
[f 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
[ understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must b
;et bck a minimum distance of 15' from my area of riparian access- unless waived by me. (I
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.
cx�q
Da
LJ WA

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: 8tdky zn3„),
Address of Property: Las Trokil Add
(Lot or Street#, Street or Road)
7;10S6-ii 6ea'A e-- a el/#.3
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individu
applying for this permit has described to me as shown on the attached drawing the development thf
are proposing. A description or drawing, with dimensions, should be provided with this letter.
/ewJ I have'no objections to this proposal. P ra v,c/e� -�
whtc-� to(,,) 1
p� e,
ttg�^'yy >a c�i� S"S re ina
If you have objections to what is being proposed, please write the Division of Coast,
VIanagement, 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
[ understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must b
;et bek a minimum distance of 15' from my area of riparian access- unless waived by me. (1
'ou wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
&0-6 I do not wish to waive the 15' setback requirement.
ge_e.,44if 64). /vo v / 9, Zoo 4
>ign Name Date
w A`55 _A

WILMINGTON, NC 28411-7130 / G 08-19/630 NC •
DATE—_ 702
•
PAY
TO THE / �l
ORDER OF N` PV t ---- $ �&
G(n.e /' \� --- DOLLARS
Bank ofAmerica
410.40014911t
ACH R!T 053000106 e�
FOR__G I:12 1 / "P
11100 133011° 1:0 5 3000 1961: 0006847437 811■
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