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74CAMA/ ❑DREDGE & FILL `Si2 .."
AENERAL PERMIT Previous permit# ,--
ANew ❑Modification III 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 -7 0[ ' a!z G U
❑ es attached.
it Name €. J E'- IM I(I Project Location: County t D ll.(A-
' 2 5 T,7CL f l N Street Address/State Road/Lot#(s)
W I L. kw, Stated( ZIP 74j . 0f6tt /lJ
t( )06 - 1 Fax#( ) Subdivision F-1( ' ' Ise
:ed AgentT J h` City )f L lti` ZIP 7 ril
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E CW EW )TJA ❑ES ❑PTs Phone# ( ) River BasinC f�—1
❑OEA /❑HHF ❑IH ❑UBA ❑WA Adj.Wtr. Body L"ANAL 6FF 6 WKS ( a
❑PWS: ❑FC: �pn-,
yes no PNA yes / o Crit.Hab. yes / no Closest Maj.Wtr. Body M(PPL C SCJrP
I Project/Activity lA. i) /in- 4 P t 4 r T r' do c4---
/ (Scale: 1 i1
)ck)length / il
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ner(s) i i
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:ngth i t - —J— I
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,d/Riprap length t
g distance offshore ... _ _.
ax distance offshore _. • —_ -. } -. + _ _. �-
hannel I I '
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re Length D D I
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not sure yes -_ .— .,—--L' .__- --- _. _
;s: not sure yes no
rrum: n/a yes ,
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Yes g i i
,
Attached: yes
ing permit may be required by: IGLU 40Vet j" • . See note on back regarding River Basin r
ue -i // /7ie.c

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: 'west fl4 r'O
ADDITIONAL NAMES: Jobs k/k
AEC DESIG: W1 f 7'4 DEVELOP AREA: (9 a t) Z PROJ DESC: -
(Will only take 6) (Will only take 1)
WORK: FS, g 2 41
(Will only take 4)
TS , t�
MAINT:
(Will only take 4)
IMP: Cm/ 3 2 d
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: ('j"O"( - n-09
CAMA MAJOR DEVEL REQUIRED: LI- f 9ra1 ` 11-0L1

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: DR + PitizS ERNEST AA)(an
Address of Property: 25 1MCL 1p3 NWT
(Lot or Street#, Street or Road)
WDA41.M6.1C11/41 i 1JC_ z.J- ti
(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 developmei
are proposing. •A description or drawing,with dimensions, should be provided with this lei
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of C
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-39'_
within 10 days of receipt of this notice. No response is considered the same as no objec
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift m
set bck a minimum distance of 15' from my area of riparian access- unless waived by n
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.
t,
Sign Name Date

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JOHN H. KING
rs 477 4
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1:053000 L961: 000 L80017535i' 4774
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