Measamer, Wesley 76682C

/ NOREDGE I FILL
ER/AL PERMIT
trMoOifictfn DComflete Rerissue trpardal Rdssue
As by dr Sa of Nordr C:rolina Depennrent of Envlronrrcnal erellty
rnd thc Rcsourccs in ur arcaof cnvlronrncnEl puntnnt60 l5A
Applicant Prolect Locaion:
c
Phone #
ArdrorLedASsr
-\i:' :5682
Prsvious pennit #AB
Afre@d
AEC(s):
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trura orya
Phone #
Adj. Wtr.
Closcst Mr{. Wu. BodyORW: y6 I PXA ys I
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Type of Proiect/ Acthdt,
(Scdc:)Pb (dock)
Fixrd Phdann(s)
HdrSPHan(,
Firgr
G.otr Lrldt
B*tr4RIprrpt
.Adsrrro oBhotl-
mu&ancc
Bain,drarrEl
cr.trk
Bot rartp
Badl
Stpolhc Lrqfth
sAv mtsr F D
Mmodum rtlz F no
Ph@c ,c
CI
no
\tYdvr Atodrcd:no
A bulHlrg pcrfldt may bc rcquhod by:note on bock River Bsio
( Nota Loc.l n nr*tg
D
--L - r. -.
P ANP PERTY
I hereby certify that I own property adjacent to es
property located at ?\\I ut< d6
-Tk 0/&i (Aa rees, Lot,k,d,
on in
(Waterbody)
qAef
Owner)(
)(N.C
(City/Town and/or County)
The applicant has described to me, as shown below, the development- locetion.4 +1+- I have no obiection to this proposal.
I have objec{ions to this proposal.
DESCRIPTION AND/OR DRAWNG OF PROPOSED DEVE
(lndivldual proposing development must fttl in description helow or attach a site drawing)
oo )q'00
lb'lL'
3t
V
I do no{ wish to waive the 15' setback requirement
.lnformation)
o
^1
L IH
lnformation)
e
C4J6<r1
gf/L
66f
.mI -k^$-.ff;
0
.?t
(t
)
I understand that a pier, dock, mooring pilings, breakwater, boalhouse, lift, or groin must be set
back a minimum distance of 15'from my area of riparian access unless waived by me. (lf you
wish to waive the setback, you must initlal the appropriate blank betow.)
Ftl I do wish to waive the 15' setback requirement.
(P
s,
Pint or
cit
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eme
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Date
)5t)
Date
O
az
Type
RECEIVED
JUN 10 2020
(Revised A1V2012)
DCM.MHD CIry
at the
ADJAC RI T
I hereby certify that I own property adjacent to YA 6uv
)\) )ld (c*x"of Property Owner)
pro
on
located at
*r),4 " Tt fl,^$do m,tJ^L,
rc
s
(
4
ress, Lot B
in , N.C.
The applicant
(Waterbody) (City/Town andror County)
has described to me, as shown below, the development proposed at the above
I have no objection to this proposal.
I have objections to this proposal
DESCRIPTION ANO/OR DRAW!NG OF PROPOSED DEVELOPMENT
(lndivldual proposing development must filt in description below or altach a site drawing)
00 )u'o
IL'
0
0006
"-,Hfn'
9
(;
R EC N
I do not wish to waive the 15' setback requirement
r ln ation)
II.,J \[\
(Adjacent Property Grvner lnformation)
Print or
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15'from my area of riparian access unless waived by me. (lf you
wislrto waive lhe setback, you must initial the appropriate blank below.)
(l\ I do wish to waive the 15' setback requiremenr.
(P
.9I
@JNt\U
Pint or2i g
rh,l Mailing ACdrcss
,11r"o /U( 27r 51
city8iatJlzip
?t9- 729 - ??60I
Teleohone Number' A1^7ozo
Telephone N
IVED
(Rev,sedWde0l420
DCM-MHD CITY
Dale
28511
Date
zo20
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6