28290D - Grossnickle

i,
CAMA and DREDGE AND FILL 6/°S - So qo y lil
G E N E R A L Ii) 2829O
PERMIT
as authorized by the State of North Carolina
• Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC /11 /•)0 u .
Applicant Name wA //'ve /4; - t.,K t: >>A/, Alt / '/ Phone Number f qI0 j . ; -U Li 7�
Address / 5 -2---- a,...i .f r+i uCr.e 4.),Ail 14
City `,a/✓ r`; �—Px Ry State /t/C Zip D eY 6 G
Project Location (County, State Road, Water Body, etc.) S 4''P Ac1:14 C Pam-/ (i 4ija,ii/( l i/,
Type of Project Activity /'iPiu4T, A e/2 / /�/47�iA/11 , I 347' V0 U Si---
i v P; 7 (;/-,, ,:ifrity. ,--",A&,/ SPA6. Oven L1TH /howdy• S ' 46drr 1.0m4I / / irikt ,
PROJECT DESCRIPTION SKETCH (SCALE: / '7' (,b / )
Pier(dock)Length `/ Y r p1., 'fit - � y i
Groin Length
f
number t
Bulkhead Length 1 I II O
max.distance offshore "OIii t mil aa/`�►
011111111 .._ M11— ,s ' .. ,,
Basin,channel dimensions '
3 `
biiiiIii.-''ll!itglr .•'...:•"-7n n
,,,... ..... „„„,. 1 ._.__........
, ,,,,.....,;-,„
P.
cubic yards r I e
Boat ramp dimensions
POI.� r `r a o- L,
other it l 'X' > —» g
s
, . . ........aAmwmas.
,, k -,..„
..,:, a ......
_,...... \....,_..., .._.. .,. ..
, 4. 1
.._. _.. ,......y«,.._,,....... --•--. .. . ....... ...-.— .,...,Y,,..,........__.
•
Thispermit is to compliance with this application, site �� /_ `
subjectP PPdrawing _ .—, ►— - ---"
and attached general and specific conditions.Any violation of these terms applicant's signature
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void. I '
This permit must be on the project site and accessible to the permit of- / permit officer's signature
ficer when the project is inspected for compliance. The applicant certi- 09- /¶ _ 0 1 /,)- i t1'- 9
fies by signing this permit that 1) this project is consistent with the local issuing date expiration date
land use plan and all local ordinances, and 2) a written statement has
been obtained from adjacent riparian landowners certifying that they /1 / U`I
have no objections to the proposed work. attachments
in issuing this permit the State of North Carolina certifies that this project /j//0 0, CSC-1# g
is consistent with the North Carolina Coastal Management Program. +++"""777 application fee

p( c). act 110
CODES FOR AEC DESIGNATIONS
l. Ile,-
'Lou' - Ocean Hazard "PT" - Public Trust
"EW- Estuarine Waters "CW"- Coastal Wetlands
"ES" - Estuarine Shoreline "FC" - Fragile-Coastal Natural/Cultural
"PW"- Public Water Supply "OR" - Outstanding Resource Water --
CODES FOR PROJECT
LLP"- Private-usually an individual "F"- Federal
"C"- Commercial "L"- Local Government
�
"U"- •Utility "H"- Housing Development
•
"S"- State • "0"- Other
•
# CODES FOR PROJ DES CRlFTION
"11"- Bulkheads,Riprap "16" - Utility Lines
"12" - Piers,Docks Boathouses "17" - Emergency Repairs •
"13" - Boat Ramps "18"- Beach Bulldozing
14 - Wooden-Groins "19"- Temporary P rary Structures
-- — "15"- Maintenance:of Basins, Channels,Ditches__ -__— _- ------ --------
GENERkL PERivirr COMPUTER FORM
APPLICANT NAME: /A'V/VE 6,e v S S/(// AiI,- •
ADDITIONAL,NAMES: 4476 ivo/ 7 of
AEC.DESIG: tw PT , G(A" DEVELOP AREA: v, ( PROJ DES C:P -
(Will •
(Will onlytake 1)
WORK: PR (I, 1,2cc L 13i l ?cA'
(Rrtll onlytake4)
a " � 1�'O wP 3 I 3c� v
M_AINT:
(vim only.take4)
IMP: rj V✓ —1 b )'
(cull only take 6)
.ACTION EXPIRATION
.DREDGE FILL REQUIRED:
CAMA MAJOR DEV!-:I.REQUIR,L-2): 01 s?fr°/_ (")- f

j.
CAI'IA• 1hd DREDGE AND FILL 6°S - Sc� 9°LII �
E , N E A
N. 28290-0.
G
it
_ ;- P :` €I t 1 . T
as au nori i nd by the State of North Carolina
ii .. ": Depa h t of Environment and Natural Resources and the Coastal Resources Commission
' '- in an area of environmental concern pursuant to 15 NCAC 71f• /0-00
Applicant Name ki /Ve , _ �` D ss�vr eK/t' Phone Number C9f0) 33 7. . 0 (475
Address /53 B,11 .1- , oci �e, Aq -
J J � �_ •
. City �/✓��r �/�P y State Zip �6 G
Project Location (County, State Road, Water Body, etc.) s4 , 4J•Q-Ge C44cv) ic £ r
6ws,Io i., a .
Type of Project Activity- 1° v�ce �t e2 `J/ ,?,t , 1 , G"� use
-g- • o;er Sit! e Rie'I SP4-6- o deR &fzf-f officedr- SI 4'6 a-c 47m*f 411
= 4 144/
PROJECT DESCRIPTION SKETCH (SCALE: / ' 6p'o )
o e � € _ � F
Pier(dock)Length 4� t f-- f_ r g._ s 1._ r _ � _1 m ' ..�1
l _ _ #
Groin Length ii i € { _r l ._ 1 1_-r i { j €
number i _.i # [ ,.n( 1 • > _.$ 1 1
Bulkhead Length 1 i n _-1mm [ j 1_ I . 1 I j q� l
max.distance offshore .� / 1 I 1 I , 1 € 1 ; ,. 1'r" k 1 . g^ i
�p► r-_ -t---- -.._.. (j (Al _
#s
)Basin,channel dimensions x :, 6' r
i
cubic yards • 1 i ; 1 i ! i i 1 a € 1 1 i 1 tr ,. € i € ( i ! i ' I eosi L :,
1, 1 1 1 ' i I I : , 1 1
Boat ramp dimensions ' 1 3 I 1 1 s i :� j 7 1�� i ^� �mm �D1 I '€
b� t 1 E, F tom •' T-4-0- .y ,,:
trr
Other 'd *- ...•.. ." .. .._L._ .£ € F--- t --i • I I 1 i i`j-o i— 1 '
0Q _ i w_ i li . i i ,
.1
F
i 1 i �1 i
1 i
t ! _ l• i • I a 1 1 .1_ I , _ � 1 1
•
�, i 1
_._r I (._ : i i �° 3 ,...,. ._ i .. ..j � i 1 i'
is 1 F 1 1".... i _.. i { 1 i _ : 1 € 1 : i
, F _ #u...�Sw. x�c sm:.^•Y KJD 4».vG9� +m sc""'.uas�+rx--„+Sa.no�4.sS>.
: '.
This permit is subject to compliance with this application, site drawing 111/
and attached general and specific conditions.Any violation of these terms i applicant's signature
may subject the permittee to a fine, imprisonment or civil action; an.
may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit of- permit officer's signature
• .ficer when the project is inspected for compliance:The applicant certi- 0?_i r�c>( i.)-1r-o(
fies by signing this permit that 1)this project is consistent with the local issuing date expiration date
land use plan and all local ordinances, and 2) a written statement has •
been obtained from adjacent riparian landowners certifying that they 7 f/. I -O°
.have no objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that this project i�' tQO; °� C
is consistent with the North Carolina Coastal Management Program. 1 application fee

CAMA and DREDGE AND FILL c,,p5 F If — Sa0-1i7 /9-
(0 GP EE NR E R A L N° 28281
as authorized by t tate of North Carolina
> ,;,,,, Department o nvironment and Natural Resourc- - - • - oastal 'esour -s Commissi n
in an area environm tal concer pursua'tto 15 NIAC 914 - / DC) •
Applicant Name WA-Y f ; V 0 "Sit/i• I Q Phone Number 9r°, Z7 y75-
Address I 3 / ' i U 1/Ant O C.K a• I. r /e0,4(
City S/vt° -b i ,=-e21Y - .te /VC Zip
Project Location (County, State Road, Wat r B y, etc.) SA M►n-2 /4-6 T4(E C r' D t4C(c
Type of Project Actl ity nQ;cifr o /- ,c?f r- ��''I �� r — ...?o �" ti S
PROJECT DESCRIPTIO SKETCH (SCALE: / Co ' )
Pier(dock)Length
i
X SI ) 0..c--:---- NM
Groin Length
number I ill., i P
, ,
Bulkhead Length ifilit-N-4"--
max.distance offshore
_.. ..�� _ • i _ a
Basin,channel dimensions ( I
i i 7 )r i J
cubic yards
V' r i
Boat ramp dimensions t r.._...
C
___04 . _ Li‘\*;- ‘?)ipS—J
ra-t Hot s a
Other gjD I, vs. __I 1 . . _____ 1,.., .L
/0,y...1o/ 1111111111411111111 ......t
11J
}}
I
4 1. #— c, f )
I
•
T ____, ?1, [ -
("-- ,
This permit is subject to compliance with this application, site drawing i
and attached general and specific conditions.Any violation of these terms I'f �� /
g plicant's signaar
may subject the permittee to a fine, imprisonment or civil action; and 4-1
may cause the permit to become null and void. 0, . ( "`
This permit must be on the project site and accessible to the permit of—
ficer when the project is inspected for compliance. The applicant certi- D _ v y--a / /cD —0 y----0/
fies by signing this permit that 1)this project is consistent with the local issuing date expiration date
land use plan and all local ordinances, and 2) a written statement has J�_ U
been obtained from adjacent riparian landowners certifying that they /7
have no objections to the proposed work. attachments
aU
In issuing this permit the State of North Carolina certifies that this project /e, �, C
is consistent with the North Carolina Coastal Management Program. application fee

CAMA and DREDGE AND FILL-x= ---s"a '` I_?
G E N E R L ,. : 28281
P [ R . M1T r--
as authorized by the State of North Carolina 1�--
• Department of Environment and Natural Resources and the Coast I Resourc Commission
in an area of environmental concern pursuant to 15 NCAC ) =`
Applicant Name A OF V R/0 5S iv 1 C K/ Q, Phone Nu be_,_--h' �) 5 9 'U ti 7S
I
Address 115 3 I s !& /- /tit/7't 0 C Co,0 1P�
City S AI ?A b S /--p p#ey State /V:C Zip /
Project Location ( ounty, State Road, Water Body, etc.) •
C/4 I'vL-P A 9 TA C�� ✓I� C f(
1. / y . d r- 5 411". e,,e; --_,_
Type of Project Activity 49, UA: P2 l' / /47�Rir 1111
, 1/ c 7y S F'
PROJECT DESCRIPTION SKE ..i.,.
TCH (SCALE' �° ,
_ r
. , i
Pier(dock)Lengthitimmi
m,
. 1 \
----÷— s _ til 11 '
Groin Length i 11 .,
,_ .
number ll ■ , I
Bulkhead Length 111
max.distance offshore 11.1 . t
_gym'. _ a l� !! __
Basin,channel dimensionsum ..
'� W
11111
t - .. ._._.e........__ ,cubic yards 1 i • f %
*_,.._,.„. I pa 3
Boat ramp dimensions t-!.. '"°
Other 30 mm". Inla
IIIin -
..
I ' xi� .m_ _. III" ■
I— riff
MI
. .._..,..- .- —4-- , r • . _._r
This permit is subject to compliance with this application, site drawing -�y, ,;__„_ , / r'�' ( _J -
and attached general and specific conditions.An violation of these terms K
` �'v "� �— \ ( ` 1g p Y � applicant's signature
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void. 4 1 • VA ^'' —
This permit must be on the project site and accessible to the permit of- permit officer's signature
ficer when the project is inspected for compliance. The applicant certi- (9 - C) �/- G / v /1:' r,, Y- G /
fies by signing this permit that 1)this project is consistent with the local issuing date expiration date
land use plan and all local ordinances, and 2) a written statement has 7/7 f'=.2 u
been obtained from adjacent riparian landowners certifying that they
have no objections to the proposed work. attachments
°v
In issuing this permit the State of North Carolina certifies that this project /Q�1
is consistent with the North Carolina Coastal Management Program. application fee

CAMA and DREDGE AND FILL
G E N E R A L
PERMIT
as authorized by the State of North Carolina
><.,......„„------.2.% Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC .
Applicant Name th \V/v f +WV 1 ir J'S wrc." K / 'F Phone Number
Address r C.- f./,4tii rN i( v P), c 1 _ ��-6
City --e/ ',?/ —State Al Z i p
Project Location (County, State Road, Water Body, etc.) -C,1 KY'45 A '> TA ('.
y �:.,�• cam;
Type of Project Activity 4 (.0 r'- r i. //i%�-virin , / % '`t:,4,-7 S F'
PROJECT DESCRIPTION SKETCH (SCALE:-/ '' 4,( )
yr • .1iM1 leI aI_,.I..c
; •t
,.. 1
i ll
- 1IIA --- i411Mn1n11il11 11 Miin i 1m1aIm1a1lna11
Groin Length IS
number Bulkhead length IEL6IIIiiUUIflL
max.distance offshore R ! RIIIIIwI
11111
, Iiiiiilliiiifillan Illifillii ' ---- -11110g 1
Basin,channel dimensions Mt lite
N111 i
cubic yards ' < Fill. .1-'
_____m___i/____t_ animillt >iiittlta
Boat ramp dimensionsWig! •
Other /. P t �'JLA S F 111 � In° lirerlitiMa-
i t,,y...)0 i I : , '''' 1 _ ill .,_,.................--/ minium
11111111111 III
, al . ,
a - 1- . , a EL .7 1 a rn _ -
IN
1 . _ :
This permit is subject to compliance with this application, site drawing Xf 4.-•
and attachedgeneral and specific conditions.Anyviolation of these terms
P applicant's signature
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void. . --,1`�_ . �c, . - '� �"
This permit must be on the project site and accessible to the permit of- permit officer's signature
ficer when the project is inspected for compliance. The applicant certi- ,r)9- /) V-- c, / ` A • r, V-- C
fies by signing this permit that 1)this project is consistent with the local issuing date expiration date
land use plan and all local ordinances, and 2) a written statement has )/
been obtained from adjacent riparian landowners certifying that they
have no objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that this project (/)�� �/
is consistent with the North Carolina Coastal Management Program. application fee

•
ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
I Complete items 1,2,and 3.Also complete A. Received by(Please Print Clearly) B. Date of Delivery
item 4 if Restricted Delivery is desired. [// 10.4zeo / C
I Print your name and address on the reverse C. Sign. . e
so that we can return the card to you. •
CI Agent
I Attach this card to the back of the mailpiece, X /
or on the front if space permits. ❑Addressee
D. Is delivery address diff- -nt from item 1? 0 Yes
. Article Addressed to:
If YES,enter delivery address below: 0 No
R//9 i J/yi_"/-39-
/ C/7ziriv C /, J
s�i1 iC /4 3. Service Type
Z
c,-6— ❑Certified Mail 0 Express Mail
❑ Registered 0 Return Receipt for Merchandise
0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
. Article Number(Copy from service label)
S Form 3811,July 1999 Domestic Return Receipt 102595.00-M-0952

UNITED STATES POSTAL SER•• • I L Z -11111111"1.111
it -sta•e lassc .
fo id
Lu PM ry
• Sender: Please pr • a r\ . e, address;art R+Lirt4hisix x-R---w
IA1R ,� �r,�sr /Ai �/74
y
f,44: .r' C ?#"
8460-1-,- i,�l,ii�tiE�i,,1EIf��H���1�s;i,i,iti„iE,ifL�i�i„�li�i�"lt \)

�p99 3403 0n°?
?268 p851 �'
} vC) In
3m
3,51 M C O
O V1
IA N ;,_� o p< 4 g N tl, m�
O` .�0•••C O. 11 C T O N
� I T T Z al
v
uwi
',. m
.ENDER: CD
, . ' '.,-1: . ty)6 NI-0 s) 13,
o
COMPLETE THIS SECTION ;Q /,'6� ill
I Complete items 1, 2,and 3.Also complete •
item 4 if Restricted Delivery is desired. _ �� ' , - 7,--0/
I Print your name and address on the reverse
so that we can return the card to you.
• Attach this card to the back of the mailpiece, x 7 ❑Agent
or on the front if space permits. ❑Addressee
D. Is delivery a(I ress errs from item 1? ❑Yes
. Article Addressed to: If YES,enter delivery address below: 0 No
He1IUi4, ,SIteta/C'f1, \//-
Iq4- ('t1,-1 .s ( f;o/ .
3. Service Type
Svt& CIS f r,, it-) Certified Mail ❑ Express Mail
C ��,)( ❑ Registered JReturn Receipt for Merchandise
;,1� / 0 Insured Mail 0 C.O.D.
/
h( / 4. Restricted Delivery?(Extra Fee) ❑Yes
I. Article Number(Copy from service label)
'S Form 3811,July 1999 Domestic Return Receipt 102595.00-M-0952

Alo
> - 1i0.?a 08
- 'ar m
N N
a
a` a 'a o3 v- �ow 3 Q d,
,v Era,.2„'o as `g c a
:, ° .w r er camp m.a .U'a c rn
a m 0 ONo-�d sty. ai Q •0 `tu. o
C aa)aot E N.-C =
3'cs a�o Y a
ca
o O a g QE o�'� mar �cra E
v oa ��Qao tE gmo c
• °i LL .E a a nm �a °'
O. D a-D 1)0 caa O m ht
"' _r 92a v - Qo ..
3 m ¢aa, m,m mu ' —
a a o arr a;a¢E n a r,
a a _C C cop .-- o L N'a a >. •N va
La a -Q at —a a'a)a a a1 a) V C,c i
a E m `) .�€,�u( E.r EYE c
CD v d Qc E�mcv) �Cm atom o
CD
-0 .a ¢— ?avi�.�J may` �yar cv
•0 � aai 'm >'a ¢o m m aJ aai a, v a .0
p o _6 Y z > O.m m E^¢a a o'O a, m
a a. a �O a, UE �m�aZ d$O ��a m r,
•ay ; a GE v) ZOgi m m..E-a moo 2.9 c
arn �' o 0)� li m :°Du EI .ova ..-tp- a., g
r
04 UNITED STATES POSTAL SEFjV1 /,- " rst-Classil-r"
r- Z�_'' -•
-_ _a.e : -:Lij
pM ,
>- r - - - - i
• Sender: Please pr it • E7p.• e, address, and ZIP+4 in this box •
trf g>,'C�� rti ek
( �3 i w-+yv,e>r•• le, 2ci .
gii,e"
'a(/t✓S try/rj 1J- c <-'
:+_.a-i- = _ I,:I;II,;I,.I„1;II.,Il,,,i,,;I,I;I;I,:I,,I,I„I,I„;IJ;l..;ll

•
1 �
•
Wayne 8 Mary Grossnickle
153 Big Hammock Point Road
Sneads Ferry, NC 28460
[phone]
August 17, 2001
Mr. & Mrs. Melvin M. Shepard, Jr.
194 Charles Creek Road
Sneads Ferry, NC 28460
Dear Mr. & Mrs. Shepard:
Further to our letter to you of April 20, we are now writing to advise you of a change in our
plans to build-a pier and boathouse on Chadwick Bay.
We are now planning to build a single walkway on our tot, with a single pier and boathouse on
Chadwick Bay, as per the enclosed diagram. We are submitting the same diagram to CAMA
for their approval.
It is our understanding that you have certain fishing rights in Chadwick Bay, and therefore we
are seeking your permission to build the pier and boathouse.
We hope you will have no objections and look forward to hearing from you at your earliest
convenience. If you should have any questions, you can reach us at the number above.
Sincerely,
•
Wayne & Mary Grossnickle
Enc.

r - — - _ —Y- - .7 --_.._._ _ .-, _
's Y r s • Ii I , l;
b 44.kt, J' •:4 t�4 • .1 > 7,1 ii:
F t` 1 trE'1..-
«ti;• � . r t� W tit .. � , .r N� .."'. �. .- -.__'^___ -__•_.._-_- ,.. _—._... ..... .. -.. __._ f �•li:1,..,.1-:.:1111:,:l.i.
,•
ea
— ,...;—?--,•
i x it ! _•
2 r. - , . -,- .-- —..- -- 1,-1_1;
r •,,
„ ....... ., .
, • i •, , ..i.i.,.
, ... .,..
1, •....._•::,. :),..,,,,,,,
;ti:-!::,..-t,.-4,,....,..,,,..,... s,:_,•,.. .,.L,.i,. . . , • .
IN k . ._. , .
.. .. . . ,.. . ..
:3-- •
, . .. ......
. . . • .
.z.:,!.s....,.-1.;:.•:,,,.iii„,;;;;,',,:;, ;....,..----, .....--.---,—r--,••,,•.1,;::•: . ---- -----.• —•••.,,:.-7••• -,:• -7-1 .- • -- '-- . •• : :,... 7-7
r - •__ - .... _.. .. _ .: — - 1 -•
r} '.i+ t 11' I - - JI1. i }l
�t T_. r
m. w. . , ..: ,
--�.__. ( \ .4 ' ` ' �. - -tom __-..._.... +- _ - _ i__-
i • r ���
2 '!
V - u Y
s.
.. . -. - ^�j
_--ii...,',ii.
'mot •
' �..
1 1 :I
N 5.1 tT
N C O . .
y.
' ' ,....L.°.C2.1, \ ....
,A (.qpi '').1-- t,. \ ,,
V
,,tk0 1. l dfi;f,•Z/fir 1 ' .
i 1
NYI 5 y, T
i � � '' I li a
'SL 1 K1 4 4. { i 1 11
_J/M'9I - 1_�..—r_ at F4*Ali:. .—,_._...-J7...._� ,..L....0 l�l.��� x.=.a. __. __. _ _.. _ _._._ - - _ ._ass,#.�—.,•___.cs,�.rrsr�-..cL....�...........a-.... �I8:

talAi. Lt ic; 4,11LAXJSKINEKTY_USYNER NCf.IF CATI
..i:>Utfkl
Name 01 t�r.:r� ;.... . ,t rtirn� For hymn: 4)4 1,U. 9L- -14k V Ai/G4-1
Address (n• ;'r,x,r;.• Z74 PO//U (
Sti�q� iE `f a12>5L�l�
pLai or tir,�et A� Street or Read, City & County)
hereby .erT>r, th t: , ,,wt, ply adjacent to the above-reterenoed property. The individual
apphrng for ails vt..:7m1t haste tome as shown on the attached drawing the development
the) are proposing \ dirscripdeit or drawing, with dimensions, should be provided with this
ecter.
h.. ,t)10Ctioet to slit proposal
L X� have. OU,LcIC!gone .iLi. pIeaya.,, _tht fivi.iori of Coastal
Aanage.amiu• 127 North —ff-- JNnexh pa kfls ar A 41 fl 05_
100..wlrb its 1S) dam of
01mdaRe.xs en aihr hri�
ni ba ye berm nwi t.-td by flail ���
I understand that a pi ,iacjc, aoarEs ohms, breakwater, boat house, lift or sandbags must be
,:i•t back a minimum distance of IV bars nay area of ripenaa awes' unless waived by me. (if you
writ, to wage, r;ir stlha,-; wtw tam initial the appropriate blank below.)
d0 Ma ni waive the 1 S setback regatretneat.
ck� oor Writ, to waive the l S' setback requitement.
iffrAPRIPIN,
a+ •
S;e oarure Date T'^'
F/P/1Nc�s c. vfrp Q. orits.ToI'1/t^� �:4,d
Print .N - ,,
�o- Spa - 9a�o 0
rt ieptlone ? urniler Wr•' lrea emelt 14 TaLrrt b'
r ftvoro•n*I T AMO kilArtaw IttsauctClf

I
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit: 11JA`/AJ= + //R
Address Of Property: /J b/(r 1/4//t(06/<- �D/2i i eOAA
(3,t)C/oz,) (b(+ti -
(Lot or Street#, Street or Road, City and County)
I hereby certify that 1 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
they are pro sing. A description or drawing,with dimensions,should be provided with this letter.
I have no objection to this proposal.
It you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension,Wilmington, North Carolina,28405 or call 910 395-
3900 within 10 days of receipt of 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
set back a minimum distance of 15'from my area of riparian access unless waived by me. (If 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 t5' setback requirement.
Ar crA
S. a to
Pr' t Nam '5�_Ha
Telephone Number With Area Code

i , • i
1 . ,
: . • , ,
N ' ,
i.-
\\
N
' 1 )
1
,
k'N
• I li ,S
, .•
, .
i ' A