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`' . CAMA AND DREDGE AND FILL
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` y GENERAL l�0 25'76-0
PERMIT Ys7
as authorized by the State of North Carolina
Department of Environment, Health,and Natural Resources and the?oa�tal Resources Commission
in an area of environmental concern pursuant to 15A NCAC /4
Applicant Na L. rr erLl M Phone Number
Address 'D y a S
City Y AL) '``k, State O N p �t �� 2
Pro'e �-pc ctcation oun\y, S e Road, W ter Body,e 4 r
I)cl K G K 0 U r• ct a k e"- f -D A tAi K.// (II r w n S Gvt( ,got.
Ty fP o ctActivit Co S r ,c� Opp �deo ff' b—� ct � /1°►— trA /2J3wt ti ri
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PROJECT DESCRIPTION SKETCH A \Ai id ! lq r \/ ALE: S- 7' sc(flle )
Pier(dock) length f J ''VV
e x,,i,„�
Groin length I N
Propose /5t,ic hf•c
number \�
Bulk ead length ry "D t I
/-� //, eKe" rl'i I / '
max.distance offshore , ' 1 /31
Basin,channel dimensions
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cubic yards ,, \
Boat ramp dimensions s'1 r
CIs :
Other
(3)1q(t�
} ! — .
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any () c --. —
violation of these terms may subject the permittee to a fine, \ applicant's signature
imprisonment or civil action; and may cause the permit to be
come null and void. a`
This permit must be on the project site and accessible to the permit officer's signature
permit officer when the project is inspected for compliance. „9-1A7
�_ 3 — /^ 01 0 0 D
The applicant certifies by signing this permit that 1) this pro- ,,,, 2
ject is consistent with the local land use plan and all local issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no 0// f/
objections to the proposed work. attachments 44

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PRQPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit: /9 r r 6r u ivi
Address Of Property: 660 b VI-- ‘Q
a +K 1SLAtut NC. lrur1sw;ch co.
(Lot or Street #, Street or Road, City & County)
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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
they are proposing. A description or drawing, with dimensions,
should 1b�;' provided with this letter.
Y I have no objections to this proposal.
If you have objections to what is being proposed, please write the
Division of Coastal Management, 127 Cardinal Drive Extension,
Wilminaton, 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. )
V I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement. .
A& D q
Signature
Edi'4, 1-�e( h Date
Print Name
. Telephone Number With Area Code

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit: LA(17 Crow) .
Address Of Property: G G o t * aO8 ,E, / ,
r-7/41- r 3- SG,4no NG 06rwswecif co.
(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
they are pr osing. A description or drawing, with dimensions,
1. should be ovided with this letter.
I have no objections to this proposal.
•
If 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 reauirement.
I
I do not wish to waive the 15'setback reauirement.
11
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Telephone Number With Area Code

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