Piner, Ivey 77366C

CA MA / ❑DREDGE & FILL : 9 77366 A B CCD
NERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality /A J U
and the Coastal Resources Commission in n area of environmental concern pursuant to 15A NCAC
r � Rul s attached.
Applicant Name F
V �` f �/� Project Location: County w' P
Address
City _- (V,- State,/VC ZIP
Phone 3UT-1 ) /;—'I"U [-Mail
Authorized Agent
Affected �W '. A
ElOEA ElHHF ❑ IH
AEC(s):
PWS:
ORW: yes / no J PNA yes`
Type of Project/ Activity
❑ ES ❑ PTS
❑ UBA ❑ N/A
Street A dtreesss/ State Road/ Lot #(s)
Subdivision
City ✓� �/t c ZIP'A If
Phone # ( ) River Basin UI�C_7
Adj. Wtr. Body l _` / 61r e& man unkn
Closest Maj. Wtr. Body GV"1t_ �✓��'"
Y -7 L ' /,/o c (t
Pier (dock) lengthY777-
I
i
Fixed Platform(s)
i
Floating Platform(s)
Finger pier(s)
i
-
--
-
-
-
-- -
i
Groin length
I
number ---
.i.... _._..--
T --
-
--
-- -
i
- .
-
- - ----
Bulkhead/ Riprap length—__--.._-_--
t I —
avg distance offshore
max distance offshor
Basin. channel
I-.
cubic yards
Boat ramp
Boathouse/ Boatl
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes no
Moratorium: n/a yes o _
Photos: yes no ...__ ._ j ...
Waiver Attached: yes no ---
A building permit may be required by: C c„-
( Note Local Planning jurisdiction) /�
Notes/ Special Conditions / `J U U
Agent or Applicant Printed Name Permit
t6pplicati.n
Please read compliance statement on back of permit" $
` C q 1
Fee(s) Check# Issuinj
(Scale: ,A/r )
❑ See note on back regarding River Basin rules.
l'/,) GL- �,T,z
Date

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property owner: :�: C-'-IG a k pR-k-i� A G, piy,,
Address of Property: A— 9 1ACC 12WW, QQi Sii1`i W'. ,
(Lot or Street #, Street or Road, City & County)
Applicant phone #: 9 - VaOi Mailing Address: Z�S AZA' 12�D4A
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 ;��d&s&ijatian or dca nor ,--tvith dime nsi ns�riiust b pro Itd ci with t iis,[etter.
I have no objections to this proposal. 1: have objections to this proposal.
N you have objections to what is being proposed, you must notify the division of Coastal Management
(DCM) In writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastaimangement.nellcontact dcm.him or by calling 1-888-4RCOAST. No
response is considered the same as no oNection if jou have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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 15' setback requirement.
(Property Owner inf at' ) J� (Riparian Propertyer Information)
` 7 `
'zgnatcrr•e /` ( tgrrcriu
Z.
Print or Type Name Print or Type*me
!.Qqi 14 6e t•'••1 r-" yZ q'y(34
Mailing Address
CitylStatelZip
— 7Ag— 4 a 1
Telephone Number
i dx r 120ao _
Date
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Mailing Address
CitylStatelzip
Telephone Number
mate !
f�.

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONM(AIVER FORM
Name of Property Owner: -T,,Jj'�j C # ' uc' G ; "0
Address of Property: "AAll - F _RD. s`Lc\"q P'Cgp- : "�'`��P'
(Lot or Street #, Street or Road, City & County) 1
Applicant phone #;—}( Mailing Address: 3 VOC
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 �oposing. A descnpttvn or dra4vina,with dimi~risitins."rrtust bt; pr%videcl with this letter.
� I
I have no objections to this proposal I have objections to this proposal.
tf you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www,necoastaimangement.net(contact dcm,htm or by caring 1-888-4RCOAST. 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, boathouse, or lift 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 16 setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Inf matt )j AU 1
gnzrlttre
Print or Type Name
Mailing Address
CitylStatelZip
a !') 9-ii
Telephone Number
r OCT 1 61
Date
(Riparian Property Owner Information)
-4f,-f�
Si nature
Print or Type Name // 1
Mailing Address
rCity/State2ip
Telephone Number
Date.