15923_PILLA, DENNIS_19960123

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Applicant (yam e
Address
CAMA AND DREDGE AND FILL ,y 015923
GENERAL
PERMIT
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as authorized by the State of North Carolina
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Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC .' 11 6' n
art fC,
Phone Number 2 /C'' 712 1 9 "'Y
City \kIC�►fg,��3's �l�l �^ri ! S t State+! Zip
P4ect Location (County, State Road, Water Body, etc.) �^ < <' �' �, -D r
Type of Project Activity / h t, I k- A ..O
PROJECT DESCRIPTION
Pier (dock) length
Groin length
number
Bulkhead length
'7c"
gaz. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
SKETCH }� 1` I� (SCALE:
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This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine,
imprisonment or civil action; and may cause the permit to be-
come null and void.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
ject is consistent with the local 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.
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applicant's signature
/—� permit officer's signature
issuing date expiration date
attachments /✓ 4 C
In issuing this permit the State of North Carolina certifies that / l
this project is consistent with the North Carolina Coastal application fee
Management Program.

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/ WAIVER FORM
Name Of Individual Applying For Permit: 1Je&1AJ14
Address Of Property:
(Lot or Stree
, Street or Road, City & County)
I hereby certify that T nwn property adjacent to the
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 be provided with this letter.
I have no objections to this proposal.
If you have oblections_to_what is being proposed, lease write the
Division of Coastal Management 127 Cardinal Drive Extension,
Wilmington North Carolina 26405 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 tha ier, dock, mooring pilings, breakwater, boat
house, lift or sandba ust be set back a minimum distance of 15'
from my area of riparian acCesz unless waived by me. (If you wish
to waive the setback, you mus nitial the appropriate blank
below.)
I do wish to waive the 151setback requi`r-ement.
I do not wish to waive the 151setback requirement___
Hrea uoue
0 A7,t).
[DEHNR

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit : ,/DL1V is Y /� f /� jQ ?/1-L-4
Address Of Property: Lai SHILLKO K- L6tiUc-"-
(Lot or Street #, Street or Road, City & County)
I hereby c'�rtif_y that 1 -:)wn property add--cen-'Z 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 be provided 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 iat a pier, dock, mooring pill-n-4s, breakwater, boat
house, lift or sandbags� must be set bac minimum distance of 15'
from my area of riparia-ir-a"ess un_i-es waived by me. (If you wish
to waive the setback, you;irit_ initial the appropriate blank
below.)
I do wish to waive the 151setback requirement.
I do not wish to waive the 151setback requirement.
J IL f ' t
WA
SignAZtrre ate �0
Print Name _ .�•++���
4 L'n 7-!X6 4;F' I 0 _ EDEHNR
Telephone Number With Area Code

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