SW8900811_HISTORICAL FILE_20190203

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 90 09 11
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
201 A0203
YYYYMMDD

NEW HANOVER COUNTY
Engineering Department
230 Government Center Drive • Suite 160
Wilmington, North Carolina 28403
TELEPHONE [phone]
Fax [phone]
Memorandum
Date: a 131 Lj
To:
NCDENR - WQ
From: Beth Easley Wetherill
Soil Erosion Engineer
Beth E. Wetherill, C.P.E.S.0
Soil Erosion Specialist
Re: Sedimentation and Erosion Control Plans
Grading Permit # &p
lOK-Ut, Tn��sl- Pw < a ���� ?t�) Dac��LoP �•t
The attached plans have been submitted for approval
to New Hanover County Engineering. If you have any
questions regarding these plans, please contact this
office.
5-FVVµwaAe4'-- P9-1-n
1/12.1 t4q.a

APPLICATION FOR PERMIT FOR A File # �'
LAND DISTURBING ACTIVITY
Under the conditions set forth by LD Fee - Review RA � D
The New Hanover County
Soil Erosion and Sedimentation Control Ordinance Date J Pd 1 Zy 11q
Engineering Department
Applicant or Applicant's Agent: 1-1, I- /" i t7 h/'/ c" I u't S L_
Mailing Address: P 0 /,i , W 1 2 / 2-r Telephone Number. ` & -22/- 2G LV Fax Number:
/- 7Qto Email Address: e4,'ez L,i* ,:t--,I tot r
Total Acres o Land Disturbance: S Purpose of Development: , <' .T`', .., v c z� c'. zg! ✓r Lti ri. i f �4 n ei
Description of Land Disturbance:.... -- -- - - -- -- - - ---- --
Address of Land Disturbance .2 q 7 2 Cct4ele' Latitude: Longitude:
STATEMENT OF FINANCIAL. RESPONSIBILITY
Land owner(s) of record: Person or firms) financially responsible for the
land disturbing activity. If not a North Carolina
resident, you MUST have a N.C. agent. (List Below)
Name: �"Dt-IZoti "t'lilf* w;1rvtt,t.L6A LL-C Name- /4:____7 t�� lcle'rs l L L'.
Address: 40o , -_ I:F 'I m'\ I�r Address: / , C , c; i� /, /Z .175
City/State: 41l ft bu f 3 N I,J City/State: /,L/, t wr ,L I/ ' i
7
Zip Code: l i 0'15 Zip Code:
Telephone Number. Eo 0 - i 5 o d 9 5 o Telephone Number:
Email: PaxNumber Email: FaxNumber
Location of deed(s) or instroment(s): County: N i:w NL n o va'v- Book:6 0'1Page: Z3' y ro
The above information is true and correct to the best of my knowledge and belief and was provided by me while under oath.
(This form must be signed by the financially responsible person if an individual and by an officer, director, partner, attorney -in -
fact, or other person of authority to execute instruments for the financially responsible person if not an individual.) I agree to
provide corrected in rmation should there be any change in the information provided herein.
Date: � 2�91 /8 Name !mil w*'e_ "f-Pr Title 11'1'6� ' w
Signature
I, K W VDl l l t! n N t r t n 1'{ f.- a Notary Public of the County of W CVC,' • State of
North Carolina, hereby certify that !�)ky r bl lF W • 11 i A rvt 5 appeared personally before me this day and
being duly sworn acknowledged that the above form was executed by him.
Witness my`hand and notary seal, this 1 q *" day of De C s-r.n �3tnr _
Notary F-1't�f�Wtl._,.i f)1'I.i My commission expires
Permission to Enter on Land
I cerri fy1r I am authorized to grant and do in fact grant permission to the Erosion Control Inspector and his agents to enter on
the )Ad in juestion,;L"gt0jr%lated to this permit app4catiop.
lZ
Signature and Date llvj
PLEASE COMPLETE ALL PORTIONS OF APPLICATIONf I I) 1 , `011 2 Q
ENGINEERIN,G'�EPARTMENT