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Home My WebLink About72141_Pier and L-Head_20180521CAMA`-/-QDREDGE-&FILL , ��Qs 4; GENERAL PERMIT �wc (� New ❑Modification ' ❑Complete Reissue ❑Partial Reissue A arc D, Previous permit # Cam? \A.,: Date previous permit issued \y \�- As authorized by -the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC PRules attached. • Applicant Name, Project Location: County�{ _. r„2 l u Address I'Z- 1 `[ XA41c. S yc t Street Address/ State Road/ Lot #(s) r City )iJ(k�rN i �?tn�y tJ State 1�L ZIP 2� 4�SC� 121 Phone # (?C?_)�33--2q CY E-Mail Authorized Agent tA 1 K-- Affected Elcw ❑ EW PTA ElESTS AEC(s): - ❑ OEA ElHHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes no PNA yes / no> Subdivision City �./ A -� aTl r.,-r-� i�i ZIP '��7 S'1 w Phone # ( ) River Basin'"] /-Va- 6;N,� t_ , (c Adj. Wtr. BodL, e-✓__ 65iDhah /unkn) Closest Maj. Wtr. Body ' y -,N L ■■■:■■■■■■�=_'''I:E■■■■■®■■■■■ ■■■■MEN ■■■ ■■■■■■■e��a■■■■■■�■■■■■■■■■■■■■■■■■■■■■■ ME ■■■■■■■■■■■■■■■■■■i■■■■■■■■■■■■■■■■■■■■■■ )', 6, . N , �0 tg 6- ' QeK�� Agent or Applicant Printed Name ,�C=. X 1. • Signature Please read compliance statement on back of permit e4e"N'\y— 'ZD c7 % q 1? �Q Application Fee(s) Check — Issuing Date Expiration Date by certif r that I own property OP? kocated at H "Uri" _8 F 's (City/Town and/or Dr unty) has described to me, as shown below, the development proposed at the above I have no objection to this- proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENTideal proposing development Must fill in description ;below or attach a site drawing) WAIVER SECTION ,,understand,that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin trust be set back a minimum distance of 15' from my area of riparian access unless waived by �e. (if you wish to waive the setback, you muses t initial the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not: wish to waive the 15' setback requirement. Properly Owner Unformation) �r6l ivipgt�g,Hga � �ill� • N C ��V! d e f=] 117--73 Teleohone Number/email Tess Dale* `Valid for one calendar year after signature= (Rev/sed Aug- 2014) I hereby cerffy that 1 own propn n V A-v 's Of P props located at Pe / on (Address, oc ®d .) in �Paterb®dy)(City/Town �✓ N.C. (City own and/or CounW) - - TheZeppl!Gas, described to me, as shown below, the development proposed at the above locaave-no objection -to this proposal ,J PropelBy Mmar I have objections to this proposal. aukkane DESCRIPTION AND/OR DiRAWtINO OF PROPOSED DEVELOPMENT {individual proposing development trust fill in description befog or atfach a site drauiing} 0 �rA�ER sEC�o01� or I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, li or groin �rsr must be set back a minimum distance of 15' from my area of riparian access uniess a!v by me. (If you wish to waive the setback, you -mu ,the a p "ate blank below:) L V I do wish to waive the 95' setback requiremen -/ `�DG'�"�-e I do not wish to waive the 15' setback requirement. MPBAY Owner Unformation) (A 'a n$ PM@ems ®caner In aM n) afore � n P ' or �� e N ro4 Pri i n Ad r$ss n g/�ddre s Ju v in G teff --y r� �O Criy/State2ip ... e fthone Num er/ email s �TWgp -one Numb rf emaff address Date Date's . Walid for one calendar year after signature= (Revised Aug 2014) a goo emu. ,t u-, Applicarit ' j� �q r1 �l y 1 r•/ o c� :..� iZ Penriftt —7 21 4-) 13 Date; . 2 1 1� A % - 2v j Describe hefow the HABITAT disturbances for the appCc-odan_, Ail'values should match the nacrte, and c is of measurement found in your Habitat code sheet TOTAI, 5q_ 1✓t FIT�[A.L Sq_ Ft TOTAL Feet FU�IAL Feet _(Applled for. (Anticipated Ras[ (Applied fart (Ant(dpated firm► Habifat Flame OI5TURB•TYPE disturbance total disarbanca Dlstdi bance didurhmm Chaase: One includes arty Exavdes aql total includes Excludes any anticipated re5fniatiafr any antidpated restoration andlor restaraton or andJar temp restoratna or temp impact temp Impacts) fru act amouatl temp impacts) amount} W e-+9— Dredge Q ' Fill Both. Q Other( Qredge Q , Fill Q Bath Q Other Q ' ' [dredge-Q Fill Q path Q Other Q Oredge Q M Q Bath C! Other Q Oredde Q Fill Q. Bath LT Mar 0 _ L ❑[edge"Q rI Q Bath Lt Other Q Dredga Fig F_, got C! abor Ore- Q i Q_ Got Q- Other ! t ' � ^• I - -- I[- - Qmw i ul Q aam C, rJitiar. I, Dredge t F ill Cj Bach C, ether f=' =91,' ' San .1t ter �reage %; �• 'Aotft `: :,then i r Oredge Q Rf Q ' aath'Q' other. Q I Oredgt= Q . Fiil Q Hdtl1 Q Cffter'Q ,