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Home My WebLink About71157_Delmar Hilbert_20180831PJ CAMA / 4 DREDGE & FILL GENERAL PERMIT New `Modification ❑Complete Reissue ❑Partial Reissue No 71157 CA B C D Previous permit # Date previous permit issued 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 EM Rules attached. Applicant Name %Er t\gA2 ffiL j2 -- Project Location: County Ga�J11aE--k1 Address I k /, L j„L l EGAD CitySwTlf i'State_ C ZIP 2 IJ7L Phone # (252 ) 771 • $14..E E-Mail Authorized Agent ❑ Cw A EW ['PTA Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ PWS: ORW: yes / (9 PNA yes / Street Address/ State Road/ Lot #(s) 5j2 11*9 1 C I t--, Subdivision TiZtA :, I,y4F_ FL i W r- City i'�t=lu ZIP EYES ❑ PTS Phone # ( ) SAMi-_ River Basin rig S! FLICTiS.tu1G ❑ UBA ❑ N/A Adj. Wtr. Body E-,� �LjyTAN K- nat /man /unkn) Closest Maj. Wtr. Body IWl VILIZ i ■1O.!■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■f�■■■■■■■■■■■■■■■■■■■ M. ■■■■■■■■Ll■ ■■■!Tc!�Y■■■�,■■ ■■■■■L�■■■■■ ■■■■■■ 1'A C::::::::.:::::::::ii: ::::«MENEM • \-� �'_ v , Agent or App1Uicant Printed � Signature *• Please read compliance statement on back of permit Application Fee(s) Check # LAOJN t�� S Permit Officer's Printed Name Signature Aur. sI f 21- l t et . 02c ifs Issuing Date Expiration Date NC Division of Coastal Mgt. Habitat impact Computer Sheet Applicant: i DeL i q LIEyt ( Permit #: 7 t L Date: A, ,/ 3 l ) "2v t 25 Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement found in your Habitat code sheet. Habitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp impact amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount u6f Dredge ❑ Fill ❑ Both ❑ Other L. t V y)XTL--(b,�j ill Both ❑ Other ❑ Dredge ❑ Fill* (r� �� Dredge ❑ Fill ❑ Both ❑ Other Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED i that I own property adjacent to oct wmxu r �� \Y- 's I hereby certify p p Y 1 (Name of Property Owner) property located at sn (Project Site: Address, Lot, Block, Road; etc.) on :-x Rw ey , in CcA � G(�� N.C. (Waterbody) (City/Town and/or County) Agent's Name #: Agent's phone #: Mailing Address: He/She has described to me as shown below the development he/she is proposing at that location, and I have no objections to the proposal. ------------------------ DESCRIPTION --- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) 1 If you have objections to what is being proposed, you must notify the Division or coastal Managemenr (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S. Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264- 3901 No response is considered the same as no objection if you have been notified by Certified Mail. (Property Owner Information) Signature L-ti- Print 11e f or Type Name Mailing Address City/State2ip 2S2 ?fir sl �� Telephone Number/Email Address ,�-/3 // - - Date er (Adjacen roperty Owner Information) Signature l �- Print or Type Name Mailing Address �w-tOr.i1�1 V� 23 3 y City/State/Zip J 27 6 > Telephone Number/Email Address Date* DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED I hereby certify that I own property adjacent to 1w moTL IA-1�� is /� (Name of Property Owner) property located at ] d 1 a St (Project Site: Address, Lot, dock, Road, etc.) on i�Gr xT �..�.JW �� e-,Y , in CC IW-1.'e'hi N.C. (Waterbody) (City/Town and/or County) Agent's Name #: Agent's phone #: Mailing Address: He/She has described to me as shown below the development he/she is proposing at that location, and I have no objections to the proposal. --------------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) If 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. Correspondence should be mailed to 401 S. Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264- 3901 No response is considered the same as no objection if you have been notified by Certified Mail. (Property Owner Information) Signature 1 A'e'k IJ't �N�c�� Print or Type Name 6� I -Ill Mailing Address City/State/Zio AIC, z��-n Telephone Number/Email-Address z S.2- - '72 � - s11 C 6 (Adjacent Property Owner Information) Signature �( j/.kra/ P - S� 121►' Print or Type Name /i2 d f� Mailing Address City/State/Zip z,1 ,)- qzZ 90 9 1 Telephone Number/Email Address P'/? /Y natP*