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Home My WebLink About68958_Bulkhead_201801164, t.71 'T '6AhiAi' D'. GENERAL--P :-'ERM1T- �_Previo6s p6rr New'. .-. Modification Conn'016te, Reissue, EP ial Reissue su 6d As authorized 'b"y',-t-h'e-'St'-ate'.of North',C4rol - i ia,,,bepart'ni'ent of .Einviroinrnen . t and Natural Reso6rc6s and,tfie Coastal, Rdsourees.Co�mmisspn 1n.an ar:e'abf en4o'ni-nefital Concern pursuant to 15A NCAC 4:711 Y/V Rules attached: 2- Applicant Name.' AVZFi.k Pr Oject-qc4ti'i e -oI -0� t Address' 7ic);:", Street A ddress State' at Road/ ZIP - A State ty, PA12 WOK 1A 140 A) I Phone., E-Mail Subdivision Author. iz edAgerit",_ city ZIPS 7,9 v ' ] ES ❑EPTS Phone River Basin ia�rV +TA Affected, I ) DOEA -EHHFE1H 0 UBA 0 N/AAEC(s).Adj. Wtr. Bod&U0AKLC <IwAh , nat/ man /unkn)sPws:, Closest Maj. Wtr. Body A 0? F/W it "doI '(5RW:.' yes ?fo�) ., ".FNA yes no NNE , hea d/ :Rip6plength_/Io, istaneeo' s ore m distance s o n,cha'inell,'," '. - ..; cubicy4rds_._ ramp—, EMENEENUMMEMONOMMONI ..... . . . . . - MEN MEN ME, HOME M M MEMO MEN mmMMMmMMMMMMMMMMMMMM MEN 0 ONEEMME�nimmommomoms MMMMM MEMINOMME MEE Bill MEE! imommol m wM1 Emmom MEMO IMMMOMMEMEMMEN MEMO NEON OEM hduse�,B,q�tlift h 91 MEMMEMOMME MOMMUMIMEMEM MMMMMMMMMM MEME MOMMENEEN IM11111,11111 WHMM MEN MMMMOM1MMMM1 ME IEEE I MENOMONEE NNE MENNEN 0 mmimmmm 111FAME323 OWMEMEMEMEMEN No rel I ine'�ength s no ye E51 L - M Hum.- n/a ',yes no to I S , ME 11MOMEMOMINMEMEM1111111M." yes if. 00 MENNEN -�eiAttached:: s' n 0 Biiii Im 0 .. . I MEME NEON MOMMOMMM 01MURNIOPIP, mom ME I MEMEN 11110:1-111 IMEANOTIM, mom I �k 12p Ag'en-tor-'A-pplicaritPrinted,Na ,P,ermitC?fficeri'Print6d.Name' ,.',,- :"•§ignature.-5�leasereadc an 6kme�i-ockofpe`7mSi g,nature. .=Apf" " ,Dat e' e�a6t e,, 7, Applicant: Date: -16 J AIJ �D i -General Permit #: o Sg rz 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) Sr6 r� Dredge ❑ Fill0— Both ❑ Other ❑ Jop r IDo%7 ,goV_A Dredge ❑ Fill ❑ Both ❑ OtherA 00�T2 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 ❑ f • ! ®4AOENT WARIAN PROPER— If�Y 0�96� ER BIA�f�l��i( I hereby certify that I own property adjacent to L S-c p- � S ,s d�a�e of Property owner property located at 7 � � r t n er- �!/��-/f//�_ p.,. ,,/ (Address, Lot Mock, Road, etc.) on /� �GI%�V /Y ��/Y'C/ in N.C. (Waterbody) (Oltyffown andlor County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION ANDIOR DRAWING OF PROPOSE® DEVELOPMENT andimiduaff proposing deeeipp mrent Must rii in description below or aaach a side drrswing) T:Cp " e"-4-I.SA Wt bU l W.AIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin 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.) 1 do wish to waive the 151 setback requirement. I do not wish to waive the 15' setback requirement. t'. =Ge) Information) (Adjace Poe y Owner Information) Signature SignatureSC /lam Print or Ty a Name Print or Type Name AIV Id Mailin dress Maili Address Telephone Telephone Numberl email address/email address 25-a-Z1I3-e-f33� Date 1 f 1� - 201F Valid for one calendar year after signature* -. / /A — 3-aa 7/ CeIt --4t47 % email address (Revised Aug. 2014) CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: LQW rev'y—e 1✓ . J(3 h & S Address of Property: 37,0 rna r I v-L r pS T) r , ► EO iJ ,er `y C.. 'x-m (Lot or Street #, Street or Road, City & Cou ty) Agent's Name #: /` 1zR '8wtieY Mailing Address: a9 WS kd Agent's phone#: asZ-9yS-i9Gi 16eUau-gh MC 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. A`descriptiori°-or drawing, inrrth" dimensions .;must be <proVided with this letter. I have no objections to this proposal. I have objections to this proposal. ff you have objections to what is being proposed, you must notify the Division of Coastal Management (DCAI) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at htto.Uwww nccoastaimg aAement.net/vreb/cmistafi listing or by calling 1-888 4RCOAST. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION 1 understand that a pier, dock, mooring pilings, boat ramp, 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 IF setback requirement. (Prt Owner Inform io V to Signature Lqw reh"�_ o �• Sbn�S Print or Type Name 7 9 Mgo- tvvFrs -PC-. Mailing Address Re Pam, mn . a�9 7o City/State p �.s:1-- `7RS-Lq33R Telephone Number/Email Address Date (Riparian Property Owner Information) Signature // -t nnr Z t oho Pfinthr Type Namd 411 Al. Curr. r c l fir. Mailing Address San4re , NC., a"7 336 City/State&ip Telephone Number/ Email Address Date 9 4- (Revised Aug. 2014) �..c go -2106ro/ jco r eq. prop �o s h � his 4 L, D, TO'Aes D. Sc- a-r7-9 33F� =2-IC� l Duur 'oe rl--: -Jz — z AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: � Mailing Address: r C ^-Q-(--ST)i -70 Phone Number: Email Address: I certify that I have authorized .)..sz -93, Y3.I Y ,dr y2 eL �P— Agent / Con to act on my behalf, for the purpose of applying for and obtaining all CAMrA permits necessary for the following proposed development: i�Ju �C k +eo-,I a at my property located atr in U,),a« -�w'County. I furthermore certify that I am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Prop Owner Information: Signature —,'Sfl n S Print or Type Name Title 1 -2-- l l-7 l I q Date This certification is valid through I I ■ Complete iterbs 1, 2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front,' , spa a permits. 1. Article Ad r ss d to: Lyr�"e C�rri-e�r r. �n�oird , VI�G, "�7 33fl A.i :Signature � � ❑ Agent X � ❑ Addressee B. Received by (Pri -t6d Name) C. Date of Delivery D. Is delive !I address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No II I IIIIII I'll III I I I I II i IIII II III III I III II I III 3. Service Type ❑ Priority Mail Express® ❑ ❑ Adult Signature Registered MaiITM ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restrictec 9590 9403 0268 5155 9336 22 ❑ Certified Mall® Delivery 2. Article_NumberrRansrer_finm er 701,7 ]070 Da i ❑ Certified Mail Restricted Delivery 11 Return Receipt for ❑ Collect on Delivery Merchandise OXWI t ^q Delivery Restricted Delivery ❑ Signature ConfirmationTm :7 7, 9 6 8 4 6 8 �I 1 • . • , ❑ Signature Confirmation ail Restricted Delivery Restricted Delivery _UU PS Form 3811, April 2015 PSN 7530-02-000-9053 Domestic Return Receipt