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Home My WebLink About70616_Bulkhead_20171207V r 1'— FAMA / DREDGE & FILL '� �'� � N0 70616 C D i -Previous permit# A G'NERAL PERMIT C New - ❑Modification ❑Complete Reissue ❑Partial Reissue Date, previous permi issued- 411W, As,authorized by the State of North Carolina, Department of.Environmental Quality a and the Coastal Resources Commissi in an area of environmental doncern rsuant to 15A NCAC// , / , /'�-09 Rules attached. A licant Name-'.P�/I �' r �ll�I�/h 7 '14f��1_Y/ �z Project Location: County 111 /_L. - �O Address V S� r 7 C/ Street Ad ress/ Stat oad/ Lo #(s) 3 City Goff StateNC ' - Phone # (.��) .9 �/�% 3 E-Mail Authorized Agent" 'Affected ❑ cw �� [ PTA AS �TS -' ❑ OEA AEC(s):" ' " ❑'HHF ❑ IH ❑ UBA ❑ N/A o _Pws: • 1 - ORW: ' yes / no f PNA es 1 no / Type of Project/ Activity P/(%'i 42 �Cr;1//•/G J ner Fixed Float Fing Groff Bulk t Basi Boat -Boat Beac .Oth Shor SAV Mow. Phot Wai Subdivision City 6G 1 n ZIP_ Phone # ( ) �River Basin Adj. Wtr. Body Closest Maj. Wtr. Body,,, r 44 in" (Scale: �7PI1�II��Iu7►lmWw�u�ii�j�ufiiiw+�ufi� �W�ra�■■��■ • . ... �KtittilwW�1�1�,�1� _.._� _,..c�.�■��■■■ NrirriVrr�rrrrrrw.tip^L..r�c� :s::::::■■:::::::::::�■■:::::::: <lei'Lc■■■■■FJ�AI■■■■■■■■■■■■■■■il`■i!!■■■■Jsl■■■■■ ■■■�■■■■■■I��II)�)�l■■■■■■■■■■■sib sli■■f!■",��';1dfii�l■IBS avg distance • max .• ■■■■■■■■■■■■■■■■■■■■■■■■■■1��:■■■�■ I�r.AJ ■■■■■■■■■■■■■■■■■■■■■■■■■■�■�■■r��■■■ :::::::■:■::�: OEM ::ONE ::::f gym::::::::: ramp ■■N Bulldozing ■■:■■■■■■■■■ ■■■■■■■■��■�■■'�1�■■■�■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■r■'t�1E■S■■■■■■■■■■■ not sure ■■■■■■■■■■■■■■■■■■■■■■■■■■rr�■■■■e■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■i►�■■■■■■■■■■ -yes u�' yes ■■■■■■■■■■■■■ ■■■■■■■■■■■ ��■■■�■■�■w��■}} A building, permit may be required by: ( Note Local Planning Jurisdiction) / Notes/ Special Conditions �G /l/IGVi/ � -PAWL Agen QjAprplica t" inte 1Name •Signgt rePlease rea compliance statement on back of permit Apq jcatiori Fees) Check# Permit Signature Issuing ❑ See note on back regarding River Basin,rules. Y11- Expiration Date-,_ NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant. Date:rQ`.LGjYI�C� General Permit #: 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/ortemp 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) Dredge ❑ Fi4 Both ❑ Other ❑ Dredgek 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 ❑ 252-808-2808 :: 1.888-4RCOAS'T :: www.nccoastaimanagement.net revised:02/03/10 ADJACENT RIPARIAN PROPERTY PMNER STATE I hereby certify that I own property adjacent to �� it Z, C� "` 3s Blame of Property Owner) �l property located at 23C1 i�OSllt en L�c< c V� G (Address, Lot, Block, Road, etc.) 1 on iA r CAZZ - , in k N.C. (Water[body) (CatylTown aiddlor County) The applicant has described to me, -as shown below, the development proposed at the above locati n. _ I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual propozing dedeloPM fit oast fill in descrip�%n iGiow or avach a mile drawing) (FAC IQigiu1iiIliiii1iiiilil� WAIVER SECTION I understand that 9 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 16 setback requirement. I do not wish to waive the 15' setback requirement. (Pr ,pefty Owner Information) (Adjacent Property 91xner Information) S torre., Sig&ture Print or Type Name Pant or r y�pe tvame �l G y i Fr� nro<,c�� ,2Z IJ Mailing Address Mailin Address ci /statd p City/statep '� �C4�{- 23 �A"1Y�c.�CC�C✓kt� ��c�>.�;f L- �7 Telephone I,Vumber/email address Telephone Number/email address Date ---r Date* L (Revised Aug. 2014) `Valid for one calendar year after signature¢ ADJACENT RIPARIAN PROPERTY OWNER ASTATEMENT I hereby -certify that -I own properly adjacent to TO 1 �'l{ Le C ( G ✓ 23� C�vs Hen (Name of Property Owner) property located at ( -(<- P4 ron . — (Address, Lot Block, Road, etc.) (Waterrbody) (City/Town andlor C no�aTty', I N.C. 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 AND/OR DRAWING OF PROPOSED DEVELOPMENT (7ndividual proposing development must till in description below or attach a sage drawing) WAIVER 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.) / I do wish to waive the 1 V setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) --- -- -- - ----- -_—� c_e. V S, KS� re Si ature * t y=, C Print or Type Name Print or Type Name Mailing Add2 g-�� Mailing Address /State2i C' /s te/Zip 26(2 �{33�3 G��viCcct�r�o.(QG�w c�n� �ci liov,�.r n �,�Q? S'I 41 uv►1ll Telephone NumJerlemall address . Telepho a Number/email address ll(0 Vk2' Date Da * (Revised Aug. 2014) *Valid for one calendar year after signature*