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Home My WebLink About68363_finger Pier's, Boatlift_201710107 .if J r}; dn't rf p1l lit'Printed Nq1-6e,-7` P'ermkdff _. S. �'s'Ziread/c'OM)I'li'a'ncestatemii6t*6n-�;ick'�tp'6 g U rrhit 7 Nature X, %rr pp at (s 1. lr ve,--P —U&AMAI/ DID-REDGE.& n D' Pireviods,opernit # L"PERMIT,, ENERA X 111N&V, 11 Modification Complete qrnp ete eissue", Partial Reissue perrhi Date, pr,@Vi6us t-issued 7 'As i'Norih-Cai�oli6z�,' Natural Resources, authcoHzed� �j the be0artmeht,,'oitnvi�on1ffieni and andthe'C6-,CoMmission,han,area o ehVironmentaI,co tern p r uantto 15ANfAt D. l kogRulis ched'' pp icant'ine Project Location: C66hty -Z Address. Street Address/ State Road/ Lot #(s) -2-L City' - 41 , � C) ev Ph o fte` �13 E-Mail Subdivision 'A City. zip Authorized'Agent' r,,n,e- A& 0 CW;; 0,EW TA El ES El PTS Phone # River Basin re--.1 --/-7 I - . Affected •. EiOEA' 0 HHF DIH 0 UBA El N/A, Adj. Wtr. Body'0,,0 1 AWf Y (na't-).an /unkn) 'd PWS: 410 -- Closest Maj. Wtr. Body ORW -yes /(n�) PNA' yes / 1W,-) -a T f 'Project/ Acti 13 ype 6 Vity Al-,�,e6T-e ME M MEMEMEN M No ONE W195 IF MEN MMEMOMMEM M IMENOM MENEM MOMMEMIN ra MMOMMEMOMMOM 0 momomm mm�oommmmoom MEMEMINE M 1100 No No M ENE IN M IMMOMMEM EMEMEM ME EMEMEM M ME MIMEMMEMMOM MEMMME MEMO ME 0 MEN EMOMMEM MEN MEMMEMENMEN MOMEMEMEMEN MEEMMONE MUMMOMME M IFAMNI NNEMM MEMMEMEM 0 ENEME 2WERAFF Oman UNMEN MEMEMEME ENE ME M 'RIME M MENEM morimmumm MEMO MEN IN M .4 wit I EMOMMOMM �ii mommmmmmmoommmmm omoomNNIMMIN ONE OMMOMMEMEMOM M EMEMEMEN MEN 0 i mEMENEM MONMEMEM ME 0 MEMO MNIEN ME ME M ONE MEMEME MMM1MMMMMMMMMMM1 MEMOMMEN OMEN MEM MEMMOM MEMOMMEMEMMEN EMIMMENNINME EMEMMEMEME 0 mossimmummo MIMINEEMMOM 0 IMENIMMENIMME ON M 0 MEN 0 MEN M OMEN MEMMI OMEN ENE 0 ENE MINNEIN MEN ENE ME 7 4 �,E idnD , , X X, C Division of Coastal Mgt. Habitat impact Computer Sheet . • � `/�� ...�� Applicant. Date: /0 General Permit #: a-300 `�3 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) aim ` Dredge ❑ Fill ❑ Both ❑ Other x f9f� aze ak- Dredge ❑ Fill ❑ Both ❑ Other h I 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 :: 1-888-4RCOA T :: www.nccoastaimanaciement.net revised: 02/03/10 Authorized Agent Consent Agreement herby authorize Tobin Jay Tetteirton of (Property Owner(s) ) TJ's Marine Construction, LI..0 to act on my behalf in obtaining LAMA permits for the location listed below. PROPERTY ADDRESS: I I l5 is -, -, k" C" ^ );"� --Bc 1 x-k- 0 PROPERTY OWNER'S MAILING ADDRESS: -SA-A4 �5- Phone No. ZrZ 9 r'I--? PROPERTY OWNER'S SIGNATURE: AUTHORIZED AGENT SIGNATURE: DATE: W/Authorized Agent Consent Agree. 20 2r Zo if i zG Xf�/2� S '{G -4��Ae fy To S/ 2�� 5Z SIACC, bv.ke- �j idK • ` ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to-Rs�,, C✓=c � S LLL property located at f'� Sy iV1ng 4/K'n Jai C[ f Property Owner) M4 on 7 < Crce- (Address, Lot Block, Road, etc.) ��P � , in �e I �avt� Z. C , N.C. (Wate ody) (City/Town and/or 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� I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT Individuate. ro osin `clee% "m ntzmustf/ in`'�mm 9description �ielow;orach;a site tlwing), 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 15' setback requirement. _ I do not wish to waive the 15' setback requirement. (Pro a Owner Information) (Adjacent Pr perry O ne Information) Signa e iLC Si nature* Print or TyRe Name Print otmTypb Narhe �{lailig Address Maili Address 2l City/State2ip S City/St e 2y /Z qy�� z R 431 a) 3 r,�I LzWe rl �w 7 Telephone Number/email address Teleph ne N tuber/email address It 07 Date Date* (Revised Aug. 2014) *Valid for one calendar year after signature* 0 • I 2� 23 2 Z 2i 20 [ID 20/j/2� f \�2 ,X (.On Ik V // Y � �ACG bvaier� yr L'IOG�C' G}C� 20-25� on eAe, i D ca'hon Z� �i� /mil !> • S� ,a, . , � �"L...�s,-' , . G C POSTAGE / BELaHAuVEN, NC Yl� /ice \�� .1.�. 27610 AUGG 25 17 uwireasrnrs AMOUNT -' J 1` Y POSlAC SERVICE¢ PLACE STICKER AT TOP OF: ENVELOPE TO THE RIGHT 100o 27377 F12$3.84305K14266 4 CERTIFIED MAIL 7016 0750 0001 0402 9998 - NIXIE 274 4E 1�z�9-f14/17 RETURN TO SENDER UNCLAIMED U.-N'•AB,L E TO FORWARD � • WALTON, OIN EAL III /V/" v 75 ah Al T . o h " e' `' i � ` n ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to r i s� \ Cam= _- property located at ) 1 O S i vI', a te ✓ --e S LLL of Property Owner) 'S �Lir� r►Y�q (Address, Lot Block, Road, etc.) on Cece- , in e ! �gv-C� A-25 C , N.C. (Wate ody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR _DRAWING OF PROPOSED DEVELOPMENT Indivdua%` ro�' osinrdere%``nent`must'fi_Il,.►n?"descri �tion�tieloui o�'attac/i�a�sfe�drawng) 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 15' setback requirement. I do not wish to waive the 15' setback requirement. (Pro a Owner Information) (Adjacent Property Owner Information) 91�i�.n ��1"' eS Signa Are _ I -LC Signature* WARP', ep Print or T e Name Print or Type Name Gi V1.Zi i MAddress_ Z) Mailing Address eAJt/1 City/State2ip City/StatelZip 25 2 g431a ) 3 Telephone Number/email address Telephone Number/email address S 1 S J ► l- Date Date* (Revised Aug. 2014) *Valid for one calendar year after signature*