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Home My WebLink About62242_Replace bulkhead_20171017IVs..VFXT WtV+o+ %,,...11. JkCAMA ETDREDGE & FILL �218 3 5 9' D L EN,ERA_.PERM.1T.��Previous'�peirmit /,71 �kNew ElModificatl*0 n omplete Reis§de""E1Par'tiA1 Reissue DAte.pTqvious permit'issu6d 4uthc'�rizeclby.the State of North Carolina,Department of, Environm'ent and Natural Resources and Commissio6 in an area,ofenvir6hmental concern pursuant to -1 5A NCAC Applicant Name_/-,/ Address City—_"-V State ael-t ZIP23 �3'1 Phone # E-Ma Authorized Agent Affected E] CW EW XPTA (:1 ES El PTS AEC(s): 0 OFA El HHF El 1H 0 UBA El N/A 0 PWS: PRW: ' yes /Lnp, PNA yes Le:fRules attached. Project Location: County. Street Add reW. 1� ate Road/ Lot #(s) 21 Subdivision 7(.y k City ZIP 19e7 Phone# A River Basin Adj. Wtr. Body All, 2n, Closest Maj. Wtr. Body AoLo SEEN MEMMMEMEMMINMEM■■■■■■■■■■■■■■■MEMIMMMMMIN M MEMEMEMEME ••••••••••�•�■■■■■■0 MENNEN■MEN■MEMO M. ME: EVAT 0311MEMMEME MEN No NONE MEN MEN MOMMEEMOMMEMEMEMEMENFAMM MEMMIMMOMMIMMEME WIPM OF10=0 MEN■Mimi • MEN 0 No MEN NOME A" I I MMMF%_ 225MENVIS Z'S Agent-r/App ca t I P t d Na i n 01, P rAt_0ffJ'—'SPr-1nfed Naiii6w,f"" signatdre 131'ease read compliance statement on back of permit S!'gn re'_ _VJ —1/3 AppjcationF e(s) IssuingEx I ration Dai� VZIL L. NC Division Of Coastal Mgt. Habitat Impact Computer Sheet Applicant:4��i�nc� Date: % �. General Permit #:��j� 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) Dredge ❑ RIX Both ❑ Other ❑ 3� Dredge,( Fill. Both e Other ❑ 3 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 :: 1-888-4RCOAST :: www.nccoastalmanaaement.net revised:02/03/10 (Addrbss,,Lot, Bias , fro d, etc.) on_ 1-26nr"0 kle/ in Jar R[.C:" (Waterbody) (City/Town andlor County) Ttie= applicant has:described to, me, as",shown, below, the development proposed at the -,above, location.,.. Thaveno'objectibn tb this°proposal. `have objedtions°to'lthis propdsal,. DESCRIPTION ANQIQR DRAIiUING'UF PROPOSED DE' VELOPMENT (tadivicluat proposing develoDment m'usf fill, imde`scription-below or at#acha site drawing} �v j7le.S WAIVEWSECT10b! i understand "that"a pier;.dock, m6bring,'pilings;: boat xamp; breakwater,' boathouse, lift, or�groin must beset back .'a,, distance of �15''from..my area,of riparian access-unless-waived'by.." me. ,(1f`youwaish- to.waiv64 a setback; you must 11nitiai.the appropriate biank below.), 1 do wish to,walve the f 5' setback fequirement. i do not,wish`to, waive the-:15'-sefbaek`requirement. : (Prop_eity er information), '_ cent, Rrope dwribr Inforrriationj` Pant or Type N,Sme "! % _ Pnnt or Ty e,N ems: - i v 3�1Q3<h��alF �CtLsI .t �" �'' t 1 Vl M i1' dre s -"Mar in A`ddres°S 7 CitylState2ip cwstafe2i v Telephone Number/erxiail address ielephone�Number-ema7`address t7ate , - ' % ��. �c�Wt�.✓>��-�!G4 'E , . " (RevisE'tt,Aug.20,14f.:, " " 'Walid for-bne calendar year.°after signature" ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to zec-4 rtr)"l SUS«� L�(LvN�zr^!c .s ;�� (Name of Property Owner) property located at / / -) Lo 1JOIL!! -, ��'�� Z0,1 /-f L' (Address, Lot, Blo , Road etc.) on fll c.�e/ , inBe" it N.C. ','(Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. j,v\lip C.- I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site drawing) WAIVER SECTION 1 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. (Property er Information) (Adjacent Property Owner Information) r Signaiure i%(.;ii%�»t -r z� j��.Q r'dpy1 Print or Type N�me r Pant or Type Name , ++ 39- 1lt tte ! (lit .` t 7i 3 WAi l � Mail�'!1g9��! d s Mailing Add ss l y«t�— 1►aaP . 1VC 7.7.�1L City/State/Zip City/state/Zip It ;'>_�lc; `tl%`G'-C' / i c� Ce.��;tte�✓Y�+%� , j� .1 Telephone Number/email address Telephone Number/email address Date Dale" ;-�..• . Ct.� �^-` . c r c"` ; �� T t (Revised Aug. 2014) 'Valid for one calendar year after signature'