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Home My WebLink About71231A_Lois Hartnack & Rebecca Smith_2018100912'�CAMA / ❑ DREDGE & FILL No 71231 (T) B C D GENERAL PERMIT Previous permit# New ❑Modification ❑Complete Reissue ❑Partial Reissue 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 I SA NCAC N , 11 O u L4-Wes attached. Applicant Name L004Nar i ru k `. Z Q he �c SY•. 6. Address Q 11 IlAt-1 k ► t,6 J Shu rcS JOr City t-, OC L State N c ZIP A-4 S S'� r Phone # () �5++- 4`1 �� E-Mail Authorized Agent %„r r-V i , rA_ Affected ❑ CW ❑ EW I PTA ❑ ES APTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ N/A ❑ PWS: ORW: yes / (fib PNA yes /(pv Project Location: County CU Y r -�-L �C Street Address/ State Road/ Lot #(s) a o R�ech. � Stiutrs �i 5Ra Subdivision ►.tom h�,.oa cl 51�oi < City t— J U' 1C ZIP ';)-i Phone # ( ) River Basin Adj. Wtr. Body ic, 10 'Tut1's Cry k (natunkn) Closest Maj. Wtr. Body CLJr r }" C K Type of Project/ Activity N e,, .k 3� (Scale: � ) Pier Fixes Float Finge Groi 1' Basir Boat Boat Beat Othi Shor SAV Mor Phot wai, ng Platform(s) 7length—, ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■�i�1Gti r pier(s) i number avg distance offshore max distance offshore- ■■'!■■■■■■■■■■■l!f3�il■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■!!■■■■■■■■■■■■■■G!■■■■■■■■■■■■■■ cubic yards ram ��■■■■■■■■■■�e��■■■■■■■■■■■�■■■■■■■■ ■■■1■■tip■■■■■■■■■■►1■■�■■■■■■/I■■■t'�!■■■ -i Bulldozing fline Length not sure - ■■■■■■■■■a■■■■■■■■■■■■■■■■■■■■■■��■rvr+�� ■i��iiii i■■i■iiiiiiiiiiii■iii■■w�iiiiii torium:yes '�E' '■■■■■ii■ice■i■iiiiiiiii■■■■■iiii�iwi■i _.... _ "Al.�■■■■■■��■■■■■■■■■■■■■■■■■e■■■�■■■■■ A building permit may be required by: CV Y c ( Note Local Planning jurisdiction) Notes/ Special Conditions Agent Signature`-. "Please read coriipliance statement on back of permit" .414 x_V C%(-) 4asci Application Fee(s) Check # ❑ See note on back regarding River Basin rules. PermkOfricer's Pri e Si re 10/4 Ao)r Issuing Date Expiration Date NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Date: 10 )q41 Permit #: —4 , �L3 1A Describe belo'�/ 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 S�ltow p� }¢ Dredge ❑ Fill Both ❑ Other ❑ I I g Sho PL(• Dredge ❑ Fill Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other, a 1 V O 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.nccoastalmanagement.net revised:02/03/10 DIVISION OF COASTAL MANAGEMENT AGENCY FORM FOR PERMIT APPLICATIONS I '/b o«ner of the property located at: (properry owner) �l l �2e1'i`i.lclUac%� Sl�1 �'�S Q` Y n do hereby authorize (name s=p-= - _, - acting as agent) to act as my agent for the purpose of obt " ;rg —%--did cas al Area Management Act and/or Dredge and Fill Act permits, that may be named Ye =- posed development at the above - indicated property, which entails: (describe proposed development or -.:rich permits are being sought) This agency authorization is limited to the specific activities described above, and will expire on: -1 (date on which a envy authorization expires) (signature) !date) (printed name of owner) (title, if officer of Corp. owner or trustee for property) CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTiFICATION/WAiVER FORM Name of Property Owner: L o , S 4 ,A /-/1 ±C, Address of Pro p e rtY: ke4hG '� c e—S r� e G 7�l �11�� , I (Lot or Street #, Street or Road, City & Cou ) Agent's Name #: �IC,IC tty c� SUn to (-Mailing Address: 71�1 l�s' C��c�.� Agent's phone #: 333—o3 &,4— !Z t'lla w,, ,e ,�l tV-, z 7 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 p oposing. A descridffon or drawing. with dimensions. must ire pray . I have no objections to this proposal. I have objections to this proposal. 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. Contact information for DCM offices is available 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 I 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 15' setback requirement. (Property Owner Information) �_�'Ignature Print or Type Name Mailing Address iy-d-5 %' i L City/State/Zip -4 � I K-- Telephone Number/Email Address Z) /09 /1�- (Ripari Property Owner Information) ,7, gnatu ,e �S(,, p�+ -De �� lot- P-1 Print or Type Na me me a X'30. - y I -:�- C J W 6 J Mailing Address mo�ock* b �( C ity/State/Zi Telephone Number/Email Address Date (Revised Aug. 2014) CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: , v; 5 H A d 6 G K Address of Property: geIn.4 S,htve. 2?G31 (Lot or Street #, Street or Road, City & County) Agent's Name #: { ,r l� i-it��u r, 1 ��1 c tn,_ Mailing Address: 131 S -tv21,S -oee KC �a Agent's phone #: 2 - - /1 ,C7� f �,.1 ,_ k. i.jc 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 descnM=- or dra Nhg, with,diim�mug be ora�,oft, jjs er, I have no objections to this proposal. I have objections to this proposal. 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. Contact information for DCM offices is available orby calling 1-888-4RCOAST. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I 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.) 1 do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Informati Signat4re L.0 ;.s ter,-�f'� K, Print or Type Name dr Mailing Address AJJ— City/State/Zip Telephone Number/Email Address ti - /Z g Z, /9— Dt a- 7 wress oI�w�r��l (( uMailing Add C' ate/Z Telephone Number/Email Address l Date P1, (Revised Aug. 2014) MALL, t l6w -WY� AFAF 44 Oki - WR�.)j