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Home My WebLink About68656A_Mike Dubberly_20180403C.4MA/®DREDGE !FILL I (A"\ B C D GENERAL PERMIT Previous permit# \1 New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Resources y y and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / i�' Ly6i 'T 1� ®Rules attached. Applicant Name m;Ke OcA 0" wt Project Location: CountyDcerC Address(1 12 `j D TC Y ro jjA Dr. Street Address/ State Road/ Lot #(s) City- n')gnassa- State Y c zip 112 3(o fpoinI Dx Phone #(2=2)ra'73"II`13 E-Mail cl—,ae ( I m, Ye@ ao) Ca M Subdivision Elf a 1C''S Cakle Authorized Agenti)cMe, r(Q D,l4f od-3 City iYlani as zip a/c%j cl Affected ®eW 09EW NPTA El ES ❑PTS Phone# ( —)_fie River BasiIn AEC(s); OOM ❑HHF ❑IH ❑UBA ❑N/A 1J PWS: Adj. War. Body c^ ep SonM at,man/unkn) ❑ PW� ORW: yes / no PNA yes tiny Closest Mal. Wtr. Body P&A4'l koo poke 50c. nd Type of Project/ Activity ��LLLLLLLLLL:LLLL��LLL:L:LLLL ■:■■�m�j■■■■�Q ■ IS ■ ■■■ w ■■I . ■■ ■■ mo lllEMlr4=IK!!•:wCCC�PENN CQ g EI MEN Agentor Applicar¢P Intes4Name Signature "Please readm pliance statement on back of permit' Application Fee(s) Check# CuhVha 90u„I1cL Perrnitooftkee/ Pd ted Name �z �Y Slgnatur �7il,k Issuing Date Expiration Date NIC'Division of Coastal Mgt. Habitat Impact Computer Sheet 11 Applicant: miVR- 1b..bbzriy Permit 8: Date: tS/`� 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 Impactamcunt) 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 $iw��aw Dredge ❑ FIII ® Both ❑ Other ❑ Dredge ❑ Fill I i Both ❑ Other ❑ Dredge ❑ FIII ❑ 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 ❑ Dretlge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill [I Both ❑ Other ❑ Dredge ❑ Fill ❑ Both Other ❑ 252808-2808 :: 1.8884RCOAST :: w .nccoastalmanagement.net revised: 02103110 Nam v 7a0,Ap,19ying For 9nir;,N. \.aJd --- MaMway _ k250 Tvv ;mil l ww a£(A I V-k-&»& »«=c _mwag {@n wc4er , ThLi ,-U!�,ate; K , a o %-.-� . CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONANAIVER FORM Name of Property Owner: Mt K-F IJIA (0641 ✓ Lylt� p ,, Address of Property: 3 to S+ i"0I 1.+ IJ✓ 'y`gnLeei r A) C t•f VV�� (Lott or Street #, Street or Road, City & County) Agent's Name #: (AY IX nub, r�Mailing Address: IPO 'r Q C 5 n Agent's phone #:2S2-alto I--ILf LPCe Ill NO ffiU5,N(-23-7qS- 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 description or drawing with dimensions must be provided with this letter. 1 have no objections to this proposal. I have objections to this proposal. Nyou have objections to whatisbeing proposed, you mustnotilythe Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at httaYlw w.nccoastalmanaaement.nethve&cm/staN•llstino orhv.111na 1.saR. Rrna.cr 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.) KI do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature tr g �t�ld0alt lf� Pant or Type Name IDaSOyrapia Dr. Mailing Adtlmss WnauaS,0Pr 2011� City/Statelzip Telephone Number)Email Address (Riparian Property Owner Information) K Attnn_ -YA,i gnature LAuy-a N/IbfS•; r� Pant or Type Name 35 AodLac+- Pn;nfi pr Meiling Adtlmss L�iGfvl�-ev , IU c 2'1�t SL/ City/Sfete2ip x Telephone NumberlEmallAddmSs K Dare (Revised Aug. 2014) CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: W(k-e biA Wbey (. U Address of Property: -3)(0 RA(laSi"-UTA+b✓ NAQA t'-ev-,NC- ,f,. 1� (Lot or Street #, Street or Road, City & County) p Agent's Name #: rf it lew V �D ,ix�.('G-(.��d S Mailing Address: Pb &K '550 Agent'sphone#:�5a-p(PI-'1q" KH1 bavtil 2:JcaKR 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 description or drawing, with dimensions must be provided with this letter. XI have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must nofifythe Division of Coasta/Management (DCM) In writing within 10 days of recelpf of this notice. Contact information for DCM offices is available at htfpYIw.nccoastalmanaaementneVweWcMstaR-listina orbvcalino I.888.4RCOAST. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must be set back a minimum distance of Whom 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 t 5' setback requirement. I do not wish to waive the 15' setback requirement, (Property Owner Information) ��RiAarian Property owner Information) Signature Signature WP lbtl bbey�i( Print or Type Name VKD T'evyuoin by Mailing Address ' t uAa%,ci \lh2�ll� C#y/StatelZip Telephone Numberl Email Address Dere �)I`COLUS CDva f Fn A - Print or Type Name l Sal k�sh Dr. Mailing Address Wrltheo „lf ciSL-1 City/StatelZip �6 a -ct i3 _ L(a a SK(A1,UV)2-6r6t4&3-00V?.Ccihn Telephone Numberl Email Address 34-/S Cate (Revised Aug. 2014) �V'vyJ t_ L, N r( FtOANOKE SOUND raw �[]b� NTiREIIUptATLR/ ' 7J EC- . x twcx '3= i.yy IV. L nY�!'GSntl.ks.: nanmrnmurtnrnm�m --^ --- A T ij \} 0 I