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Home My WebLink About63114_Culverts_20180808VIA 1ADrREDGE & FILL ��CAI" N2 7 A, OB C D GENERAL• PERMIT Previous permit El -[)(NeW; Eikoclitii'cation Complete Reissue' E] Partial Reissue Date previous permii issued A; W -�As authoriz6d by the State of North Cairolina, Department of Environmental Quality and.the toastal'Resbueces Commission in an area of environmental concern pursuant to 15A NCAC _Aff Rules attached. Applicant N4rhe_ IA— 1-21 Project Location: County- AddressY. , Street A dress/ State Roa d/ Lot#(s) Cit ig,�Icd e-- State/ ,L4, �C— 12k 4- Phone-# (2a �)73 'AV"E-MaII 0/ Subdivision / 5�/ Authorized Agent -7 zip City � �,e '_ ❑ Cw �,Ikw' -p�TA 't' F's ;�PTS River'E Phone # 4s n Affected. - . I - 0 OEA El HHF El 1H El UBA El N/A `AEC(s')': r, Adj. Wtr. Body— 4at Im5n, Yunkn) El,pws: -ORW:' yes,/ CO) PNA, yes jn�o) Closest Mai Wtr. Body WIN MENEM MEMEMMENME EMOMMEMEMOMMEME ME■0 MENEM MEN ■'■■ NEMMINMEMENEM�=MMENEMENIMME■EMEMOM MENOME MENOMEN 121010MEN NNE M MEN M MOEN 0■0 ■MEMEMNON MENEM MENUMMOMEMMMEMMENNE EMME EMEMEMEW MEN M NNE M -W MEN ME MIIIIMMMMMEEMMMMMME■MEMMONOMMMEMEM MEN NUMMMEME ONEEMOMMEME■MOMEMEMEME MEME NNE WMEMMEM MEN ME MEEMEMMEMEEME MOMMEMMEMMEEME NONNI! ■OENo NOON No MMEEM■MMEMMEM "Agent: or ApplLcAnt F, J( ,Sig tune ' Plea -Alication Fee(s) ted Name -ead compliance statement on back of permit CIO Check # Per itO i er' Pri teriTf 'ame Signature - - Issuing Crate Expiration Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT Uk-7 CJ LC. CMo, I hereby certify that I own property adjacent to L)LIAi4,�_ , Am L4 ,o 2a _ 's , � (Name o Property Owner property located at � �'2 67 Oa2C4/ CAJSi - VZe-, ' A !Sto 51,1 73 (Address, Lot, Block, Road, etc.) on l�?fA LC CA21�J41_'� in , N.C. (Waterbody) ( ty/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 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) -"W�'L ACI�X4-clxic' sopm(t fri/T Waw I 1 v F', /u D 7) C rt, f)(ZAJA),44 K_ 57re-a G7u ettfS 5 1-7y;?a c7cWaX� f KcZKca r2K d2U LJ!i S 5 -7,17K- %#,1-7 Gv -770 711)q- VLMC ri S 1411V q. /NJ .J NI 71 ✓�'L . (,✓I-,l fe' 2 K_ A/ 0 i, 1 col ✓` N*3 L WAIV R S CTION 7A/cd/'V— dr l �/j�j I understand that a pier, dock, mooring pilings, boat ramp, breakwaterath X" must be set back a minimum distance of 15' from my area of riparian access me. (if you wish to waive the setback, you must initial the appropriate blank below. AUG 2.7 2018 I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. DCM-WAR® Mailing Add ess / City/State/Zip r Telephbnj Number/email address �9 16; :1- q 7 � uJ�'`)- (Adjacent Property Owner Information) Signature * Print or Type Name Mailing Address City/State/Zip Telephone Number/email address Date — _ Date* 'Valid for one calendar year after signature' (Revised Aug. 2014) /c t-i ri N. � Certifled Mail Fee - j r - ! .toJ. CO Certified Mall Fee $3 a _ !fit Sa rl.l $ r:: -r lint i ru $ 'I ?`' If Extra Services & Fees (check ba,4 add laa$j�pp(o�(fate) - Extra Services & Fees (cherkbcr4 add tee s�pmpr�ate) C3 ❑ Retum Receipt (hardcopy) $ C3 [I Retum Receipt (h-copy) $ . C3 ❑ Retum Receipt (electronic) $ � E Postmark r ❑ Retum Receipt (electronic) $ $ ,I , ? I i_i Postmark C3 Certified Mail Restricted Delivery $ X! Certified Mai Restricted Delivery $ 1 i _ ! :! 1 ❑ ry Here � O ❑ ell' _ Here =: r_3 ❑ Adult Signature Required $ -4. yl CI;-, C3 []Adult Signature Required $ •�,® i ' ` "' > �� a ❑Adult Signature Restricted Del ❑Adult Signature Restricted Delivery$ Postage _ . {_ Postage p $ +_}ti _LI "_fit p $ l 11 M Total Postage and flees -7; , m Total Postage and lre8s _ M1 $ AUG 27 20 8 M1 $ _E -- _ r- Sent To Sent To OSreet andAPt No, Od,orPOBoxNo. - - - ------------- ----------------!� -------------------------- - -- - City, State, ZIP+4® ! City, State, ZIP+4° �- :.. MW :.. t 11 11� •1• • oVP2LETE- THISSECY10N ON • `pleie:ii�iiisl-2,-and'.S.' -_ A rSig11 Ure fPkk--your name';and'addressM'.—w:'so thattwe'can'returnthe:card:toou.: _ `- '�-- - _ = ® ®''Attach this card to the back of the mailpieoe; B `-Fiec ved by (Printed Name);: _ A C Dateof De'ly L , "oronthe;front;if-spacepermits..:=_; t';Miicle Addressed,toi - ;D.: Id delivery.address. Ifferentfrom ftem l?-, :If YES. enter"deliVery,-addresslieltiw: r' J a ....(-., 3. Service Type . p Priors M ail Exp essV II I IIIIII IIII III I II I IfJ I II I I1i�I III I II ILIII'III ❑ Aduit Signature ure Restricted Delivery '❑.Register d,Ml Rest{ p ❑ Certifled.Mall®. - .Dehvery_�e t,. 959Q.94Q2- 381=1" 8032 31'12 'S2 - ❑ Certified Mail Restricted Delivery -t7:Retum Receipt•hir ' ❑ Coiled on Delivery • Merchandised _� _-_ n_ennactnn-oeli4ery Restricted Delivery _. ❑ Signature C'onf'innatic 2. ----- _ __.-_ _ �.: ❑ Signature Conf'trrnatic 7 017 3040 0000 `2889 711E °, I RestrtctedMilivery i Restricted;Del! ry PS,Form 3811; July 2015• PSN 7530-02-000-9053 Domestic Retum Rece phir eMh�fTdTEs e17 3040 0000 2889 7123 '7000' U.S. POSTAGE PAID WANCHESE, NO 27981 APR MO�UN ATi $6.70' R2305K142812-02 a LN RECEIVED a AUG 2 7 2018 77 DC _ 7:1RE URN g r UNCLAINE.D UNASLE TO F0RWAR D N 66 pp ,fig 0 ._•`i.$ I -09-89 .;?^I:.a.;.?I:�._.��g��'111ij1i11ij�1�111it1t11i1i1i1j11i11t�1�1'i111�1t1i11t111it73t1f � ,}jj'� NC Division ooff/Coastal Mgt. Habitat Impact Computer Sheet Applicant: Date: .D �V./ 'oo10 General Permit#:r"0 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 Fill)� Both,k 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ 252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimananement.net revised:02/03/10