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Home My WebLink About72526A_Tim Tant_20190205CAMA / DREDGE & FILL NO. 72526 r. GENERAL PERMIT Previous permit# O B C D NNew .]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 15A NCAC Rules attached. Applicant Name 7 t ... moo .. Project Location: County �', , r A, r- K Address ► 10 l�, , 1) , .`k_ City„rr •'�. 1 State _ILL— ZIP a�cld 9 Phone # () ( _ f, to E-Mail Authorized Agent Affected ❑ CW [X EW X PTA W ES ❑ PTS AEC(s): L1 OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes /6) PNA yes / C'� Type of Project/ Activity Pier Fixes Float Fingi Groi Basir Boat Boat Beac Oth< Shor SAV Mor. Phot Wain Street Address/ State Road/ Lot #(s) I lu w, AC4,, I). - Subdivision G•t 1 c 10C City C'i't,�,. c 1C ZIP a -4ct d-9 Phone # ( ) River Basin Pe, S! Apirr IC Adj. Wtr. Body p t K & ,, et�man /unkn) Closest Maj. Wtr. Body —Corr _A IC 5,,",r\ d (Scale: t = SO) .ng Platform(s) MEN i■N■ i r i �i■��a�iii■■■i■ON. 2a3111q�i■ mull r pier(s) ■�■■■■■■■■■ l �ti I� �a �i■■■■®■■■■Ia■■■■i■■■■ i length ■v■■■■■■■�-� �� j� �a ■■■■■■®■■■■c■■■■■■■■■ ■■■r��■■tea ply►`.iiJEa■■■■■i�i■■■■■■■■■■■■■ number ■�■■■■■iri■■�■III ■t!?li■■■■■kl®■■■■r.tFR■!!', MEN■■ length 3 ...SO avg distance offshore,). ====== === ='= 4=►:yes'��■■■■■1'�11P1!�l�r''�1�1!1�Ill �11��■■■i!!'d�T�■Y■■ ■�1■■■■■■la■■■■■■■■ram■■ max distance offshore. -I' ■■■■■■■■■[!RC�ti�■■■■1�1�►��tit■■■■■■ ■■u■■■■■■■■��■■■■■Q■■�aa�.�■■■■■■■■■■ ■■1 ■■■■■■■_■■■�■■■■■■■��►l■■■►l��■■r■i■■■■ cubic yards ■=■■■■■■ No ■■■■lAf�!!!!1�'��!■�u!■■■■■■■■ ramp ■cam■■■■■■■■■�■■■■■w��+l■■■■■■■■■■■■ �■I 'MEMO■■■■■■■■■■�■■■■■■■■■■■■■■■� , -i Bulldozing ■■■■■■■■■■■■�■■■■ ■■ ■■ ■■■ ■■■■■■■■■■■■■■■_■■��■��_\■�■■MI■■■ ■■■■■■■■■■■■■■■■■■■ ■■UMITT VINFAR,FROAS■■■■■■ -line Length not sure MENINIMMEM NEEMEMEMINE yes "v MEN MEM ■■■■■■■■■ 1G1.!4ew, torium: yes no ■■■■■■■■■■■:■■■=_�r.aW■EM■■■■■■■M■■■■M■■ . tt . ■■■■■■■_■■■■■�■�■■■■■■ i M�■■■ ■■■■■■■■ ME,A,mi■i A building permit may be required by: ` vY r •� C j� ( Note Local Planning jurisdiction) Notes/ Special Conditions Agent or Applicant nted Name X7, � o r "� Signature*Please ead compliance statement on back of permit ,4Licx_�). Dy A.Hia Application Fee(s) Check # ❑ See note on back regarding River Basin rules. ?0 , I d 1, PermitOffi e Iftnature /t/'�D1q GIs/�oig Issuing Date Expiration Date NC Division Of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Date: Permit #: IC� _16 A 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)impact FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp 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) 55 Dredge ❑ Fill Both ❑ Other ❑ 5,ko,'l 1r-k- Dredge ❑ Fill Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other 56 :ToU(D 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.nccoastaimanagement.net revised: 02/03/10 DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED I hereby certify that I own property adjacent to .77iy7 o-1-A 's (Name of Property Owner) property located at //0 l.! ► A.9 to l7 !Z (Project Site: Address, Lot, Block, Road, etc.) on �q,�,� 1 �_ —. in u ��t�, N.C. (Waterbody) (City/Town and/or County) Agent's Name #: Mailing Address: Agent's phone #: He/She has described to me as shown below the development he/she is proposing at that location, and I have no objections to the proposal. ------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill to description below or attach a site drawing) /W T. Ff r-, e__ — Z, 6f "rro If you have objections to what is being proposed, you must no the Division of Coastal Managements (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S. Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can a/so be contacted at (252) 264- 3901. No response is considered the same as no objection if you hava tieer _ _ (Property Owner Information) Sig lure Print or Type Name Mailing Address City/Stafe2ip Telephone -IL r / Email Address r � / Date "Valid for one calendar year after signature* (Adjacent Property Owner Information) Signature Print or Type Name 167 Wio;eau T)K Mailing Address t�RttetWck City/State/Zip Telephone Number / Email Addre ss Uat---- * ._ Revised .Ian. 2017 I 2- ��