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Home My WebLink About71296A_Brian & Lisa Holland_20181206P�YQAMA /XpREDGE 4 FILL N2 71296 Al B C D GENERAL PERMIT Previous permit# New ZModification ❑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 II I�,Rules attached. Applicant Name $P i m .. 9 L i s t� % o� l g n tl Project Location: County Address 3 5 2 S t Jv; e 17 r v e Street Address/ State Road/ Lot #(s) L o-f-si y 6 City/I TJe%l fly ll1 State Nt ZIP -2-"/7y8 35 2 S fir. Phone#(ZsR)YY/-B050 E-Mail o.(ox��//u at�s/I_''f M a:/,c,�Subdivision 141(L11< -5EC M Authorized Agent City k, //f ZIPAffected ❑CW Y(EW 5PTA MS C3PTS Phone# ( - ) - Q River Basin 1 rjrti.� AEC(s). DOER ❑HHF ❑IH CUBA El N/A Adj. Wtr. Body c n n al' (at ~a /unknl ElPWS: ORW: yes 1(0 PNA yes /Cno) Closest Mal. Wtr. Body Type of Project/ Activity C o g 4 r U c �'- ci.r Fixes Float Fing. Groi Boat Boatl Beat otht Shan SAV: (Scale: /Nf-7a y ) 0 OEM l■iiiii mii ii i, Plwfi.rm():aiiiemi�®l� w pier(a) ®C��:::: �::11 ME ■■■■■■■■■■■■■■■■ ■1100 number ■■ ■■■■■■■■■ ■ ■■■■■■■■■■■ ■■ ee C■■■■■■■■■i.mm ■■■■■■■■■■.c� �■MEN ■ ■ ■ i�Qiiiiiiiiiiii ®®C��i ■■ mill so cubic rds ■ ■■■■■■■■■■fi■ ■ /'lo■■■■■fi■fsm Nis■■ ramp■■■ ■■■■■■■■■■■■fl■■ �G■■■■pl■■■■■m. ENO ■■■■■��iiifiii n MENOM ME ■ii iii■■ ■■■i�....� g ��1;'■��■■gin ..Cj.=� Eo�-�T—s■a�.■��.. ■Q�..�� ■��8i�%��■�n■■■ s ■me■f �e.�ee■■sltae�a■ �ii SEE�� ■■■■■ e■mI■■■■ ■■■ ■■ ■■■■■ SOMEONE_ G Emmon■■�G111MUMMU 11 �■ ■xialfR�!■■■■ m®i■m■■■■■ffl■■■ l■■■fr■I.I/E ■ ywi■iiiii ■ii ■®i®s��Miiii� ■■�iun"m= ��i■iiiI��■■i��Giiiiiii'o�■Giiiiii7 ii Mor Phot Walv A building permit may be requlred by: I Cot+ ( Note Local Planning jurisdiction) Notes/ Special Conditions Signature ** Please read compliance statementon backofpermit** Applicationfee(s) Check# ❑ See note on back regarding River Basin rules. (�✓"n_E Gnrv.r Pe 2 ItOPocer's Princed Name 6' _ ,,'- Sip ure `,/T /co /lS Issuing Date E pirate nDate NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Brian & Lisa Holland Permit 8: 71296A Date: 1216/18 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 ferns 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 Shallow bottom Dredge ❑ Fill ® Both ❑ Other ❑ 195 2teJ 1.96 Z4 S Shoreline Dredge ❑ Fill ® Both ❑ Other ❑ 130 130 High ground Dredge ❑ Fill ❑ Both ❑ Other ® 2600 2600 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill❑ Both Cl Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both 0 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.uccoastalmanaeemen6nel revised: 02I03110 \ A)E \ \ /§° § \ AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: GLCLIA flul Ia'1C_I Mailing Address: 35A Sha"view D(-We� Phone Number: c25M '1 "I 41-90rJI 5'D Email Address: _o6 1�U1 (a� Q/j `��ffyI II r coyr I certify that I have authorized (k �-IC,V(,N% ns , Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits 9g necessary for the following proposed development:jD IK� at my property located at in County. I furthermore certify that I am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information: or Date This certification is valid through Revised Mar. 2016 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT FOR CAMA MINOR PERMITS I hereby certify that I own property adjacent to P3 0A �61 n J a 22�! 1 ,(�-,, �I (Name pf Property O�w,ner) ' I property located at M A_fty 66"M . M'1YM461k It _ I Add,ess, Lott Block, Read etc) //[�,, � on Cq� / c_ `�'+ , in &�(�I.�' 5r a I IJIUI7U . N.C. (Waterbody) (Town and/or County) He has described to me as shown in the attached application and project drawing(s), the development he is proposing at that location, and, I have no objections to his proposal. (APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED) I VI IIaLUUJ v I2.L rP int or Type Name Telephone bar X� to ADJACENT RIPARIAN PROPERTY OWNER STATEMENT FOR CAMA MINOR PERMITS I hereby certify that I own property adjacent to lY I U,1 `:6 I Yhr,✓ 's Prol /ple Owner) I property located at y A.YL YVj (�(�l/ j1�e Z3101I Alk l..11l pp Adddress, Lot, Blyyop�k, Road, etc,.) n,, on *E ,In Vitt bA )IbIJ$ AP�ur7 1 N.C. (......body) (Town and/or County) He has described to me as shown in the attached application and project drawing(s), the development he is proposing at that location, and, I have no objections to his proposal. (APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED) Telephone Number /(jz9J.i Date :, & ?, n, .2 . ) _ Vz � ! y a2 m \ \ \ ® �kIDESCRIPTIM oLWp� mp27 ~MOBILE ®� �E° ±2¥� . 252�2�300 EOe_m 0__. fi,. "6 fl. W¢.- -� IM 1 ( ( 1 1 I �I2 a%,O. - �€ B R. `--MPR X 3 :0 3 :rY Ye Sip N N Elm Np% z=21Vr h,�NON c / ff�'- g Ao°o ,P/�F59 �° ° 4�r�� og5t •n£ 2 F � ? E ., . \ / 2 \< ?< ( ??d \< § - :<<° « � 2 =: !� . \/^ ) \0 -------------a � �