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Home My WebLink About72580A_Christine Zilliox_201902263,CAMA / t DREDGE & FILL PENERAL PERMIT ew ❑Modification ❑Complete Reissue El Partial Reissue No. 72580 rA7) B C D Previous permit # 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 -4N .11oo Rules attached. Applicant Name Ch r% S I ,11 i o X Project Location: County C 11 v'( , � „ c 14 Address Iou (3 �,y cl Z)r City A 0na !po I '5 State MD ZIP Dt I u103 Phone # (a") 54 %- jhe D E-Mail Authorized Agent Lc ..p ; ,—,-. ❑ CW [YEW 4PTA JES ❑ PTS Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes /tom PNA yes / no Street Address/ State Road/ Lot #(s) 61wIIL, 1). Subdivision --- City (")'4.LX ZIP I =;9a 3 Phone # ( ) River Basin IL Adj. Wtr. Body SD y r` cA A"KaV/man /unkn) Closest Maj. Wtr. Body L 1 r r y— L. K S oa�l c4 Type of Project/ Activity %J•t w f3 he r,Y, , �� ., r o 1 S !, , { 1 M (Scale: _ Li 1 ) Pier (dock) length _ Fixed Platform(s) — Floating Platform(s) Finger piers) Groin length number Riprap length 1$d, avg distance offshore max distance offshore Basin, channel cubic yards_ Boat ramp Boathouse/ Boatlift Beach Other Shoreline Length al simm SAV: not sure yes "` ■UN■■ 1111111IM''NEE .�■■■ ■■ w.+ • ■®t�■■ ■�■■.,■■ ■■■i■■M■ Waiver Attached: _ ■�!I■■ IL"000 ■■■ ■■■■■■■ii■■■■ A building permit may be required by: C' r f . �.' c IC ❑ See note on back regarding River Basin rules. ( Note Local Planning jurisdiction) Notes/ Special Conditions Ny�t : r o ,,,,� F �.� , T ,tiwn 1u h.c i !,, �u .f c!o w r-, Agent or Applican� t Ytgd Na e Signature ; lease read compli nce statement on back of permit" 4HULD-oo Ul 191 Application Fee(s) Check # Permit Officer's Printed Name— ature alahla�l� �/abT� Issuing Date Expiration Date NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: —; 'N �%o X) C I ( Date:-f,�V�l�f Permit* 3 ) s-86 A Describe beldN 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 ternimpacts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp im act amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or ternimpacts FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount 5 ' s Dredge ❑ Fill 9Both ❑ Other c) k,) {e t . , . Dredge ❑ Fill Both ❑ Other ❑ (� d Dredge [IFill [IBoth ❑ Other !S' Li L) (� 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:02103/10 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION GNi2.lSrtNC M Z i�c.ioJc. Name of Property Owner Requesting Permit: THOi1dAS ZILLIOX Mailing Address: Phone Number: Ernail Address: 100 BOYD DR ANNAPOLIS MD 21403 240 841 1160 I certify that I have authorized LAYDEN MARINE, INC Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits L necessary for the following proposed development: VINYL BULKHAED at my property located at 1426 WATERLILY RD in CURRITUCK County. 1 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: signature C i4oc / S ,("cam M Z s [. c 10 >�. Tho'`Ii4S Z%L z i e'�- Print or Type Name Title 27 1201F Date This certification is valid through O `r 13_1 ■ Complete items 1, 2, and 3. ■ Print your name aril address on the reverse so that we can return the card to you. O ■ Attach this card to the back of the mailpie B. or on the front if space permits. Article Addressed to: A:ctiatd web b 1 9590 9402 4365 8190 6154 86 2. Article Number (Transfer from service label) 7018 1130 0000 5399 PS Form 3811, July 2015 F?SN 7530-02-000-9053 k%Cgent ❑ Addre Received Printed N e) C. qa pf D Is elive�ryaddresj differint from item 1 If YES, enter del' eryis dresspelow: 0 No 3. Service Type ❑ Priority Mail Express® ❑ Adult Signature ❑ Registered Mail- ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted O Certified Mail® Delivery ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery 0 Signature ConfirmationTM ❑ Signature Confirmation 4788 Restricted Delivery Restricted Delivery Domestic Return Receipt ADJACENT RIPARIAN PROPERTY OWNER STATEMENT Cri(11�St'PN C tA �Z i LC 1UX THOMAS ZILLIOX I hereby certify that I own property adjacent to (Name of Property Owner) property located at 1426 WATERLILY RD (Address, Lot, Block, Road, etc.) on CURRITUCK SOUND in CURRITUCK COUNTY N.C. (Waterbody) (City/Town and/or County) I The applicant has described to me, as shown below, the development proposed at the above location 1 have no objection to this proposall/s e ►�� be o !�►45� I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must rill in description below or attach a site drawing) TO INSTALL VINYL BULKHEAD LOCATED AT 1426 WATERLILY RD t l� QC°v�' VW nPrt 1�/U �e A�rctrvtP i,�aa(c. WI ProPer � O whe tr c14 bu.t UC r' I n 1 1f L ,f No c�re, c(c`nc� O'�'�'�c••�arcc�. cs dt5r.r� �'o bt le4cZ I v Cur✓Ort'I r-(eVaT 1 J J Sop c"rosrd 1 �f �� c�rrte(pva F+o� WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin 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 I do not wish to waive the 15' setback requirement. (Property Owner. ( orn:iat, Signatu C 11(2 %S 'r j& M THOMAS 71LLIOX Print or Type Name 100 BOYD DR "AWAOMIS MD 21403 City/State2ip 240 841 1160 Telephone Number/email address Dat (Adjacent Property Owner Information) Signature Print or Type Name 6 la i A S IeL� ! r- Ma-,- A , S �-'Ls te- Mailing ddress City/State2ip �-o „�'��(� A)C 27g,3 Telephone Number/email address 2S�—(ot�—OoG4 Sr'a�lcmu.y@�Mat�,com Date* p! /.2 1/-aclq (Revised Aug. 2014) *Valid for one calendar year after signature* LAB bF� i'►'►A lttA✓F, 'in-C Iet fW46^J'4 : P,a. 8 d IC i as as adds i- othl J�aso �o�j;Z II j —Vail ti e 1v �11OS J-)Yl W'"o Ny e 1 ks:� i� qg 9 3 �? ti r '1-