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Home My WebLink AboutJohn Santilli 63283D jit4:4-5 1\1411 -1-K a 40' 7cAnnA / DREDGE & FILL 7 ZORT;A N. 63283 b 9E'NERAL PERMIT Previous permit# 6t254j 7-b >� New Modification ]Com lete Reissue Partial Reissue Date previous permit issued . /Q �p p �-/ f r 3 As authorized by the State of North Carolina,Department of Environment and Natural Resources t) 0e and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7-I/ . G)v�'" • -�` A ff 1 Rules attached. I.Applicant Name J j il,n_1a `jT Project Location: County /�'C� / Ore,' Address J O 7 It:. Igle.5__Y r At _ !_. Street Address/State Road/Lot#(s) -_ __ __ __ City Lf State At ZIP_ lI • 970-1.7-79_3_ cornpltss 71 Phone#(i7412 031.3 Fax#( ) Subdivision ,SCai?jime,Zelejci Authorized Agent ��-' Caidits. iiiiii i, ( prE, City bJfi?ftyrj> vi ZIP s Affected ,-,CW :YfW [te'PTA L I ES C'PTS Phone# (Si)3I-?I River Basin-��__ _ ( } El OEA [_7 HHF i.7 IH U UBA [7 N/A I Body M 7 e f z- —) AEC s : Ad'.Wtr. + r + - r tc- v man�unkn PWS: C)FC:ORW: yes / no PNA CI no Crit.Hab. yes / no Closest Maj.Wtr.Body- �,�/J,, -S:, Type of Project/Activity ReyosaC /ofrper(y t/k/(X O 1&or p icrey i*i_s _ Re r, 04 e / oh c/G/i19 #QC//i`r (S% c tyo / (Scale: f 30 ) Pier(dock)length_ V -_ � Plattorm(sJ'� � „�s/i �.. �..} �.. !'— .., ..� Tle "�""1 Finger pier(s)— ------___ d1 y ki JoistJ„At[2 *Pt::11 u 77� .Groin length ( p c t3 wq t'�•P/�„G number__ i Bulkhead/Riprap lengt 4 avg distance offsh• a fOH `�1 '� max distance offs Basin,channel4 cubic yards Boat ramp '1 t it c,. F . -. Boathouse/Boatlift v ,/ti Beach Bulldozing Other ear'? . . 4- - - ---_. _.t . ..... ........ N....,_...,-. , _ , -lir . eir . , , . Shoreline Length let /245 tUQS ietrr. SAY: not sure yes o ;_. :-.:: _ • __- �lfL•QRi}�_ I Sandbags: not sure yes Moratorium: n/a yes i ♦ roe fl ! s . , Photos: yes } •is ! WO�- . Waiver Attached: e no i l _1._ —_ ---. —_,_ �... A building permit may be required by.A� lew !/4+I� JIl4� • ,___,See note on back regarding River jBasi-n-ruulles. Notes/Special Conditions 4/i74-5--Arm 09tt /41 moo/ „S00 0 wetit-as bed' /I fickr' (laktriae �f'��„ ►► n,tc 1�4✓-/i/r'S i1i.ee #2,1 �c-a!f'c4 t�l n, • - /�CU E 9e-74 Agen r Applicant Printed Name ! Permit•triter s S :t e ifj 10/31/1 K yi 1,C Signature ** a ead co/3/k fiance statement on back f permit** Issuin++gg��Date Expiration Date All At* -__ Planning Jurisdiction Rover File Name gJ Application Fee(s) Check# Local AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: ;c)\^^ °`"*.%' S``N';* Mailing Address: O 1 . 'S ,A.A. � T v r Q w °� C-- at- c- , �cv G Z�l 5 \‘ Phone Number: 0..E \ "�x. 2- - 03 b3 Email Address: .r•Ick `' . I certify that I have authorized C. "- : �� ` �-�-^ ,e• ^--*\.) Agent/Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: S s 'R o..` ... a z.�. C .. o... '. c . LPL . at my property located at -1 Z 3 / .�� C " a '" ' v., in N - 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: Signature Print or Type Name Title i 3 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to -SoN"^ S O"""` ' `XS 's (Name of Property Owner) property located a1 1-1`�-1 C. o •• \"' "` w ,- •-, ' . w c, — (Address,Lot,Block,Road,etc.) , on % Gw ,in ea„..,,., _,,.., _ Cc ... _. -\,N.C. , (Waterbody) (City/Town and/or County) Thea licant has described to me,as shown below,the development proposed at the above location. i I have no objection to this proposal. I • I have objections to this proposal. ; /, / /ram /0/Z'85 r. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill In description below or attach a site drawing) • WAIVER SECTION I understand that a pier, dock, mooring pilings, 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.) ___12:4_ I do wish to waive the 15'setback requirement. I do not wish to waive the 15'setback requirement. (Property Owner Information) (Adjact Property O er Information) Sr lure Signatupe , S o�..., S a.... :\\. :.A/-)6 r ,Z 1.X/V/ /' Print or Type Name Print or Type Name t o-1 w .a `.. v c., w -7703 Oh f„', 1 '/ Mailing Address Mailing Address j. a C. o.-'-, . Y,r C. 'L .\1 S' j t)/./I�'//�l 6,I^iv /✓C 2 `O/ City/State/Zip City/State/Zip, c\ooq - `- L• d 1 kal Qlo._ y L LS`s Telephone Number Telephone Number ‘ o • 1-0•k.,% /07.)//) Date Date (Revised 6/18/2012) Scanned with CamScanner 1 I ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to °"^^ S °"-'� ' ‘Xi 's c p M Y; (Name of Property Owner) property located at 1� �' a .,.. .`--^•-,› t '- . w c (Address, Lot,Block,Road,etc.) on t C.v.., ,in w �..,, R-va..• _ Co.. _ti -N, N.C. (Watorbody) (City/Town and/or County) The,a licant has described to me,as shown below, the development proposed at the above location. A !•.1 I have no objection to this proposal. I have objections to this proposal. '�/ �, i /` /i DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) WAIVER SECTION I understand that a pier, dock, mooring pilings, 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 do not wish to waive the 15'setback requirement. (Property Owner Information) (Adjact Property 0 er Information) St lure Signatur 7 te .a\... S a.-."N :NX. ::,,�?Cres 747,1 X A/V: Print or Type Name Print or Type Name k a-� w .a %A.`�. VC-, w ?7O J CoH,eif... ( 'I Mailing Address Mailing Address ,r. e C. o.., hr. . Z . r c1Sti.♦ /t)t 4//V&TO,`. NC GJ 70/ City/State/Zip City/State/Zip, q - �'�t...• O +.1 �'10- (- q a Y--(NS Telephone Number Telephone Number‘ // �O723// . O . 20•tQ,� l � Daft Date (Revised 6/18/2012) Scanned with CamScanner 0 v VI' �� nL �. X erg' 0 c. L- eo 0 > tra'''Y 't- 1 j H i i t i 1 a i 1 1 I