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Home My WebLink AboutKenneth Hendericks 72345D ,J�eip' 'CAMA / DREDGE & FILL No 72345 A B C D GENERAL PERMIT !ECr Previous permit# > -'New Modification LComplete 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 I 5A NCAC frqfl, a ,,�/ Rend"; ,,/ / ❑Rules attached. Applicant Name keirel yl `//7, nd";CLS Project Location: County 12e -I'//' Address /5S, 1 IOW/fir EetiP.5�/Aad Street Address/State Road/Lot#(s) City Ke hie State / e, ZIP a8451 &VIII' Phone# ( //J ) 6/6 p69 E-Mail k 1 Petwit/hire/as/Ail Subdivision Authorized Agent /V!r! City ----...."....•••• ZIP Affected ❑CW 54 XPTA ❑ES ❑PTS Phone # ( -.) River'Basin �,po �fr AEC(s): ElOEA ElHHF ❑IN ❑UBA ❑N/A Adj.Wtr. Body NE('fi Rft or man /unkn) ❑ PWS: /�.r Fur- ORW: yes / no PNA yes /0 Closest Maj.Wtr. Body NE Cape Type of Project/Activity_ f{4I" 0LTIJ r bii1!/ �/�J cI�Oyed 4 �J//Y/'i ra i ��/�.f14' 0 ?try f / (Scale: 'a ip ) Pier(dock)length AS Fixed Platform(s)4/41/ // +/1` I Floating Platform(s() r4/O)/h/fig/ i Finger pier(s) Groin length number eft 1, , - Bulkhead/Riprap length G/• avg distance offshore max distance offshore A NF Cap e.er,r71C , Basin,channel cubic yards 1n ' Boat ramp re - L" rwl c Boathouse/Boatlift I fhoir .doXi,5 l 4C 14 1 te f/et" Beach Bulldozing Other- Id j 14 3/ 1 r'Arf," /.! ,' , _. 4 KO' :ur :: 'RP I Photos: yes C no . ,f, ,, t„ Waiver Attached: no �Qr _ - 1 - • Aorrpson i p . ' A buildrng permit may be required by: p,//, ,/J,//(, . See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) Notteess/Special Conditions c' gai/thaft // dy er(St( inr . kii 2a y>< i 4 'pierle /n Y /4piit tit if Orr- / -' -, ! '-; _/.,,,,-j /7-�,-,.:'/,.-%( Pairek/tiike) Agent or Applicant Printed Name Permit Officer's Printed Name /&-eirjAhr"? Signature **Please read compliance statement on back of permit Signs ure N & /W/a0/ /02��°7) Application fee(s) Chec�lc#" Issuing Date Expiration Date . — AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: /6 , /-4-4rl..-eG Mailing Address: /37s �S / /77 $7 /' /-s/ /es /Io,( ,74 , — ZScS-7 Phone Number: 9/0 a/c- Z Z‘- , Email Address: Ce/ /IQuui .e_o n- I certify that I have authorized Agent/Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: 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: J Signature Print or Type Name G Title ` 1/ 1 /9 Date This certification is valid through I I ADJACENT RIPARIAN PROPERTY OWNER STATEMENT,/ • I hereby certify that I own property adjacent to kv, i eh-c #7G.-ce,te,/`-5 's (Name of Property Owner) property located at /375's A/%,%!,gs ,,1 /zaZa0 X .of Afiic z8Y_5'7 (Address, Lot, Block, Road, etc.)" on/./1 Cv t/% e/` 1tL u-1- , in A. tC- , N.C. (Waterbody) (City/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) L--- rr ,UG eU ..e. �"wr Alt r t /Sk,/h= �_� —�' 1 o �° i ' ` l'ai 20 rr 1L,''- 1 X• C( c 1 l,,,a.rt-c..ola/o — S"v frS s,c// ' ' tic-42 1v7.5 OM ).S/eIt,e s•14.1-fJ eL 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.) et, , I do wish to waive the 15' setback requirement. iI do not wish to waive the 15' setback requirement. (Property Ow r lnformatio (Adjacent Property Owner Information) dt / E: -drLt_7 S'gnaturle� S Sign y Print or Type Name Print or Ty,Z Name lJ /3?C.S /�u L,, .5 .de-"fis/G% 4e 40 b Col"l�ki-M cA ur,c.h gi i,ling ddress Mailing Address City/Stale/Zip G City/ tate/Zip Telephone Number Telephone Number / /ej/s /- /9- /9 Date Date (Revised 6/18/2012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT ` I hereby certify that I own property adjacent to /CC1') 4 jV-�e,, �.� 1.1e-' 's (Name of Probe Owner) property located at /i7.S'' S f4'/`7 4jl 4C.Adec ,,e P,I.1C e69,57 • (Address, Lot, Block, Road, etc.) on�I ��fc.r' /z,c„Cr , in /f i#- , N.C. (Waterbody) (City/Town and/or County) The plicant has described to me, as shown below, the development proposed at the above location. i 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) "Y Pr'4 d‹...........0' " A:44....A —___..--, F----- -2.2----- ii> pi Ref/ t im cods fo rt r /d�ZD! ,� euat di oC cJ er^, 7401115 a ll j7 WAIVER SECTION ai 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 set c , you must initial the appropriate blank below.) V - = I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property O er Information) (Adjacent P erty Owner Information) 74-- -/-- h— ,,, Signature i gna //��7/ amen Print or TypeP t or�T4'pe /e RI/ & Addres, Ma �y es „ �o G.CCI itlG Z$/SJ / :G!/ n't C, d City/StateZip Ctty f ' 2/0 l/ z z 6 g wi--i 1- s7"? Telephone Number Telepho Number /// F/i9 //„i-// Date Date (Revised 6/18/2012)