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Home My WebLink AboutCrocker, James R.®NN AMA / ❑ DREDGE & FILL No. 75716 A B C D GENERAL PERMIT Previous permit# LINew ❑Modification ❑Complete Reissue []Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environtrt'ental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC i ❑ Rules attached. Applicant Name K_ (\J1__; 'v Project Location: County— __ _ -- Address ) Street Address/ State Road/ Lot #(s) CityState ZIP _ i Phone # (_ -I _) E-Mail Subdivision _ r , Authorized Agent ❑ CW [ j=W ❑ PTA ❑ ES ❑ PTS Affected ❑OEA ❑ HHF ❑ IH ❑ UBA El N/A AEC(s): ❑ PWS: ORW: yes / no PNA yes / 'no' Type of Project/ Activity Pier (dock) length Fixed Platform(s) Floating Platform(s) Finger pier(s) Groin length number Bulkhead) Riprap length_ avg distance offshore max distance offshore_ Basin, channel cubic yards i Boat ramp Boathouse/ Boadift Beach Bulldozing Other City I i . r — ZIP Phone # (�'River Basin Adj. Wtr. Body . __ (nat [man unn Closest Mai. Wtr. Body___ — (Scale: ) Ililslel�il®ll�lA®IS�It'�SISv'!a!®I!f I®��il�l®®I®I®I®lie�ilB�®®I®ICI®®19� Shoreline Length SAV: not sure yes no Moratorium: n/a yes no Photos: yes no i Waiver Attached: yes no., A building permit. may be required t ( Note Local Planning Jurisdiction) Notes/ Special Conditions k ❑ See note on back regarding River Basin rules. PermitOffcer's Printed h Signature "`* Please read compliance st t menton¢ackofper ft** Signature ' Application Feels) Check# Issuinging )ate i Expiration Date ❑DREDGE & FILL ' i ' I v 75716 ENERAL PERMIT q Previous permit # ew ❑Modification ❑Complete Reissue ❑Partial Reissue a1`�� Date previous permit issued ^ As authorized by the State of North Carolina, Department of Environ.nental Quality �,f,�l and the Coastal Resources Commission in an ar f environmental concern pursuant to 15A NCAC L/ / VJ(�JtJ Rules attached. ApplicaaAamejtE�'Project Location: County CA4NI n::V= AddresStreet Addr ss/ tate d/ Lot #(s) City State ZIP T . pI Phone Authorized ,agent ❑CW 4W (PTA ❑ES ❑PTS Affected ❑OEA ❑HHF ❑IH ❑UBA El N/A AEC(s): ❑ PWS: ORW: y s no PNA yes / no Phone # Adj. Wtr. Bode Closest Maj. Wtr. ZIP Basin a ��■ .- .!■�N■■■N■■■�N �/R■ 1.� '!1% �XL►.iIhi/IIIi!i��l■FREE■■■ ■■ �iilWif�■�1■I�\/9■ O■■■■■■■■■■ �►�1�1,1�:I!■I�JJ%'fyil/�ll�i1.�I[�►'®�■■■■■■ //�iLl■7■, Iu�NN/■� r ®• il■�1/�liir■■■�iSWAMIMONS ■■■ w=r'J ■EM= iA�■■I�;'�VI■L'�j9Q,��■■H■■■■■■ ■1■III�IAIITieTi1E'1i�i1/L.■■�9e/%!��/,11■��"�s�XL��:��■■■■■■■ ■ K/VIII% 11(/ L�'i�rLlt�,��"r'■I�M! ■llli►71/J;�I a�� /ir1. r+llH ■I/I�fII II'� �G■'�IPI■■■■ r Agent or A plicant Printed Name SI natu Please read compliances /G��r�e/on (of (it g **d nt P �a•'��ackkper L—P6� Applic on Fee(s) V- d Check# ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to lQ✓wm P'�' ludel 's Name oflproperjy pytr)erj u propertylocafedat_�C J(�til�(LS PW00r jj�NJ�� MISS on-OaJA0, hi 7VIut'e S(Address, Lot, BIpp k, Road, etc) if i 2 C) N,C. (Waterbo y) (City wn 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) -DU dirt ti MCk1h6a-t`ACe., :'rl (eLVAC� LAkkdtr alt cr Cimw � L- SIvA 5 dun, 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) Date (Adjacent Property Owner Information) Signalitre� �— Pdn o Type Name Malkfinjg Address Ci /Stqt19 A ,k iJ' V .3 icj L Telepho Numbe Dare (Revised 6/1WO12) ADJACENT RIeAlRJAAI PROPERTY OWNER STATEMENT 1 hereby certify that I own property adjacent to . J(An Ps _KU )C XP/' s f� �� " (ame ofjFrop�rty Ownef property located at, l_'T'T'_Jlb1l j.(S <pr, on QY�GU — , l_ 'Address, Lot, Block, R ad, etc.) r 15Y1Qtr%S in �)PL�iCU 7-! N.C. (Waterb dy) T (Olty/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. r I have no objection to this proposal. have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must till in description below or attach a site drawing) Do dredyn9 n{' vvikinc�,viee, iY) c6w6d i,ud-ev- ai d ` mk cxu�So Yt UPrt'e-, WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 16 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) (Adjacent Property Owner Information) ante £0( a SU - W3 - ) :�e N Telephone Number L)ArB (Revised 611612012)