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Home My WebLink AboutDixon, William & Sarah®^ F CAMA / ❑ DREDGE & FILL ! ( «`�No. 74914 A B C D GENERAL PERMIT Previous permit# r New ❑Modification ❑Complete Reis sue 7Partial Reissue Date previous ermit issued As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resqu ces Co m_ ission in an a a of environmental concern pursuant to 15A NCAC ❑ Rules attached. Applicant Name � �/{E I ,�i�(J� Pr�jectLocation: County( Address �' (' �% ; �.-�1 ,i 1 �� j l t t' - _ �"I'' , Street Addre{s/ St4e Road/ Lot..#(s) t ZIP_' Phone # Authorized Agent [ICW ❑ EW LI PTA S ElPTS Affected ❑OEA ❑HHF LAH U A El N/A AEC(s: ❑ PWS: / 1 i ( 1 ORW: yes / no PNA yes / no / Type of Project/ Activity Pier Fixe Float Ping Groff Bulk Basin Boat Boat Beac Oth Shor SAV Mon Phot Wain i� ZIP Phone# ( /,'�`".' River Basin Adj. Wtr. Body Closest Maj. Wtr. Body (Scale: ---_ "_._.___ . ) Mom i■ E■■ r■■■■■■■■■■■■N■E ■:■..�?mu■■ � �■■■■■■■�■■■ � r■ ■■ENE ■OMNE■r r�■■■l:�.EO ■■■ ■ n■■ i5'lEIrAM �MHU !■■n IFAR► AN :n■■■ Mom■ ■■■N■■ ■■■ii■nIN' MEEltl■N■■■■�■■■■ ME■N■N ■■■■■■■011IME 0■■■ ■■ ■■■■■■■■■■■E■■mN■■■En�Elj�1�7%cl� ,a�■■■iIfA No ■■■■■ ■MII■E■■■/■■En r�■sE Uluil[41�11'�M�M■■ No ■■■■■�EI�In■ ■■FAM MLlL1Effm. I� <r■■■■ nN■■■■■■ ■■■■■■■■■■�.■■■■■■■EIII MEN ■r1 ■■■�■aE■■■■■■ ME ME ME ■■■■ ■51011 . Qn■■8 iiE�■I�■ U■ I�i■■.�■�i■■■■■■■ ■■■■ie t..■1,i =ME anEE�M■�i�■■.I■ cubic yards■■■■■ \�iM �.■■■.■� ■■■■ �■■EmI I■■1�^.1 iE1� ■■■ ■ w E�iin1�■ii■iN°■i1�r■i■ij■i�M MEMOS lEiin�iu��i UM ...■■. �...■a. ■..■., C�■■®I C..�.a■.■.■■ ■ ■■■■■n■ r�cEri ► ■■ En ■iM ■ �i■■■■ ■■■■�■�■■■��■■■■�iri■■■�i■■��i u■�i�■r��■� ■■■■■■■M■■ME■N■■■NM M&I ■■■■■�■■■■■■■ ■■■■■■®■Ems ■■■■■EIJr,■■■n�■■■■MA G■■■a ■■■■■■E■ ONE i■■■EI■■IN®Nf/1■N�1N■■�l �/IG�i �■■i1■ '.. :l :::::MM0 E:::: : ■C notsure yes :CSC::::�CC::::�C::::�C:::::CO:�C M'■:C" yes oM:M M :: M MINES ::C'::�=: , . ,. ■■■rsX ■■ OMEN ■0■O■ N■0■MN�■■ ■■ EN A building permit may be required by: �I ( Note Local Planning jurisdiction) Notes/ Special Conditions i Agent or Applicant Printed Name Signature *Please read compliance statement on acko pe �* - / Applicatipn Fee(s) - Check# See note on back regarding River Basin rules. Permitofficer's Printed Name � r i Expiration Date ITN6,o,'C I hereby certify that I own property adjacent to r (M Fat, b1r'-X 0L^1 s (Name of Property Owner) property located at �s' (Address, Lot Bloc , Ro d, etc.) on a( _, in �1 6�toal C7'r, , N.C. (Waterbody) (City/Town'a d/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 haves objeoiion-s-to this-pro.posaL_-.______--------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) �'X -sea b�)q -f-o (-,e ILA,r- UP c-4; a� (a5fdu �� 1urr� c� RECEIVED MAY U 8 2019 WAIVER SECTION DCM-MHD CITY 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.) e� I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature Wfi ► t ; I vv, Date (Adjacent P op Mty Owner Information) Signd ere Print or Type Name 16 C'e^-t cr �� r Mailing Address p-&W..f z&W City/State/Zip %(9 -alq- iv�9bdJ Telephone Number Date (Revised 611812012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Th-.4111. a'&(a k i Xc3 's (Name of Property Owner) property located at 113 Core br. IJ2S B (Address,. Lot, plock/ Rgad, etc.) on in zuel v (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above loc' n. 71 have no objection to this proposal. _.__—__1flaye-abjeLQtions_to this -proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) �t�`��-�-; s?�t� ct(1-fe3 c� UeC4� Ca ( bi rds u�r� � e qtQ_ 0tnQ-_ 1O ' 6kJd(i ®C, �ix�vPGPsSarQ- fim 61 `n n6c 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 inittiial the appropriate blank below.) C� I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Ad/jaccennntt Property Owner Information) Tel�l}o� Number t /�Date l lber e C4/!d CJ Print or Type Name t �a Mailing Address City/State/Zip Telephone Nu ber Date RECEIVED (Revised 611812012) MAY 0 8 2019 RECEIVED MAY 0 S 2019 DCM-MHD CITY RECEIVED MAY 0 8 2019 DCM-MHD CITY m ty ro t7 y .9sr o �o A ns v W W W W �p V W Go 0 C a WB �n o HO�JJ o o* 00 t+l r• o--i c x W r o 00 O, O C7 'f1 4 s C Fw 7i A may/ 7y S m QJ t<1 °o d b N r e x C 0 0 y is Ol W a i. to O 'B $ a� �g ¢a R n MR �u R 0a 'sg �a Av c� ?c go A,S o N� �m mm 5� ym� R$ m� a P �F o —ff � may and 9 S o x � °° x �i a rt"• �, o?D rn z N W H W r CA V to to F+ � O H O x 9