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Home My WebLink AboutFutral, Anthany®❑ CAMA /❑'DREDGE & FILL t ' No. 74476 A B , GENERAL PERMIT Previous permit# t ❑((J'ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As autho�'ized 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 ❑Rules attached Applicant Name I 1;- \. Project Location: County a t Address l(. _ _:' Street Address/ State Road/ Lot #(s) i City ) i i State ZIP _-_- -i- i Phone # ".3 ' }t- t 'Mail Subdivision_ Authorized Agent .. __ .._.,._._...__.._..., city(. .. (: Q" l ` l,1_ ,_! ZIP _, - Affected O OW ElEW ❑ PTA El ES ❑ PTS Phone # C. 17;�j. �L i� ' 1' River Basin _ AEC(s): ❑OEA ❑HHF ❑IH ❑UBA El N/A Adj. Wtr. Body - (nat /man /unkn) ❑ PWS: ORW: yes /:no PNA yes / b } Closest Maj. Wtr. Body . - 1. Type of Project/ Activity 1 Pier Fixe (Scalet ) ■®■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■ .■■■. wG1■■■■A■■■■■■■■. ■■■■■MI■■■■■■MN ■■■■■■■ :::I% I:b:W :ram::%i::I% ::::::'�1■MEMMEMEM ■■■■■■SERMIail■■■9■�■1■■iu■■■�n■■rn■■■►■■..■■■■■ ':::::::::::::��::::::�: number :�::■ :::® ■..■■.■■.■■■■■■■■. lilt■■■■■■lAil■I■�fd��■�■N■■■■L� ...... . avg distance offshore■■■■■ N■■■■ ■■■■ max distance offshore■■■■■■ ■■ ■■■■■■■■■■■■r�■■■ ■■■■■■■!J ■■■ ■■■MMM :■■■■■■■■r ■■■■■■■�!■■■■■■IA ■■■■'�■■i■.I■.rANN ■■■■■■�l ■■■■■ ■■■■■■■■■t■■■■■■�■■II■■■■ cubic yards■■■■■■ ■■■ ■rY■■■■ N■■■■■■ ■■■■NOW ■■■■■��■■ ■61■i�■:■i�■■■■■1■■■■■■®t,�l■ur/■■j■r� ■■■■■■■■■■■■■■■I■■■1■■■■■■■ ■■■■■■� ItC1��■�■ ■■■■■■■■■■■■■■■■■�■■■■■■■ ■■■■■■N�■■■■■■ ■■■■■■:::■■■■N M�C'iM IF it :p ■::� M� ■■b�I■.■■■ N ■■o■ i Bulldozing ■■■■■■■■■■I1G�Ibq�i�■■P,L�■■rd■■■ ■■■■UlO11lI/1■■■ ■a■■■■■■■Ea■�I■t■■■ ■■■',A■N■■■■■■■■r ■■r�■■■I ■■■■■■■■■�■■,■■�d�1■M■■r/■n�l■n /l�l■►i■'�MMMIME■ � i■:IMINEMEM 0M:::::i■�::■i:::�■:iii::�I::::, Mine Length 11 ■■■■■■■■■■■■■■■■■■■■■.■o■I ■■■■ ■■■■ ■■�::■■■■ ■■■■■ ■ notsure yes no ■■■■MMM■.■■■■MM::::■■. ■ :: ■..MC�.MM MEN ....■■E■■■■■ ■■■ is: yes no r ili ::■■::::::::::::::::::MINI::::::::::::: Float Fing Groi length Bulkl Basir Boat Boatl Beat Otht Shen SAV. Mora Phot Waiv r _ J / A building permit may be required by: ( Note Local Planning Jurisdiction) Notes/ Special Conditions t%�� Agent or Applicant Printed Name Signature ** Please read compliance statementon back of permit** PermitOffcer's ❑ See note on back regarding River Basin rules. Signature Issuing Date - Expiration Date Application Fee(s) Check # I hereby certify that I own property adjacent to I • •. - • • • .(1�t�1i)\�3i;SSY��r��%ILSK.'!!i/�/�,'%��%//CIO/�/,7p 'film The applicant has described to me, as shown below, the development proposed at the above location. j,--� 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) 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.) Date I do wish to waive the 15' setback requirement. do nox wish to waive the 15' setback requirement. L email address 'Valid for one calendar year after signature' Date o-z7s-v ler/email address (Revised Aug. 2014) I hereby certify that I own property adjacent to I property located at U 1Al" l.VL1 Z�O (Address, Lot, lock, Roq4, etc.) on & , in iRIJE r407r—RET , N.C. (Waterbody/Town and/or County) The applicant 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) �r2EN�G �fL.W►Z7 �!L 0,qaArrOIATNCt )EX74AJAT�NI 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 do not wish to waive the 15' setback requirement. or Vie.- !/ -C.'-ci Telephone Number/email address s--7-.f Date `Valid for one calendar year after signature' Owner Information) M ' ing Ad ess city/state/z, ZSZ- 393- �!/G Telephone Number/ email address Date" (Revised Aug. 2014) fV/J k] F �i W W w v U z v o 0W ca z M a 5 a � 0 3 N %D 00 N CO N M .� W O °° 00 a LO b a N N H y O e�� co N 00 � N O h N 10 N Cl) 7 h S fH Y} y NIT no a p .. FS W t F A P, A FS