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Home My WebLink AboutHill, FrancisF-,CAMA / ❑ DREDGE & FILL j J ( i l I( (NO. 75084 A B C D ^GENERAL PERMIT Previous permit# JNew ❑Modification []Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality //J and the Coastal Resources Commission in an area of enviro mental concern pursuant to 15A NCAC I Rules attached. Applicant Name _ i (` ' ' i / Project Location: County - Address / f Street Address/ State Road/ Lot #(s) City_ _ State ZIP y Phone # O�M j17 Subdivision Authorized Agent ❑CW bkw 14etA El ES ❑PTS Affected AEC(s): 00EA ❑HHF ❑IH ❑UBA El NIA ❑ PWS: ORW: yes / no PNA yes / no City l ZIP_ Phone # ( I );i ) %'�)f. �( Rider Basin Adj. Wtr. Body ! �, Closest Maj. Wtr. Body (nat .[man /unkn) ■■■■■■■ ■■■ ■■■■■ ■■■■■■■■■■■■■■■■■NEON ■■M■E■IMEM■■■�■■ NONE ■■■■N ■■�� MEMO ��■■■■ ■■M■■■ ■■EOM■ ■EEM■■ ■■■M ■■■■ ■ME■E■M■ME■MEW ■MM■MM ■■■■■ ■■■■■NOEMra■ MIUMM■EMMI MEMO Nii®iu—� iMOEM■■�IIMIEE■IiM®■iiEi ■■■■■■ ■ ■■■■■ *iME■ L■PiME■ ■M■I! Is.UlME ■■■■■■1M■�1■■■■, �1! ME FARM EOM■■ ■M■■■■■■■M■■■■�'■■E■■■F/■O■=1111!■■■N■■■■■■■ FIE■E■■ME M■■O Elm /■■MEe!!I/■M■■o1■■■■■■ ■■/lO■ ME■E■■UM �E■■■lli! ®,MIiE 1101 !iM■M■ ■ ■ M ■■■■ ■ ■■■M■■OM►,■■■ME M■OMi1■ .:■■ ■ERE■■ME■M.O■■M■m■■�■�■�I■® ■II■■�■�■■■ ME■■■■■■■O■■ME■■■ ■E■■■r■■■ MEN ®e■M1!■■■FA■■E OEM■■M ■■■■M ■■EE II<MIIf1■ //■■ C■■ERE■■ M■M■E■■ ■.M■■ ■■■■��■■�■■■i ■■�"� ■M■ ®iiiiSEE : �0 ®i::i CMEW r� li'i� ■�i ®�0 ■■■■■■EE M■■■■■■I■■■■.■■ISM■■//■■■■MFI■■ NEON mom �OM:::� MMMMi : MEMI MM I®:'I ■■■■■M■ ■■■■■OEMw■EE■' M■M■■DIOMEMEMM0■NE 0 iiiviiii ...■■ 1EI■■■■■■■�■.■ MEN :::p:M■■■■■. 10 :1 5... i :E■ INEMEMEME 0 : ■■■ ■■■ ..■■.HIM - Agent or Applicant Printed Name Signature **Pie ere ad compliance statement on back of permit** Applicatio Fe j/Ch Hurricane Florence and TS Michael Replacemen'i/Repair Request Form Date of Request: O Property Owner Name: Address of Property: Telephone Number: Type of Work: NOTE: l� The Emergency CAMA General Permit 2500 is for repairs and replacement of water - dependent structures damaged because of Hurricane Florence and/or TS Michael. The replacement, reconstruction and maintenance excavation activities shall conform to current standards and rules. All work under the Emergency CAMA GP 2500 must be made in the same footprint of the previous structure with no additions, expansions, or enlargements. • If any portion of a structure being replaced is within the 15' setback of the riparian line or access area, signatures of the adjacent riparian property owner(s) must be obtained acknowledging the notification and waiver of the setback on the forms provided by DCM. • Any maintenance excavation or dredging requires signatures of the adjacent riparian property owner(s) on the notification forms provided by DCM. Signature: * Mdhave us ftl 2er�i1- Wk'A'i o � ROO O SS --71� C-aAei h � w � 1so NC." RECEIVED JUL 2 2 2019 DCA4,MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to FP at1r%r 5 A. H; I I 's (Name of Property Owner) property located at OnUSi;rjAr aAD. aek)u-F'nQ-t on in Lot, t , N.C. 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 mustflit In description below or attach a alto drawing) FID (1 (Will � j K 4 i i 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 16 from my area of riparian access unless waived by m . f ou wish to waive the setback, you must initial the appropriate blank below.) j}( I do wish to waive the 15' setback requirement I do not wish to waive the I& setback requirement (Property Owner Information) 14"Ux AI-t-E'X /�' ". u0m (AdjacentProperty pertyO�nnation) (neVISea Aug. eU14) `Valid for one calendar year after signature' RECEIVED JUL 2 5 2019 DCM-MHD CITY 0 ji rn p N {}:}Lwi+ O d. O F4 d O �" O x eu ao N m U m a w z A F+ k. W o ti 0 w i k"+ A F4 r4 .7 W y .7 W 55 N co �' co p O' y M 7LO Cl)v> 0JR u T O 7� d d