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Home My WebLink AboutHills, JeffLAMA / ❑ DREDGE & FILL 1 " t�" �t j � allo. 74915 A B C D ENERAL PERMIT Previous permit# ew ❑Modification ❑Complete Reiss. ue Jrtial Reissue Date previou permit issued As authorized by the State of North Carolina, Department of Environmental Quality I `�'` > and the Coastal Resources Commission in an area of environmental concern pursuant to 15A N( ule8 attached. Applicant Name `�1 i Project Location: County Phone # Authorized Agent E-Mail ❑ OW L!(W ONfA ❑ ES ❑ PTS Affected AEC(s): LJ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: es�no PNA yes / Street Address/ State Road/ Lot #(s) �,/IV Subdivision_ City LL ZIP Phone # (.) _ River Basin Adj. Wtr. Body___ -. (nat /man /unlcn Closest Mai. Wtr. Body_ _ _ ■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ : :::�■�/■■nN■■■■■■■ ■■■■■■■■■■■ :■:::■�■:::�iiie i�i:::::: ■■■■■■■■■■■ ■■■■■■■■■■■■■■■�■■■■■.■■■■■■■i�w■■■■■■■■■ ::::::::::::W i eINIi::IiMEN■:: MEMEME::::::: ■■■■■■■■■■■■■ ■ ■■■■■■u■w■■■■�w�■■■■■Hi■I::■::MER■ m1�i::■ VA :M Blom ■ ::■:::::nM■.■■■.�■WEE :: ■■■�■: 0 ■ IMMENIFIEN WE ME M. 1101 mom ..■rNEEMEMMMERRIMMEMIN ■ ■1.■■■ ■■■■■■ . ■1 M.■ �■■■■:�■fl■■■IN ■■■:■■■■■.■■■■r1■■.w�:r/1■■■■.■..■■■■,.■■■. • ::::::::M�::RMEMEIIC�►y: ■■■■ ■■■■�■:■■■� ■■■■■■■ �'91■■■■A■■�'■■Itl n■ ■■suit ■■■, ■i�I , ■■■■��1■■1� ■■■■■ ■■■■■:■ ■ .�IGI■\■.°.trl■I/!r■ 2 1111lll■■M■`■19II�I ■■ w■ ■■■■ Moll ■■� ■■■/ljl9►T1I�t1!#r/�®/�►!!u■��■�� ■■■■■ ■■■■■:■I�:a1:W■■. ■'� w ■■/�■■�■l�■■�w.ra0r■■ '� I�li■■il �■■HEN r � 1:: E:■■�: :.�....■..■■.a.i►I�■�IJI■®1■ : : ::0::■. ■::::::::::::: MEN .. ■■■■■■. INN I . /I/l [` Agent or Applicant Printed Name ` Please read compliance statement on ack of permit" Application Fee(s) deck O Permit Off ce rs trinteu JJarrµ Signature Issuing Date �Expi�D to ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Sr. ,�p Ct 1 `15 's ��(Name of Property Owner) property located at a 0 qo� 51 _ (A resit, Lot, Bloc, RoC c J on � C/-Cek , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above I a io I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development mus�t`fill in description below or attach a site drawing) i� N&t' N kNL2 l X Ce-QIA�1 0 vJ 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. Information) ne Print orTyp ame VSttll.t.. �r�� 20� MaHi ddress !� s1 s t V City/ to e/Zip I er / email address Telephone Nurhber 'Valid for one calendar year after signature' Information) NL z�sgy (Revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT 1 hereby certify that 1 own property adjacent to Se�� t t t� `t� 's r�(Nfine of Property Owner) property located at 0� �0.y5' Jo`%kl — � (Address, Lot, Block, Ro d, et ong.) t 7� lL' N.C. (Waterbody) (CitylTown and/or County) ihe a has described to me, as shown below, the development proposed at the above o ion. 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) 14i�q/�7��tJ�/�vc WAIVER SECTION 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. n TZpsi �n % V Mail' Address SI)e- City/�S tate/Zip Telephone Numberl jernall addr ss Date "Valid for one calendar year after signature' L- '�11047-s - 7 \ (¢ Telephoneyumbe/r�email address S/ d/ C/ Dare" (Revised Aug. 2014) cFn LL' r f F �r N •N y• N • N�l1 1�� m .'P �-i. Fa ,. +e.P f Y N u¢mi i r. m Y Gffi f' n J @ tAfff N E mg a@ �•'s4 G ffi "Ao pU� 00 N N Lo g r35N O � OH &c N W W N O (yi N IL 3' L� O YLO o WW D�U U 0 a V F W of Ww ODco ono F z pG 4a v c� q �j.x]] N o v °t-° o ac 8 W 00 Vi W N f" 7 M uj N O 7 M P4 F" d F '� e`ri `.i M fn � O (� rgLL P. .�','' h tr y Q ro Q C7 .. C14 PLIpyj{ roy a� {yy ro a ro r°. A .