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Home My WebLink AboutTurner, DonQCAMA / ❑ DREDGE & FILL ( ' ✓'"^ ' No. 74428 -� A B C D GENERAL PERMIT Previous permit# LgNJ \p ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resour es Commission in an area of environmental concern pursuant to 15A NCAC i Rules attached. Applicant Name t /,A Project Location: County Address " j: r Street Address/ State Road/ Lot #(s) . City /' State / / .� ( Ci � i � ZIP ,:.. r � Phone # O_ Authorized Agent Affected ❑ cW AEC(s): ElOEA ❑ PWS CIRW: yes / no E-Mail ❑EW —1PTA ❑HHF 'J IH PNA yes / no Type of Project/ Activity Pier Fixe Float Fing Groi Bulk Bull Boat Boat Beac Oth Shor SAV Mor Phot Waiv Li ES ❑PTS ❑UBA LlN/A Subdivision `1 r CityN r✓ ZIP Phone # O River Basin ,_A Adj. Wtr. Body ��I �� /�. �' !(hat /man /unkn) Closest Maj. Wtr. Body _ I ' - / (Scale: ) ■SV■■ MME ■■■M■■■■MM ■0■■■■ME■■■■■E■■M MON::::::E:■■■■■■-:......... ing Platform(s) ::::::::IN ■■SEEM■ MEMEMEMME length-■■u■E■■■E■■■E■w■o■■■■■■E■■■■■■■■■■■■■E ■■■■■■■En■ME■■■FAMENE■ME■■■■■■M■■■n■■■■■■ ■■■ME■■EFAIIIN ■■MMMMEM zaEMM■■MnVIEREME■EME number ::::��:�::::�:■��:::::::::■�i:::U��::: avg distance offshore max distance offshore ■■■■■■■E■■■w■■■■■■■■■w■■■■■■■■■■■■■■■■E ■■■■i�r�w■■■■■■E■■■■Sri■■r�u�a■■Eyi■E■■■■■■■ cubic yards MEN ramp::::iii:::i::::::::: :i■::i�::::MEMEMEM! MEN ■:::::: I:::a::::::il��:::::::.'.:■:.:■'. ::SEES■■ Bulldozing ■ ■ ■■■■■■■■■■■ ■■■■■■u■■■■■■■■w■■■■■■ ■ ■ ■ME■■■■■■■ SEES■■■a ■■■■■■■■ SEES■ ■:■ 000000000::■■■■■■■■■:■■■■■■■■:SEES■ MENEM :::::: ::::: MMMMM::■:::::MEMEMI ■E■■■:■■M■■■■M■:■ME■■■■u■■■■■■■■■■■M■■E :::::C:::'■::o:::::::C:■i:C::::::::::MEN •■■■■■■■■■■■■SEE■■■■■■■ ■■E■■■■■■■■E■■ ■■ E ::::::::■::::::::::::::::::::O MOMMEMME A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions ❑ See note on back regarding River Basin rules. Agent or Applicant Printed Name PermitOff er's rmted Name Signature ** Please read compliance sta✓:ement on backofpermit** Signat re Application Fee(s) Check# Issui gDat Expirati Vi Date N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date A `LI j d Name of Property Owner Applying lot- Permit: ,Do,u '/ tr,Jtr Mailing Address: 7 s'a 7 I certify that I have authorized (agent) � nwS I X--) to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) /,�yI at (my property located at) ) 2 S M This certification is valid thru (date) II I q Property 04vner Signature M ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to C -ma '1)D-,y4, A 7--"-RN E/1. czie . 's Name of Property Owner) property located at I = s lA , oob-si s C>xxk Vet.. -5AIr ,OLAvAl 0./G 94'5 9 n� (Address, Lot, Blo , Roadetc on M t Ao ENS (7A,6-eK- in Sm.0 p u rL . Li,4A-,re2ET l �a a. , N.C. (Waterbody) I (City/town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. K MS 5i 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) 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.) J rqB "1rr I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) ( acept Property Owner O /t Slane 9 Date Print or T pe Name :221 .ref th S"^ti_f��a M_a 6'linAddress &n4qq Cit.y2 t� t cfI" --t q13 Telephone Number/email address i f 1 s/ 2.0 e4i RECEIVED Date* (Revised Aug.Nl4 3 2019 *Valid for one calendar year after signature* DCNI-tv1FID CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I herebycertify that I own property adjacent to ,rt,3W ^� Y p P Y J .LbNA•en 14LANg1C' 's (Name of Property Owner) property located at 125 $4rone2Q5 eQcEK. v SrhfftxAJA � AJe- z86-74 (Address, Lot, Block, etc.) on fit vVe71S CIZGK _, in 6PK faA.)A tAKM?L6T P0., N.C. (Waterbody) ( ity/Town and/or County) The applica -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) 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. Owner I Print or Type Na/m�e ! /5323 %3OFFA10 I�c4• Mailing Address 0-1,6144y^� , A/Sta $615. 37o t � Fnw..n� GYDr,r� 1eb.co,n Telephone Number/email address zfa�.11,R Dade (Adjacent Property Owner Infor ation) ig+�ature* , frV Cal � c .� M L�Jr S Print torTypp� Name aYy�aaa�'CJc, 1i-�1 Cit /Statc/Zip If Dine* ;J c 2er5 y-j'3 ED (Revisedo . f (V n 19 *Valid for one calendar year after signature* DCM-MHD CITY �IivP V� Nr�C. SMOtN�P �,.M �H yceePtl�ff� � tpy/� w *a , N .Q N 4 Z X„ 4 Q 2 x S$ � 2. � � � ■ yew fJ �aN w y}4Willi ply g m i w p ONE Cpl,REE2 a psas to A N Setback 404, 39'. Toth /Tod II HAGNETIG NAP N= 29, PAGE 24U 5F30 TE'"ja�'---- — -- 3 • t`F'W • p.c,Arr4Nl RECEIVED MAR 13 Z019 DCM-MHD CITY