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Home My WebLink AboutWade, Jamesr FJ W,1;Ke- C-/-.MA/I DREDGE&FILL -'�. No. 75070A B C D GE NERAL PERMIT Previous permit# I i ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized 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 1 % /� f ` ❑Rules attached. Applicant Name n� ./ r / Project Location: County%j % ' `_ Address i . ( (�J f (' Street Address/ State Roadl Lot/ #(s) Cityt, _Pi'f §tate_ZIP /i(, l Phone # (,HW ti H Authorized Agent Affected OCW ❑EW .DkA DES ❑PTS AEC(s): DOEA ❑HHF ❑IH ❑UBA ❑N/A ❑ PWS: ORW: yes / no PNA yes / no Subdivision City ZIP Phone # O River Basin Adj. Wtr. Body e ' �'' 7 at an unkn Closest Mal. Wtr. Body ■■■■■■■■■ M■■■■■■■■ME 0 ■■■■■■■■■■■■■■■■■■■■�■■■■■■■ 0 -ME■■■0 ■■■■MEN ■■M■■M■■■M ■■E■■■■ONEEME■■■■■■ MOM ■■■■■■■■um mm■■0■■f1NMEEEE■■■I■■■■■■�MEN ■■■■M■MFJ ■ OM■■■M■Ii■ I■■E■■■■ No ME ■■■ _qMM a NMI MEN ■■■u■■■■■...iiMUMM■■E■N WEEME■■■Mf/I�I�i■no =0 MMMMMMiIffMM1 MME=MMiWMEMO=liil�luMEMNON■i ::::::::I:N : F■lA ::E C...■.UMW■■■■■ M ■ENEMarri ■i1MO■ M■■ ...■...■■■.■■fiE■■M■■N■■■■■■■.■■■■■■■■■. .........■.■I........%■■�N■■■■®■■..MEN ■No NiE ■■■■�■■■ ■■ IIIEZIEFAH■i®®�Qu■w■nou■M■m■�iMNi■u■Mi��i ■f■EMM ■■■■■■■■ E■E■■ ME■■■■■■■■■m;EE=■■■■■■■ mom ■■■■■■■■ • MEMO ■■UNNEE■■■■■■■■■■■■■■■■■■ M■■■■ ■ ■ ■■M■i�i■■■■OM■■■■■■M.■ '■'■'. M■■■■■■■■�M■■■M o'■i:: '■: :: SOM �:'■1■0 ��MOSINEE ••••••••��_:M::::000MENEM CC:::��C::�C M MENEM ■■0 MMMMMMM1 .■■■■■■■■...®. : MEN l , l � r:.- Agent or Applicant Printed Name Signature .. Please read compliance statement on back ofpermiX Application Fee(s) Ch ck# PermitOffcer's Printed Name Signatures _ i Issuil ake Expirati n Date / ❑ DREDGE &FILL F JI'�hG+ n� \N \N0. 75070 A B / C / D "GENERAL PERMIT \ Previous permit# `� 0914 ew ,.L]Modification ❑Complete Reissue ❑Partial Reissue Date previous perm� Issued As authorized by the State of North Carolina, Department of Environmental Quality //�/ and the Coastal Resources Commission in an are of environ ental concern pursuant to 15A NCA - / ' J — �-T-❑ Ru s attached. Applicant Name ✓� �, Project Location: County rV Address ev t Street Address/ State Roa / I #(s) City L� eo+ - State ZIP IV t� ��` `Y Phone #TJI(A i %x' Affected mcw AEC(s): ❑OE4 ❑ PWS ORW: yes / no M?V KPTA KHHF ❑IH PNA yes / no Subdivision City v ! ZIP ❑ES ❑PTS Phone# () River dB�asin E•^� Cdr�//t fa❑UBA ❑N/A Adj. Wtr. Body C Closest Maj. W.. R_d, - M. ■®au■■■■ ■■ME■ ■■■■■■■■■■■o■■■®■■ 0■■■Nr7■0/I■■■d ■■/l■■■■■■■■■N■I■■B■■ ■■N■I ■■■11� I ■■■N■II ■ip■■�■■�■�■/HI-I ■■� �wBS.7�{. I�� !FP!MMw. _■■N■■ ■■■O■■ M■ OMMKUEME ��L �IGi/i►1■■■ 0 ME ME 0 ME �i■MEu� �rME araiv��iw��wn■�ii■�i■■ ■■ ■ ■�i EMEEK&W,,� ��iii�■�■ai■mi ■■®�„1�ONES ■EMME r■■■■■■■ �■■�■ ■a■■ Pr Soli mot,■■■■■■■■■■ ■� - ■®ia■�®u■■■ u■■®■■■Y■■�■■■■■■■■■■u N�■i��iiia�i Nil ■■■■m ■■a■a ■ Agent or Applicant Printed Name Signature - Ielse read compliance statement on back of per it Application Fee(s) C ck# Date of Request: Property Owner Name: Address of Property: Telephone Number: Type of Work: NOTE: Hurricane Florence and TS Michael Replacement/Repair Request Form 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: Hurricane Florence and TS Michael Replacement/Repair Request Form Date of Request: A C Property Owner Name: LOAC10- Address of Property: Telephone Number: Type of Work: I'+l ,rZ NOTE: 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. RECEIVED JUL 15 2019 DCM-MHD CITY 7/15/2019 IMG_6587.jpg https:/Imail.google.com/mail/u/0/?tab=rm&ogbI#inbox/FMfcgxwChmKflrlxZZTTkgJrscNQxRxB?projector=1&messagePartld=0.1 1/1