HomeMy WebLinkAboutCamp Caroline❑CAMA / ❑ DREDGE & FILL No. 74417 A B C D
GENERAL PERMIT Previous permit#
—]New ❑Modification []Complete Reissue ❑Partial Reissue Date previous permit issued
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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 15A NCAC -
/� ❑Rules attached.
Applicant Name i%r I ! I ( Project Location: County ✓ i 'f7" ,
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Address % I (C i C ik Street Address/ State Road/ Lot #(s) �AMLr
City State r�C ZIP /0 —�
Phone # O_ __ _E-Mail
Authorized Agent _
Affected ElCW EEW ❑PTA 6ES ❑PTS
AEC(s): DOEA ❑HHF ❑IH FIUBA ❑N/A
❑ PWS:
ORW: yes / no PNA yes / no
Subdivision
City ZIP
Phone # ( ) River Basin "419Z _
Adj. Wtr. Body OAU5e241 (iL.eXti(nat /man /unkn)
Closest Maj. Wtr. Body 'gyp_p�
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Agent or Applicant Printed Name
Signature *t` Pleaseread compliance statement on backof permit"
Application Fee(s) Check #
Permit Officers Printed Name
Signa ure
Issuing 1,ate E.piratiq Date
Connell, Brad
From:
Brownlow, Roy
Sent:
Monday, April 15, 2019 9:46 AM
To:
Sullivan, Shelton
Cc:
Day, Susan; Connell, Brad
Subject:
FW: Camp Caroline?
Attachments:
CampCarolineShoreline.pdf
Thanks Shelton. I have forwarded this to Brad Connell who is our Field Rep for this area.
Thanks,
Roy Brownlow
District Manager, Division of Coastal Management
North Carolina Department of Environmental Quality
252.808.2808 ext 217 (Office)
Roy.Brownlow@ncdenr.gov
Email correspondence to and from this address is subject to the North Carolina Public Records Law and
may be disclosed to third parties.
From: Sullivan, Shelton
Sent: Friday, April 12, 2019 4:03 PM
To: Brownlow, Roy <roy.brownlow@ncdenr.gov>
Cc: Day, Susan <susan.day@ncdenr.gov>
Subject: Camp Caroline?
I think this is yours?
Thank you,
Shelton Sullivan
401 & Buffer Permitting Branch
Division of Water Resources
North Carolina Department of Environmental Quality
"please note my phone number has changed"
(919) 707-3636 office
(919) 807-6494 fax
Shelton. sullivane-ncdenr.00v
Location: 512 N. Salisbury Street, Archdale Bldg #942G, Raleigh, NC 27604
US Mail: 1617 Mail Service Center, Raleigh, NC 27699-1617
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Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
I hereby certify that I own property adjacent to
nrr,t)ert IncatPr'^4
(Address, L
on 5"'.1 Cf'K in
(Waterbody)
/v 1 VI\K I
(S"
(City/Town and/or
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 must fill in description below or attach a site drawing)
'�i �% Q WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access'iniess waived by mu, (If you
wish to waive the setback, you must initial the appropriate blank below.)
Date
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Adjacent Property Owner Information)
Signature
or Type Name
Mailing Address
City/State,Zip
Telephone Number
Date
(Revised 611812012)
AD,
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(Wate ��� W n r d = ItY)
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The applicant has dew a$ Ef?� Cr a/ _ I at the above
location.�-
I have
I have
DESCRI CD t - IT
(Individual proposh o = site drawing)
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understand thaId
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Address
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Date
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(Revised 611812012)
I hereby certify that I own property adjacent to rJo^A Pl ri��0 �` Is
(Na of Prop rty Owne C
prr,pzrty.lo ?tec! at 'J _. ... :1I
(Address, Lot, B k, Ro d, c )
on CxW'Ca� r� e�l< in r�w� �1��% N.C.
(Waterbody) (City/Town and/or County)
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 must fill in description below or attach a site drawing)
�— lO e Z.O /���� �IQAYrM ILASi Nf $RSo.�
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (I u
wish ED
to wajve the setback, you must initial the appropriate blank below.) �ECEIV
�// 1 do wish to waive the 15' setback requirement. APR 1'j 2OS
(Property
I do not wish to waive the 15' setback requirement.
ca4ca le
Print or Type Name v
3"3` 7x 7A,ntedv 11(�
.o
-3157
Telephone Number
u-;-h
19197
CITY
(Adjacent Property Owner Information)
4& z I Y r�—
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Print or Type Name
Date
(Revised 6/1MO12)
III Fust•Class Mait
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IIIIIIIIIIIIII�. r �II�IIIIIIIII�I Perms No. G-10
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■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
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■ Attach thisi to the back of the mailpiece,
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If YES, enter delivery address below: EHW
7011 0470 0003 2518 2948
I Ps Form 3811, July 2o15
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■ Complete itemsj; 2, and 3.
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■ Print your narrand address on the reverse
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so that we can return the card to you.
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■ Attach this card to the back of the mailpiece,
or on the front if space permits.
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Ps Form 3811, July 2015 PSN 7530-02-000-9053
❑ Priority Mail Express®
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