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Home My WebLink AboutCassity, AnthonyLCAMA / � DREDGE & FILL No, 74956 A B C D --� GENERAL PERMIT Previous permit# New ❑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 15A NCAC \ p Rules attached. Applicant Name rl [1(111 Project Location: County V<' r Addresls -.Y �1 l'P .' Street Address/ State Road/ Lot #(s) City { � } V cP r ^ Staten r ZIP Phone # ( )fir 'C,.�� E-Mail Subdivision Authorized Agent [I cw [IEw El PTA ❑ ES ❑ PTS AAffected Affecte El OEA ❑ HHF ❑ IH ElUBA El N/A ❑ PWS ORW: yes /'no) PNA yes / no Type of Project/ Activity Pier Fixe Float Fing Groi Bulk Basi Boat Boat Beac Oth Sher SAV: Mor. Photo Waiv LV City ZIP Phone # ( ) y River Basin / /t "/ Adj. Wtr. Body 11( C 4 % f i (nat�/man /unkn) Closest Maj. Wtr. Body l' ' /'` ' i < ` (Scale: � ) ■■■MN■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■NEW :: ng Platform(s) :::::::: ■C■......�....■■..■.EEE■■�C■■■C■■M■■ length ■ ■■■■■■■■■ ■■■■■■■■■■■■■■■■■ ■■■ .i■■■■number I ■■■■■■■■■■■■■■■■■■■■IMMUNE ■�■■■■■■■■■ ■■■■■■■■■■■■■■■■■■ICC■■■1�1►�1■■■■ ■■■�MESON ■■B■■■■■■ ■■■■■■■U■�I■■Isl■■■■■■N■ ■MEMO avg distance offshore_ ■E■■■M■M■ ■MIE■■MOiC®:�■■■E■■E■■O■■M■■■M■ max distance offshore......... .■EMEEEII■EM�9EO■E■OE=■■■■■■. .■■■■■■...■■■■■■■■■■■l�■■N■■■■■■■■■■■E■■ ..........�...EE..E.MMEE.O...ON MEMO ■■■OEMEIIENMIN ■E■■■ ON NONE cubic yards■■E■O■O■■■ ■■■■■■■■■■■■■■ENE■IIEM►11M■M■■■:■■■■■NONE ■NMM■■■■■M■■■■■MMMMIIMEM111■M■■N■■■■M■MEMO ME MENEEMENMEN MEMO MEMEE..■ .MEMO ■:MMMMMMMMMMMMMMM1I ■::■■■■■■:.::SMEMIN EE■1IEE■M�M■■E■:■ .■■■ MESON ONE MENNEN MM■E■■■■MEN■MEN N■NE:■NEENEEN:■�EE� 1 MEE IN ME ME MENEEMENEENEENE■MMM1IMMMMM:MEMM■ OEM M:■NEE MNINI .....MEMO:: M1I■■■MIENS■■ ■■■■■■ ■MM E■■■■■ I■■■■■N ■ ■■MEMO■OM■■ MEN �::MEE _ a6e Commom ::::::lm NONE l A building permit may be required by: ( Note Local Planning Jurisdiction), Notes/ Special Conditions Agent or Applicant Printed Name I t !, 7 11 V H See note on back regarding River Basin rules. Sigprure "* Please read compliance statement on backof permit'*" Application Fee(s) Check # Permit Officers Printed. Name Si natu e Issuing Date Expiration Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to /an f-konV j) 's (Nartie of Property Owner) property located at 301 F.t✓yin 11. r. 42IZnork Nl' Ak5.3.z _7� 1 /� (Address, Lot, Block, lad, gtc.) on ll)CK2✓ ( reek in Nav loci( N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above loca 1 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, 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 InWmation) Print or Type' Name Mailing Address • n' -Z �62 t4sire( C /�.C, City State/Zip 2SZ S7/-5r?( Telephone Number 3k114 (`1 Zo (9 Date (Revised 611812012) 7/13/2019 20190711_165641.jpg i d w� https://mail.google.com/mail/u/1/Hinbox&WcgxwChcsgWcBCKjxgvmvXKghQJFdB?projector—I &messagePutld=0.I ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to 7 G'! `F s/`47 's �'501 (NameofPr grty Owner) property located at I / 14� rl/NI+ P/ t-/" tV'' /a C P (Address, Lot, Bloc , Road, etc.) on /Lt C /�E/P C� C��t /� in i4 1, . Z— OC 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. 1 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, 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.) do wish to waive the 15' setback requirement. -11�1 do not wish to waive the 15' setback requirement. perty Owner Information) or Mai ing �ddr�ss ayp � ' /Ql c 1�53 Z City/State/Zip - 815-0317 Telephone Number .'v/V 131 aol Date (Adjacent Property Owner Information) Signatlexg � �--- Print or Type Name Mailing Address City/State/Zip Telephone Number t 3 -7- / 4/ Date (Revised 611812012) 7/13/2019 20190711_165641.jpg Y 1 https://mai I.google.comlmai 1/u/ 1 /#inbox/FMfcgxwChcsq W cB CKjxgvmvXKghQJFdB?projector-1 &messageParild=0.1 1/1