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Home My WebLink AboutEavp, Jae®g❑ CAMA / ❑ DREDGE & FILL NO. 75047 A B j C D ❑ ENERAL PERMIT Previous permit# ew ❑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 a .area of environmental concern pursuant to 15A NCAC l ]Rules attached. Applicant Name Project Location: County Address Street Address/ State Road/ Lot #(s) _ City '. (' sJ i, State ZIP 1/ 1/ Phone E 1 Mail 1 Subdivision_ 1 r' Authorized\ynv/sent City l ( i_ l ZIP Affected TCW ❑EW ❑PTA ❑ES ❑PTS Phone# ( ('� ,River Basin OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A i' nat /man /unkn AEC(s): Adj. Wtr. Body ( ) ❑ PWS: ORW: yes / PNA yes / n Closest Maj. Wtr. Body Type of Project/Activity (Scale: Floatin Plato �!1 CMENOMINEE NEI. mma M!'■I M®C: mommoomm ■■■■■■■■■ .■■■■■■■■■�■■■■ 1�1■■■ ■■■t■■ ■■■■■■■■■■■S■■■■■■■■■►z�■■■■��■■■EEm■E■I■■ ONE ■m�■■■■mmllim■■■■■■■■■■■■■■■■mm■■Nmmmm■1■m mom MIME mom :l:: : 'm: :::®::'■ lCC; q EI ON'■'■'■'■ ENS 111m=0MS■ IN i1011 ®mmiimmmmmmm i IN 1 ■��■■■mEmm■■■■Ijl■mli®®�■■®ME■tlillllma 1l■■I cubic yards Boat ramp■■■■■■■1■/G■[�■■1�I11G■■Q:="!�■1■■■■■■■■■■Boathouse/ Boatlift ■ ■■■■■■■mill®■■■■■■■�1�1!■■■■■■ c�■�i-min ■11�9■■i ■■ ■■■�■■■■■■m■iilil■ll'11N■■ �11[�Ir u"'t.�1rTi■■■■■1ME -'"'"'"''G.irlii■.■■.■E�I■00■!■ 0 1■■ ■■� ��■■■■■��■I�iiiln■5L�.■Iwii Beach Bulldozing—■i■■ �- • - IIILII p M MIEN ii■■■■■■ii■ii■r■■r�■■■■■■■■■uME ■■■ ■■■■■■■■■■■■■■■■■■ ■■mE■■NEmIml■■■ ..■11■■.�■■■■■■■ Emil■■■ .Nil NEE "'MEIN ■■■ E■■ ■■■EE■■ ■■Nil Nm EmEMNIZI■■E mmiimmmmmilmm Phots: yes i' ■..N....00:C::::�:C®::IC:::::®C::::1::: mil■Nil■mil i ■■:: D�iN■■■■■■■�E■N■■iii■■mi�iiiai A. building permit may be required by: ( Note Local Planning Jurisdiction) Notes/ Special Conditions } i Agent or Applicant Printed Name Signature **Please read compliance statement on back of permit** Application Fee(s) Check # aee note on aacK regaraing rcrver nasin roves. Signnattute Issuing L. aie Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: 0C • L a P/� Mailing Address: 2 �y `o/d (aklot Rd, S6cl IVC 2-951Z Phone Number: )—SZ- 3 W " y-13Z Email Address: C eaGp L0e9m6(11 LUG I certify that I have authorized Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: at my property located at in County. I furthermore certify that I am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information: Signatre Print or Type Name Ut✓hC'v Title 7 / 16 I 2011 Date This certification is valid through ,ECENED JUL 1 I ZO DCM4VAD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to a � _�aT 's (Name of Property Owner) property located at 2- �9 Rd 9&;: fnvi- A/C U%6 / (Address, Lo Block, Road, etc.) on IVe�Pd`f Riye� in .eucc( t MC, N.C. ---�(Waterbody) (Citylf'own and/or County) The applicant has described to me, as shown below, the development proposed at the above location. _j/ I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must rill in description below or attach a site drawing)n. I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, e, l�pl�rpin must be set back a minimum distance of 15' from my area of riparian access u tre T 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. JUL 17.2019 DCNI-M"D CITY I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Ow(rer Information) G�J Signatur( Prim[ or Type Na e L Mailing Address City/State/Zip "Y wm Telephone Number / email address ?- I 6- 17 Date Si rur' - it,:PH t) S %A Cit Print I 1 OTypI Name Mailingl!��ddre s /'h 0 EO&'-T n C� J5 City/state/Zip Telephone Number/ efizilif address Date' (Revised Aug. 2014) 'Valid for one calendar year after signature` ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Ag tZ ,s p (Name of Property Owner) property located at 11/C Z IS.S % 4 y / (Address, Lot Block, Road, etc.) on lI/L"v d�f�tVQP ,in Lc'R(ata } 11,C, 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, rill in description below or attach a site drawing) 1 L/� Marsti ��/1�✓�/vM/�` Ix C osed 16"n 16 D&k Ed 1404se- DECEIVED 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 wajmdpy Z019 me. (if you wish to waive the setback, you must initial the appropriate blank below.) I)CM-MHD CITY I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature - Print or Type Name ) Q 91 6oze 1of id lid, Mailing Address a'9"Le-7 w, ZsS14 City/State/Zip ,1 LSL 3wL- 4-131 jet 6f� -/ 0 u' Telephone Number / email address ?-16 11 -- Date (Adjacent Property Owner Information) Sig ature* / q n C... Print or Type Name Z b:2 < 63 ) A" Mailing Address City/State/Zip U7� �'.l m.� aS��S P✓�.Q.de�Ccl lkipr� Telephone Number / email address ') U611� Date' (Revised Aug. 2014) 'Valid for one calendar year after signature'