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Home My WebLink AboutMoore, David®C��CAMA / DREDGE & FILL No. 75042 A B C D ENERAL PERMIT Previous permit# ew ❑Modification ❑Complete Reissue ❑Partial Reissue Datep fevjous permit issued As authorized by the State of North Carolina, Department of Environmental Qualify'. _ II and the Coastal Resources Commission in an area of environmental concern pursuant to I NCAC r —1 Rules attached. j Applicant Name ( Project Location: County Address ; ) ZIP / Street Address/ State Road/ Lot #(s) City ` 1 State F Z _ - Phone #) E-Mpil Subdivision_ Authorized Agent City_ _ ZIP ) / Li cW Affected AEC(s): ❑OEA ❑ PWS: ORW: yes /.no ❑ HHF PNA yes Type of Project/ Activity DES ❑PTS ❑ UBA ❑ N/A Phone # (_' _ ) River Basin Adj. Wtr. Body Closest Maj. Wtr. Body (nat /man /unkn Finger pler(sl_ Groin length number Bulkhead/ Riprap length_e.......__ avg distance offshore■■■■ii■■■M■E■■■iE■■■ max distance —ft.h.M■■■E■M■■O■ME■■■E■■■It.�■�■■i�■■■■■■i■ESEEN ■■■■ ■■■■M■MEMO MW ■■■■■ ■■■■■■■■■■J MME =��_ ■■■■ SEEN ��MEN OEM ■■■C■■■�.■%IM�IIi[il•■■ ..... ■■■EMM MEN ONE ...MEN ■MMEMO ■■MEMO OMEN ■■..■aMEN MEN C..■ H■MM■■E■ .ME.■ MEN DEEMEMNON■■■E■■E■EnI's■OE OEM ■■■■OEM■MEN 0 0 MEM■■E■■EMM■■■ ■■■■a■■■�E■u.�E■=0 .i.l.l. ....��eE■■E E■E■■ ■■e__ ...._.__._.._.__...'1A �1"VE ■■■■ ■■■M■■ ■�■i■■M ■■■MM ■Sol ■M■■■EEMEW ■1■■M■■■■M�■E MEMO ■■■■■�■ME] ■■E■■■■M■■Ir ■1■■■M MEN E®■E�■■■ ■■■■■E■■■�■■ ■■■E■■■1 ` 11■■■■■■■ �■■■� ■■■ ■■■ cubic yards -.MEN Boat rampMEN ■E■■■1■��■■■E�■C .7■■EM MEN ...� E■■■■ ME ■■,�n■E■■ ■1■P.+. ■M■■■OE M■■ E ME 0 IN NEE 0 i� ...■��■-- IN�0'r■:i Beach Bulldozing IN • �IkLaj. :::��::::CC::C:::n■�E iv�■■i■OEM■� ■■�■■■MEEu■■■ME■M■�■ti<�■■��■o . M■■■M EI.■■■�■.�NEME■■ ■■■EEMEMM■■■ .■■. M■■■■ .AN OM ...■■ .. ■■■ .■ E■■ No SIN■MME I::�mC :�:: E so E■ ShorelineSAV: not sure yos 'in. Moratorium: "n'd' n/a yes Photos: yes no. Waiver Attached: yes 0', ■■ ::��■:::�■::mG��■:::mom ...■ ... ... n EME .. .■ :°�:® E.... ....6....j.E ........I.M�.E...... A building permit may be required by: 1 ( Note Local Planning jurisdiction) Notes/ Special Conditjons h Agent or Applicant Printed NSme Signature.. *:z Pig Bread compliance statement on back of permit" Application Fee(s) Check# U See note on back regarding River Basin rules. Officer's Printed Name Signature Issuing Date I_ Expiration Date AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: �NACY)yc Mailing Address: oce-3r.a 'z�4i'Ga Phone Number: S "j C' U 0 Email Address: ryY l lyw t l e ,r ioo; e S 66Q , ct T' I certify that I have authorized KS t)c V t Cd Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: 10,000 1 & o((4 ljj . at my property located at i0LA J2Gt T✓z t C Q k��[ r 'v„ OClr'} ,Z k $ j6 in _C QLr -k fL } 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. rope Owner Information:�� ignatu DC1vtc:� 1�i1C��-'�Q Print or Type Name Title Date This certification is valid through hereby certify that I own property adjacent to N A U t � L - lc�6 j- —. s c-, (Name of Property Owner) property located at o 4 \-)c>py-(Ac'C jply t (Address, Lot, Blg, k, Road, etc.) on l E U:) '7e-v-+- , N.C. aterbody) (CityIT wn and/or County) The applica t has described to me, as shown below, the development proposed at the above location. 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) .A v CYJ (o C� Seq �J�ac e n/ Y G AIVER SECTION E, I understa 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. ,(Prop" Owner Information) &I (Adjacent Prope ty nor Information) Sigr ure* Y� E/tl c _7- Mu. Ai!jNks& Print or Type Name '31-7 Haug LrJ Mailing Address ,!vFUpaR-T- Nc_ �f576 City/statelZip �a -< -lilt- o[y� Telephone N mber/email address -7,7011 Date* 'Valid for one calendar year after signature' (Revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to ba V 1 rA L M OD Y e s (Name of Property Owner) n Trq , property located at (0 SiC.G L ra dV�u o,,� K C' � y (Address, Lot, BIQck, Road, etc.) U on.. OQUC , in NJ)a,+- NC- , N.C. (Waterbody) (City own and/or County) The app' ant has described to me, as shown below, the development proposed at the above locati I have no objection to this proposal. I have objections to this proposal. UESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site drawing) Ke.'N Gfay 0 ct( WAI ER SECTION I understand tha ier, dock, poring 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. (Prty wner Information) G. q lJ '�-- Telephone Nunlber/email ado c G3cr. ytiI 4x5l e- A)ix (l viseH Au . 2014) "Valid for one calendar year after signature' /o sL 6