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Home My WebLink AboutSchulte, KennethAJ ®XCAMA / ❑ DREDGE & FILL No. 73486 A B Qf) D GENERAL PERMIT Previous permit# XNeW ❑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 �i ✓<-/%%-1 - WRules attached. Applicant Name �q I I I r f Project Location: County V t-; r r: I City i I . \ , � i f k State " ZIP_ /, ,. (. Phone # ( y E-Mail Authorized Agent Affected 0 CW AEC(s): ❑OEA ❑ PWS ORW: yes / no t- ❑EW El PTA -�ES �❑PTS ❑HHF ❑IH ❑UBA El N/A PNA yes /no� Street Address/ State Road/ Lot #(s) %F Subdivision r\ l V I, !" ) I /'i( City ZIP Phone # ( ) �'/i/ ` / ", River Basin AJ ! (' Adj. Wtr. Body l\j;, / - \ � L. c 6t man unkn i Closest Maj. Wtr. 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Property Owner Information: Signature Print or Type Name Title u( / 3C) / 2L�1�) Date This certification is valid through 6 / 1 I I�f ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to 1c ab .v v A;rZt I-. ti ry i3 vuT 7- s (Name of Property Owner) property located at ri 3 S sHtva u-n (,5 (Address, Lot, Block, Road, etc.) on i.,:.a_ Aaa,t:,R in „ _ ✓ N.C. (Waterbody) (City own and/or County) The applicant has described to me, as shown below, the development proposed at the above loca ioq. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development�must fli in description below,or aftach' a s►fe. drawing) `CivSyitLC (r-i�i�.wTrY 1jv )�bAa A �Y 9r.- mt;pf 1 ve A00 Y111x2 C1_'07i4 y7,607 ft fjr-AGN 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 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. Yam_ I do not wish to waive the 15' setback requirement. (Property Owner Information) n o._ Sigtt�affre Keuz< LgiEI4 Seh u lfe Print or Type Name aa5 S'Ctt'tlaWay e Mal'1117,9 Address Haar jock AJC o EQ,'•, City/State/Zip a5�2 Y#Z-16L11 KlsNcaP�g mail. Telephone Number/email address /-3b-l4 Date *Valid for one calendar year after signature* (Adjacent Prop Owner Information) Si ture* Print or Time Name 2Z S `7A« �-'ra-i �1- • Mailing Address . 2-_447_ 1<-L4- Telephone Number/email address zz:�/L':�' Date* (Revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to L/%a N (s141 5 CG P v t%Ts (Name of Property Owner) property located at w (Address, Lot, Block, Road, etc.) on A kvse Ai. xf- in liiwx voc fL, N C MT'L I N.C. (Waterbody) (CitylTown 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 develgp'ment must,fill in description below orlattach a site drawing) r Si AS 1e (;i•ht-N 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 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. (Property Owner Information) Signature f(EIUhJe`114 Se11ulfe Print or Type.SName 0�037 Rr•41-W/t� C� Mailin Address _ City/state/Zip �i2 �k{7-/G,Gy kl.SN�iI'�4 /riar�. Telephone Number/email address /-3D -/2 Date (Adjacent Property Owner Ior tion)- Signat%J��'e /lhJ'olo eor6le- Print or Type Name ,15!g dg,ss. wf / Cl City/stafe/7ip ecvrt Telephone Numb address -GGs = Bois Date* 36 i5 (Revised Aug. 2014) `Valid for one calendar year after signature'