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Home My WebLink AboutBozeman, Travis®�CAMA / (DREDGE &FILL No 71613 p B 0 D GENERAL PERMIT Previous permit# Idew ❑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 are of environmental concern pursuant to 15A NCAC i ❑ R les attached. Applicant Name �Y DV I j f G 7 e-' Project Location: County (' c i- rlr,'`/ Address / y06 O J 7 .e-%V' e, �61(( Street—A7dd/ress/ SStta/tj Road/ Lot #(s) City LU n1�—r}i ,I �q State/'C ZIP�7J �� 1 /G %Ifl f G. Phone # ( (%) ) / ' / E-Mai) Subdivision Authorized Agent �� Y '� ✓ f' City A t/ V ZIP ❑ eW 21W IfIfTA ❑ ES ❑ PTS Phone # ( ) River Basjn `J ` n Affected /a ❑OEA AEC(s): ❑HHF ❑IH ❑UBA ❑N/A Adj. Wtr. Body li P' " r' K(nat man unkn) El PWS: ORW: ,/ no ye PN�n A yes � Closest Maj. Wtr. Body �� fv �" fig MEMO ■■■■■■ MEN Pr■■■■■■■■■■■■■■■■■■■ ■■■■■■■ ■■■■■■■■■■■■■■■OI"am ORMIe■■■■■■■■■r. Pill N ■■■■■■■■■■■■■■aalrM■lAmmm■■■■■■■■■■tuft �■ ■■■■■■■■■■■■M■■■■■■■OMENOE!7■■N■■I1■■■■■■ ■■■■■■■■■■■■■■■■■ IAMEMEE■■■ ■■N■■■■■■E■■■ MEMO ■■■■■■r.iii■EEM■■■M■■■E■■■ ■■■■■■■■■■O■■■■■O■M■11EELIIWEE■NEO■■E■■NEE■ ■I ■■■■■■■ -MMr.NWYNAEM■■■M■■■ f�l■■■■MEN EN Novi r�J■■1'Oil/(■_ i►1�.■■■■ILPJ\►lfir ■■■■■I111110 M�'u`n'1V►`G�rEE iM■■■1•:�EO■►IB!!J■■■MEN ■■■E■I■■■M■■■■women■■■■■■■■unum■flM■■■■■ EN ■■■■■'■■■ ONE ■N/I■■■■■■OMEN■ MEMO ■IiH1NIs■►■■ME ■■■■■ ■■l�®7:�I<IIL■■■■■■■■■■■N■■MEMM�1■I•/I`I■■�■■■ ME SEEN MENE:■��'t:M MEN M■ENE o'.MENNENtea ■■■■■..■...M■■MENE■■■■.■■■■■■■OIL■OEft\■■.. ■ •■■■■■■■■■■■■■■■■■■■■O■■■■■E■NE ■I■OE■ ■■■■■ ■E■■■■■E■■ ■■■■■■■E■■■IMI■■■■■MENNEN■■■■■It■■■■■■ ►A■11■II11PIN 91U 1�7■■■■■■■■■■■1■N■■ No ME ME ■N■■M■I■I/SEAMME►'1'ilfl on ■■■■Ma■■lil■■■■■■■ ENE ■M■■■■N�!■!■SINE■M MEN ■ ■■ ■NM■ ■■■■■■■■MM■■M■NE■■■NN■■■■ME■■ MEN ■■■■■■■■■■■■■■■■■■■■■■■■■■C■►ll■►1ME■■M■ ONII■■IAMM■■ :::::::::mmo M� ::M I : N►11■■0NON0 ■■■■rM■■■■■■■■■N■■■NOME■■ENE■■ I i I Agent or Applicant Printed Name ' nature** Please read compliance statement on back of permit** Name f1 Application Fee(s) Check# Issuing ■ Complete'Items 1, 2, and 3. ■ Print your name and address on the reverse SO that we can return the card to you. ■ Attach this card to the back of the mailplece, or on the front if space permits. 7. Article Atltlressetl to: _ T-10 �� , � [( L_l-y • IIIIIIIIIIIIIIIiilllllllllllllllllllllllllllll .„95�9402 1768 6074 7293 37 PS Form 3811, July 2015 PSN 7530-02.000.9053 ■ Complete Items 1, 2, and 3. ■ Print your name and address on the reverse A. so that we can return the card to you. X ■ Attach this card to the back of the maiipiece, or on the front if snar•c X..._... ❑ Agent R• R- eoel r7nteUName Addre: C. Date of Dein (/cam r - D.Is V`Ipt, ,. 1-E-L�PYriL�,.,.�, If G�154�v- IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII oAdd 9590 9402 1768 6074 7293 44 OCetflea ❑ 1 PS Form 3811, 1421015 PSN 7530-02-000-g053 ❑ No JUL. 18 2018 tlae O Prl * Mall Eyreaa® 13 e®ft"RegMatedDelNery JI ReSVICteQ ❑ReWwW g;MMaORazhtcted 'eMery DellverY Rill�h�re�ryY ❑M hrtn ReaelGt far :livery Reatriatetl Dell," ❑ Sl9naemtu�maC�pnry �nm Reehtpted De �Y ❑s�enature Cormrmaaon Restrk}ed poll,�y DOMIIVc Return Re a Agent JUL 18 2018 xlDefivery OReglatered Mell^+ Re V.tered Mail Re W, Wllery DedwaY ❑ Retf' ept for cteDels �❑Si9atu, CantinnaWn. O Signature Confirmation Slivery Reytrictey Delivery Domestic Return Receipt v m �r r PostalTM CERTIFIED O RECEIPT Ln Ln Domestic Mail Only -0 Certiffed Mail Fea Ln $ Er- ckbu, ed$tllee ea EF1R Return RECEIVED C3 RiCReceiptelP8t (FIUaMwPhYe C3 ❑ Fabian Receipt(electrenlc) $ Postmark p ❑ CmtRed Mail Restricted DoINM $ Hero 0 tSignatureretired $ OMli DAdaR SlgnaNre restricted eelNery $ JUL 1 S 2018 O Postage ru RJ TotalPostage and Fees DCM-MHD CITY Sent To 1 �CA fApr-T7o.; N Siree7end o`i Pdffnx"Ffo:'—"""'--•""""CL ................ � Ii ♦ 0 F F I L, °D Certified Mail Fee ul Q' $ Bdra Services & ees(che to, em 0 ❑ Return Recelpt(hWwpy) $ C ❑ Realm RecelPt(eleasonlc) $ C ❑ Cartrat Mall RaaanYetl NINery $ O ❑Mult Signature Required $ ❑Mult Signature ReaWcted NW.,, $ O Postage fu $ `D ru Total Postage and Fees rq Sent To J. ED Stieel endFlpf: 11L or 1 0 Bon r` I.m o 6 Its® �l w tG N N cn N ® tj v � n e o 0 a m � r � � r � � � w r— P 'm a n �n rK N '0 5 � Nm�nn N Z O iiI w V O y ro v�+ EIVED PQosstmark O L t M svlHD CITY CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF ADJACENT RIPARIAN PROPERTY COASTAL F OWNER NOT MANAGEMENT FORM Name of Property Owner. 1v?x��,i , n.we-- 7�-hn 03 Address of Property: 176 Q l l , b ll -& -e_ ,, ;, (Lot or S reet #, stre'et or Road,' City 8 County)' Agent's Name #: GS CI�/Mailing Address:-io Agent's phone # �,57 7i' / y/��j S I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described they gec>tronotlr wratnig� w�ith`tdiir"nr..emns5ons mist be or'ovras[''watl�G�t�i�tt ept�`er. nt I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you mustnotify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at(252) 808- 2808. No response is considered the same as no obeectinn if,..,,, a,,, WAIVER SECTION I understand that a pier, dock, mooring pilings,r, boathouse,must be back a minimum distance of 15' from my area of pa ant access unless) ifta, orivedroin by me. (If youet wish to waive the setback, you must initial the appropriate blank below.) - 1 do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (rroperty Owner Information) ff �Avicy� J Signature ��i c�L a_7 e� //Pant or Type Name `A Maihng Address City/State/Zip zf Telephone Number 'ate (Adjaceylf Property Owner Information) Signature H l F4 Print or Type Name P6 90k (4q Mailing Address NI"7-T i✓ CF a 6 35? City/State/Zip l„4-l0 672 v7¢d�cE�y�° Telephone Number .1f t) Date I AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: % l cxy;-5 5kane, 60s, lna/7 Mailing Address V& PIA Wh fzyilk, A Ln 4ei-tn NC 'q Phone Number: _ I /0 u 9 9g59 Email Address: I certify that I have authorized Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: 9� G� hlr l t'o�e t� P l ii� PnA, Qt�ni t w�, (l—LUU A J at my property located at ILL `M,,, �)/ fi 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: Signature Print or Type Name Title Date EO This certification is valid through r RECFIvAAeo Jut 18 2018 Ca'TY Lb-0 0 1-LC f I -Ito A l l �O� L �� Q❑CI I x Iso xx 4o ht r N!o� 6 o a b��e 1� be, rMQ ✓q rl��JU, tL M�j I9O Soo i 104 -td 3D0, (�J�1 -7yo� o ,rc by,�� i n F3 in is t:J r� QI� L7 C7 f-7 cJ 0 q G`'0� w �x U� r�u J �� rLK RECEIVED JUL 18 2018 I)CM-MHD CITY CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: r Address of Property: 1 (Lot oFStreet #, Street or Road, City & County) G 2 S,6 �z� Agent's Name O�VL4r, 6Ui! t- �11 S� Mailing Address: Agent's phone 40 I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawin the development they are proposing. 1rto�or tlxvit�itls i>on sbei`ditEllter,. I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you mustnotifythe Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at (252) 808- 2808. No response is considered the same as no objection if youhave been notified by Certified Mail 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. (Pro erty O/Jwner Information) Signature I YRV (� ago Print or Type Name ,yo (o olr,r L, :;mod Mailing Address City/state/Zip Q),0-9127_9xs� Telephone Number RECEIVED t�e/,qdliy Date( JUL I (Adjacent Property Owner Information) Signature Print or Type Name Mailing Address City/staterLip Telephone Number 8 2018 Date Revised 611812012 DCM-MHD CITY