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Home My WebLink AboutFH POA Co Wayne StrausbaughNCAMA / ❑ DREDGE & FILL GENERAL PERMIT WNew ❑Modification ❑Complete Reissue []Partial Reissue No 71629 A B C D Previous permit # Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality ..Y ) J i and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ( % '/ ❑ Rules attached. Applicant Name j! I t I , Project Location: County 'Address �� i) Street Address/ State Road/ Lot #(s) City State ZIP � 'k Phone # ( ) . , ' 12 Mail Authorized Agent Affected ElCW ❑EW _. D.PTA AEC(s): OEA ❑ HHF ❑ IH ❑ PWS: ORW: yes / no PNA yes / no ❑ ES ❑ PTS ❑ UBA ❑ N/A Subdivision City) ZIP Phone # ( ) River Basin! Adj. Wtr. Body i %� _f r`- na /man1 unkn Closest Maj. Wtr. Body ME MINN :I:::::::::::::'v --- m■■■■■:::■■■ ■■Ili■■■■■■■■■■i■■■■■(.+li■■■■■■:■■■■■■■:::: ■■■■■ MENEM . .:::■•.®... ..■■..■ .... MEN 11®®:...C:N:: . .■■ ■■■i■i■■■■■■■■■■i■■■N■■ii■ ■N■■IFAMMON ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■►ml■■■EM ::::::::::::::::::::::::■■■i■�:■■■■■■I■■ ':::■i:::::::i■■:::::::EMMUMMEMEMi M:HIM:: ■■i■■■■i■■iii■■i■■Gi■l�idl■■■e■i■■■■�■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■®■■■51MR.■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■!Ji■■■ ■■■■■■■■■■i■ ■■■■■i■■■■■■�■i■■■■■ ONE :::::: .i■■■iii■■■■■ ■ii■■■n Agent o Appli t Printed Name Signature •pip aseread compliance statement onback ofpermit Application Fee(s) Check # Permit Officer's Printed Nagne j Sign ture l Iss6ing Dat Expiration Date 'a rage depth in box is now 4 fDredge to 6'. Ilk, .......... Wf\-( L9 LL-\)L-L IN 1%(3cQF- P))C--Fd )IS LISPS TRACKING 11 I I I I I III IIIII III I I I I I II I III Perms INo. G-10Paid 9590 9402 2651 6336 5517 11 United States Postal Service • Sender: Please print your name, address, and ZIP+4® in IT `6 �' C-01"A aQ Qg f-4 ! 12 rj (? Lo Q t', n fJ tj G a— 9 66 6 ■ 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 mailpiece, or on the front if space permits. 1. Article Addressed to: 6-togaf� �Jfles r fztJti7li,bar' 2 r's r119 g' I0 llil0Pill iiflili'illii B. 1, Dn O Agent Is delivery" address different from itemnlf t-VOlf- If YES, enter delivery address below: ❑ No 3. Service Type ❑ Priority Mail Express® ❑ Adult Signature ❑ Registered Mall*a IIIIIIII IIIII�IIIIIIiII III IIIII IIIIIII I IIIII ❑ Adult Signature ResMcted Delivery ❑ Registered Mail Restricted 11 Certified Mail® Delivery 9590 9402 2651 6336 5517 11 ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery 11 Collect on Delivery Restricted Delivery Merchandise Signature Confirmation - Article Number (transfer from service label))Bail ❑ signature Confirmation 7 017 1 D 7 0 O D D O 8538 4694 Restricted Delivery Restricted Delivery Did PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt I postal CERTIFIED MAILORECEIPT Domestic NEqfFfrl'I rn to Certified Mail Fee $3.45 0621 05 $ Extra services&Fees rchecx co,addW sal O ❑Rehm Rem VIP, Pd kn tlh OR ONm Recalpt(alecCcnlo7 $—.—r-- Postmark O ❑CenMed Mall ResNctetl Delivery S Here O ❑Mull Signature Requlretl s— 0i OMult Signature ResbluteO DeMetl 5 Postage $0.50 04/02/2018 Total Postage and i 70 r91;e---i-A--L- $ Sent To a _________..r..+.. a., ai�+tfgol �ff e 1 iIn 7 r�l r� ----r y<�� ktiC. 2 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to FA i )�Y-1 j CD t! A KE G U k CG s (Name of Property Owner) property located at �o � G � (` EL 0 Cc' (� C ; (Address, Lot, Block, Road, etc.) on Ff�ff�rl(i INNL�1%AR��in_GC(�'VJ 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) SI-FoA 0 r) .. Mii-c WAIVER SECTION 11 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. 1 do not wish to waive the 15' setback requirement. (Property Owner Inf� }�► 6� F IVA`� Signature A L,3 /A I N C iKf\uSO4AuG(i,piVZ�<To� Print or Ty e Name Address _ E l-1 GiL P,K) , r )C_ asj16 C�33-y5� Telephone Number/email address Date (Adjacent Property Owner Information) Signature * G-'LG -6 C- N i L l 5 Print or Type Name '9 0 `t `r F-' i IV I V7 A c / Mailing Address F��J �13L(ZNI NG City/State/Zip _ �j') (,.33 -5C�3 Telephone Number/email address 1 hf R aoi8 Date �` "Valid for one calendar year after signature" (Revised Aug. 2014) AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: hA 1KV1 CL n l P\KBCUS, MaG `% 0wN9KS 0lSISociAT10 Mailing Address: G pp Phone Number: US2) C33' Email Address: WR�INS7C-��@��fna�tz ,Ccm 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: DF F_% U ) N & gEI-(lrl9 at my property located at �, ) O JS' r L L UCH C C U Q I in CP f\y V-- t-) County. l 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 C iOF, Title a� /CJ1 / _261� Date This certification is valid through ci 9 / 6' 1 1 a U I `� USPS 7RACKWG # I t It i!I ! I tlyl .It ! lrst-Class Mail I �I �� I'�l`II�I�II Ikrostage&Fees Paid I� I I� III ll�� 1 I Pe ms No. G-10 ��llf1�I�1 9590 9402"R51 L336 5517 28 United States Postal Service i.2402 Sender: Please print your name, address, and ZIP+40 in tl WAyA/F, S�RRJsRA✓G r4 Yetie�Oc(Z 4z ,Jew (�e2 rd tjt✓ v2-440 t111vIt11t11111ti11t11er11111111t1111111111t^I111t41111"filt ■ Complete items 1, 2, and 3. A. Signet Agent ■ Print your name and address on the reverse X , O so that we can return the card to you. / ❑ Addre ■ Attach this card to the back of the mailpiece, e. Received by(Prin d ame) C. D$te of D or on the front if space permits. / -) I 1. Article Addressed to: D. Is delivery address different from Rem 12 ❑ Yes ^ tj W $o If YES, enter delivery address below: ❑ No $-1 la(v Q P d R1i<t'AC 'jew O&O-d ✓J0 �-&l�� 3. Service Type ❑ Priority Mall Express® ❑ Adult Signature ❑ RegisteredMall*. II I IIIIII IIII III I II I IIII III II I II II I it II I I II III Li Adult Signature Restricted Delivery ❑ Registered Mail Restricted 959094022651 6336551728 certified Mail® ❑ Certified Mail Restricted Delivery DDeliverylivery ❑ Return Receipt for Merchandise ❑ Collect on Delivery ❑ Collect on Delivery Restricted Delivery 11 Signature Confirmation'" nation ❑ Signature Confirmation dtiClO Number (Transfer from servire /shell 1070 0000 8538 Mail 4687Restricted Delivery Restricted Delivery Dal PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt CO $ . ..D LnCertlged Mall Fes $3.45 0621 CO $ 05 Extra Services B add lee ) C3 lF�e�a�s�(c�nAeckeox, ❑ Return fleceiPt PardocM $ p ❑ Return RecelPt telecwnic) $ $n-nn Postmark O ❑Garaged MeilfleMdctetl Delivery $ $0 QO Hem C3 �Adutt Signature Required $_ti)--00— ❑Adak Signature fleeMcteO Delivery$ � )` Postage $0.50 C3 If 04/02/2018 Total Postage and $6e 70 � aSent To p.1...4N11"IP�lio -------�`-�-Cj.................. 61�5 a 7/P+4r .... ..!_...............�-..J (? JJ d3 21Z• fll t] tD ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to �a' t e � � (-�-A l C' � dL T Q A 's (Name of Property Owner) property located at / U `b' f `e- l')C c a C r (Address, Lot, Block, Road, etc.) on n4a'-4)W -�WNtfl- l-W06rc0—,in kle-v-) f-'fR✓ N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. (have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must rill in description below or attach a site drawing) I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Ow, Info ation) �') : Si nat ' re w ti� 5'T RVS$AUGI( Z jrz i-1&tbo 2 Print or Typ Name Mailing Address rVVaJ tj22,J P City/State/Zip Telephone utqberlemail address ' � i It Dale (Adjacent Property Owner Information) Sign,atuqre * Lll I (i )g- nq ii ,J ,to, Type Name (n(£il i=a�vice� Ci -- Mailin Addres f `� City/State/L Telephone um er/email address �7i pl Date * "Valid for one calendar year after signature* (Revised Aug. 2014) 477) w y a�z