The URL can be used to link to this page

Home My WebLink AboutEdwards, MikeCAMA /.-1?DREDGE &FILL No. 75057 A B C D GENERAL PERMIT Previous permit # 7New ❑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 ' 1 � ❑Rules attached. Applicant Name �. r Address C City r States ZIP Phone # O , E-Mail _ Authorized Agent ❑ OW EW 0 PTA ❑ ES ❑ PTS Affected AEC(s): LJ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A ❑ PWS: ORW: yes / no PNA yes / no Type of Project/ Activity Pier Fixe Float Finge Groff Bulk Basin Boat Boat Beac Oth Shor SAV Mor: Phot Wain Project Location: County Street Address/ State Road/ Lot #(s) >t Subdivision i City ZIP Phone # ( ) River Basin Adj. Wtr. Body ' f - r(r /man /unkn) Closest Maj. Wtr. Body j- I 1, I I C/ n (Scale: = , _, ) ■ ■■■■■■■■■■ SEES■■ ■■t'�■■!L�■■ ■■N■■■■■■■ • ..■■■■■\7OEM■ ■S■�SSE C■E ■E■■■�M■■■■■■SEEM ININE ■■■ MESS ■■■■■ESE■■■■■E■ SSii■■■b\ SEES SEE\ SEES■■■ ■W E■■■n■■■■■ii:■■...a..■■ ■E■En■.■■.. ■■■■E■■■E■■E/I■■E■E■E ■E ■■SEE■■ EEEE■■ESE■■■0■ a ■ EE■ E■■■■■ ■■■E■■■■■E%■■■■E■�■EME =\�EE��EEE■■■�■E E■E■E■n VAN No IritE■■ ■E■ ■EEESEE EE ■■■■■Sn■EEI/■■■E■E■S■9■■ME SE■E!!EEE■nES■ ■■■ EEO ■■■■E!■■■■■■■ 111■■■ i11/G■r`Jfl ■■ ■■■■■En■■EMS■■■■Mir MR ��.l�0 ■■E■■■1®00 ■E ■SEE SEE■■■■ ENE ■■■�..i■.uII■n■E�EN■ ■S■ ■ ■■C NONE �..E■...■■■..N....E■...H.C.E.IN ■■.■■■■M...I■...■■■..S■....E■...E■ ■■ ■■■■■E■E■■■■■E■�1:�■■■ ■E MESS ■■■ ■E■ ■ ■■ ■nE■E ■q..■■.■.■CC■■a ■■EEC■■■ EEC! ■ ■■E. CNEE�CsE■ C'E�CEE1� ■ :::IN M ■■■■■■■■■■■■■■ MEMO ■■■■■■■■■■■■MEN SEES E■■ E■■■ ■SEES MEMO.■■■■■■■■■SEE■■■E■■E ■■■��E■■■�■■■E■ MEMO ■■E■■■■■■■■ E■■■ ��■■■ EEEE�E:EEBE9M :MEN M EM s0 5� E �E ■■■nmi: ■■=G111 ■:: ME :W I so.. 111111 ....EE■■■■■■■■E■S■ MEN ■■■E■C■■■I=Emlmmmmmm�■■S�E■EIM ME A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions !?/t r - i 1 Agent or Applicant Printed am S14gature s's` Please read compliance statement on back of permit" C)?171' q n Application Fee(s) Check # ❑ See note on back regarding River Basin rules. J Permit Officers Printed Name Signature Issuing Date Expiration Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT G I hereby certify that l own property adjacent to q f o�e n -V ct r-� s 's a of Property Owner) property located at _._ � is t-{ V a h It w 1' r t � 2 _ (Address, Lo Block, Road, tc.) on 17/� 0gh� Soi,n� in inn �ho71 c3�,ereC N.C. J (Waterbody) (City/Town andtor County) The applicant has described to me, as shown below, the development proposed at the above loc tion. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill In description below or attach a site drawing) 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 ty waive the setback, you must initial the appropriate blank below.) -� do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner nformation) (Adjacent Property Owner Informatiori) nt '7sa - 9s3 s_ Teleph n Num or )7a 6 ate M �ling A d�dre�s�s City/state/Lip Telephone Number Dare (Revised 6/l ar2012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certlfy that I own property adjacent to property located at n�7 tmuu.aaa on r3OAlne &(Ael� in V (Waterbody) County) 's N.C. The applicant has described to me, as shown below, the development proposed at the above location, 1 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) 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. 0 U I do not wish to waive the 15' setback requirement. !BSI (Adjacent Property Owner Information) (Revised 6/fW2012)