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Home My WebLink AboutFelder, Monica%LAMA / ❑ DREDGE & FILL No. 73986 WGENERAL PERMIT Previous permit# A B ° Aqew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality -7 L1 //�✓� and the Coastal Resources Commission in an area of enyYyironmental concern pursuant to I SA NCAC / j 1 ®Rules attached. Applicant Name 1 1' ✓t i� e (`� Project Location: County Address f i Jf -c'* �✓ 4 Street Address/ State Road/ Lot #(s) City rimer. Pam^ State/VC- ZIP 261� /Yr Phone # (!) ` ; -i' c/�E-Mail Subdivision_ Authorized Agent ) r <- - o / "' ^ " / Affected 0 CW El EW ❑ PTA �CS ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: i ORW: Ye5/ no PNA yes /`no i city / P/ /?�(` ZIP Phone # O River Basin _ Adj. Wtr. Body /1G 4 / na-t _%man /unkn) Closest Maj. Wtr. 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Pleaserea compliance statement on back of permit" Application Fee(s) Check # ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to / 1�I4N1 t✓,4 g fEG -D6 's r i _ (Name of Property Owner) property located at Z K C9 (Address, Lot, Block, Road, etc.) on 906&6- SD UNL in N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. V�— I have no objection tothisproposal 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) t'�,/Ap9n Zf2 - 2-69-7V4q 9�AlCE11-662r� WiGL EK157-/YU4/.plyM'46� 3 y 3 o/ ,3-4ZZ 8 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.) ICI} V*� I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) �0 M ta. JO -t1,PGQl2�i Signature MAV/ 4!fA 10 FELJcic Print or Type Name /3ay 5.-PI_4/w Gr Mailing Address /ll�L�ll� GVG o27v/� Cit /Sta1e,1 9%9 _R k-3 2 62 Telephone Number/email address 611,4 c0/0 I Z ri rB Z eu I Date *Valid for one calendar year after signature* (Adjacent Property OwnerInformation) Si nature* VinJCFAu'r /V 1eQeJ1V,50^J Print or Type Name /&.n/ SuAzAiY6gOcK_Lp./ Mailing Address L' MLWA Me icL 3 -76 i> City/State2ip >z. �'�.y� i 'r 442 9' Telephone Number/ email address /S Ire h .20/ 9' Date* �tECEIVED (Revise Aug.2014) APR 01 2019 DCM_MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to /Llomcfl '10 1C4C1-Ji6< 's (Name of Property Owner) property located at ,J �{3� CED�iR Tip/-R-: L /V (Address, Lot, Block, Road, etc.) on �C7GU� SOU.v� in emC-1f�t� /5 L� N.C. (Waterbody) (City/Town and/or County) The 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. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) y')G/P4xAA66f;) Sep Woof C-Z— 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) ' nliD ldct'- Signature Print or Type Name Mailing Address Q,4 k) C 2-7/� it City/stafe/Zip 1/R�e/JT_ �Z91� d?9tKL-�l,t�s2 Telephone Number/email address 644.4 // /7 FE/3 2016) Date Zoh' 10CA,Doa-6 Mailing Address AfFGt/ PDX i NC 2 $ 5 7o City/State/Zip, m Iephone Number/ a ai re s; ( t Date* i RECEIVED (Revised Aug. 201 U9 Valid for one calendar year after signature* APR 0 DCM-MHD CITY AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: c T _,�WC6I6l7', /V� Phone Number: q/ Email Address: FC—Z-Dt2 (ft0/NAS10/e/A)6. CC)W I certify that I have authorized ✓' hW ,S7-1&P,SoA) �SFfl�oAST/��4/, Agent l G6ntractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: s« /V 'qLG. at my property located at in C9R725efL County. I furthermore certify that l 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 A)0vV1CA P FCLDFt2 Print or Type Name Title 031 2ol9 Date This certification is valid through I I Co,U.S71