HomeMy WebLinkAboutFishhunt LLC�2�AMA / G]'DREDGE & FILL No. 74431
-+ A B D
OtNERAL PERMIT Previous permit#
fNeW' ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As autho''1Ij<ized by the State of North Carolina, Department of Environmental Quality —'] / / rj /i� '�i t/�,t/ )
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / /` C Grt C.
( % / ❑ Ru es attached.
Applicant Name(( { i f n GG �- Project Location: County ( V r Yy
Address ` rl �% r': (r y J �^ J �� i ;f Street Address/ State Road/ Lot #(s)
State ZIP
Phone # („�'�)�I I' "1 E-Mail Subdivision
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Authorized Agent �j1 trr f�., 4 ry, / Cityi I/ ZIP �(
Affected ❑CW ❑EW -[PTA —rjES ❑PTS Phone# ( ) River Basin
AEC(s): ❑ OEA rl HHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body - 1 / / / (date/man /unkn)
❑ PWS:
ORW: (yes �] no PNA yes / no Closest Maj. Wtr. Body
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n/aMoratorium: yes n.
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Agent or Applicant Printed Name
Signature **Please read compliance statement on back of permit"
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Permit Officer's Pr�tecl Name
Si nat re
Issuing Date E*lration Date
Application Fee(s) Check #
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
k—
(Lot or Street #, Street or Road, City &
Applicant phone #: nt d' L I tPs 1 Mailing Address: T O K� S VJ f
1 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 drawing the development
they are proposing.1 desomp`tiort or drawimti Stith 7mensre h"rr usfbe`iroVewitl�tfiis lbw.
have no objections to this proposal. I have objections to this proposal.
If you have objections to what Is being proposed, you must notify the Division of Coastal Management
(DCM) In writing within 10 days of receipt of this notice. Contact information for DCM offices Is
available at www.nccoastalmangement.nettcontact dcm.htm or by calling 1-888-4RCOAST. No
response Is considered the same as no objection If you have been notified by Certified Mall.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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 Informa
Signature
Print or Type Name
ailing A'ddre .
OtMA2- �"300
City/StateMp � a
Telephone Numbelr�/� , (� may)
"� " O p r�Y!
Date
(Riparian Property Owner Information)
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Signature
It 1I
Print or Type Name
Mailing Address
�t ll
City/State2lp
Telephone Number
Date
INS
�Ic�s �- fizsi�uNr �a�p
,6. .
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION(WAIVER FORM
Name of Property Owner: is L jjv�J (�� ( '
✓l Address of Property: ad -r,�Uv I(I K-(� i �,(r��fi✓ �� ( y `'
(Lot or Street #, Street or Road, City & Co -
Applicant phone#: )� ZI� A6IMailingAddress:
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. A 3esent Sion or diraw�na anti -dimensM mustcb provtdedNult i€C4ifs 60
(./ I have no objections to this proposal. I have objections to this proposal.
ffyou have objections to whatis being proposed, you mustnotify the Division of Coastal Management
(DCM) In writing within 10 days of receipt of this notice. Contact Information for DCM offices Is
available at www.nccoastalmangement.net/contact dcm.hlm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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.)
L�l do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prope y Owner Inform o )
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rant or t ype rvame
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Telephone Number ( O J
Date
(Riparla Property Ow r I formation)
Szgnature
Print or Type Name
Mailing Address
City/State2lp
Telephone Number
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