HomeMy WebLinkAboutGlobil, LLCAMA / C DREDGE & FILL No. 73985 A B . D
�C ENERAL PERMIT Previous permit# l
F-'�New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality % L/ // vU
and the Coastal Resources Com issipn in a area of envir n ental c ncern pursuant to 15A NCAC !
rC ❑ ulesattac ed.
Applicant Name " Project Location: County �r'r7 0/ r'
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Agent or Applicant Printed Name
Signat "'* Please read compliance statement on backofpermit*"
Application Feels) Check #
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: On LC "'tk I- L C
Mailing Address: 1' r 4 � \ 'V,V' "
Phone Number:
Email Address: \-\ -K a-\+T- \C,\
certify that I have authorized V)G— t t, cA ;\-k'F', s 3\ LZ �r V-
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: I ^`>' M,
at my property located at i .',s.j, p (r °tic F tx z • .k r c 'zXA2
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
This certification is valid through I I
CERTIFIED MAIL . RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAWER FORM
Name Of Property Owner. _ t t r; 4.� L L. '-
Address of Property: YCVf'i>al`i_?sl ji1 "F t, v.-"v w--[ECC"C W
(Lot or Street ti, $trcct ¢r Road, Ciy & Coumy)
Agent's Name #: Mailing Address:
Agent's phone fF;
i heroby certify that I Own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A dosddption or d0yAM wtlh 0MMg9in mdst be provided with thir,,(g r�
(A._ti have no ohjections to this proposal. I have objections to this prop,.. 1.
if you have objections to whatis b¢ingjamposed, you mastnotifythrDh*ioaofCoasoVMamrgement
(OCM) In writing within 10 days of recolpt of this notloa. Contact inforywoon for DCM o?Teos is
WAIVER SECTION
I understand that a pier, dock, mooring pilings, beat romp, broakwater, boathouse, or lift must
be set back R minimum distance of IF from my area of riparian access unless waived by me. (If
you alsh to waive the setback, you mu .Initial the appropriate blank below.)
1 do wish to waive the 15' sodmack requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Riparian Property Owner Information)
S'ignatan• .a Signature
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!Telepfwn¢Numbar/Emaifaddross f¢I¢phuno Number/F.maifAd rass�
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(Revistd Aug. 2014)
■ Complete items 1, 2, and2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailplece,
or on the wfront If space permits.
1. Articla dAA�e..w ._.
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9590 9402 3777 8032 3107 64
PS Form 3811, July 2015 P$N 7530-02-000-9053
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1199 NINE roof ROPt7
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252.665-A578
BOGUE SOUND RV PARK
CEDAR POINT, NC
SEAWALL PLAN AND X-SECTION
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