HomeMy WebLinkAboutJohns, James® A� DREDGE & FILL No. 73 19 //' ,,
A B /C/ D
NERAL PERMIT Previous permit# �L//
, ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality —7/-1' 2UV
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
T ❑jtules attached.
Applicant NameJq vG m r) "5U YU Project Location: County r.11�_ /
Address - C% ! a V / i M �er OFF Lr I ►' Street Address/ State oad//;ot #(s)
Phone # r) 670 —6g)() E-P
Authorized Agent
Affected ACV '�W PTA
A
Affecte ElOEA ❑ HHF ❑ IH
ORW: ( yes) no PNA yes
Type of Project/ Activity
Pier (dock) length U A A -7 V
Fixed Platform(s) -- - - _ "I<- J Out
�i 7 jGC
Floating Platform(s)
Finger piers)
Groin lengthIv/yLU1 (�
number Ci � I�"3.{-� -', -_ 1c
� r 0
Bulkhead/ Riprap length t- _ P'" O
avg distance offshore
max distance offshore
Basin, channel
N
❑ES ❑PTS
❑UBA ❑N/A
6 X a50
� • 13 x/3
Subdivision Gat o f A� (/f J1 o e-
City Cf eo 61C/T/ZIP '
ivJ
Phone # (_) River Basin <
Adj. Wtr. Body %}C ✓ c,U^ v na" /man /unkn)
Closest Maj. Wtr. Body C UK c-k�'/
12x3v
cubic
Boat ramp
Boathouse/
Beach
Other
ja
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(Scale: )
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Shoreline Length)
SAV: not sure yes - - - - f
Moratorium: n/a yes In
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Waiver Attached:
A buildin permit may be required by v CY� fr'�� ❑ See note on back regarding River Basin rules.
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( Note Local alPlanningCditto diction / ^ Ir,
Notes/ Special Conditions �_
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Agen or Applipannqrinted Name
PermitOffce 'nted
Name
Sig ire ** Please read compliance statementon backofpermit**
Signatu e
Application Fee(s)
Check#
Issuin Date
Expiration Date
71 CAMA / ❑ DREDGE & FILL
No. 73194 A B C / D
GENERAL PERMIT
Previous permit #/
__I New,• ❑Modification ❑Complete Reissue
❑Partial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental
Quality
7 / I I ;(-G
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
❑Rules attached.
Applicant Name
Project Location:
County
Address / :` / % %" ''/ �<
'" Street Address/ State Road/ Lot #(s)
City State ZIP
" I
Phone # ( ) ' / , E-Mail
Subdivision_
Authorized Agent
City / '
_ ZIPS � .
0CW ❑EW ❑kk DES ❑PTS
Phone# ( )_
River Basin _ 0/'
Affected
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA El N/A
Adj. Wtr. Body,.
(nat/man/unkn)
El PWS:
�
Closest Ma' Wtr.
Bod
ORW: (ye!)no PNA yes /�60 I' y /
Type of Project/ Activity 7, X a-70 C 7 i ` 'x ,(U l r ,l '
(Scale: )
Pier
Fixe
Float
Fing
Groin
Bulk
Basir
Boat
Boat
Beat
Oth(
Sher
SAV
Mor:
Phot
Wain
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A building permit may be required by: _
( Note Local Planning Jurisdiction )
Notes/ Special Conditions
/ r
Agent or Applirant.Printed Name
Signature "Please read compliance statement on back of permits
jj
ApplicationFee(sO Check#
❑ See note on back regarding River Basin rules.
r
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PermitOffcer's Printed Name
Signature
Issuin Date Expiration Date
I hereby certify that I own property adjacont to I! r 11 5*W=
,v(proporfy located at t B,N_� ��rsLn�t S�4 L35W SrifOii'
(Address, Lot, Block, Road, etc.) _
on 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
►nw (individual proposing development must fill in description below or attach a site drawing)
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l�J ttlCluto�ti3(r � iwr ,�\ir.� tam 0-� 2 e'a-. 20,copT�_�oR (-R}S ert �- *Kwtb
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WAIVER SECTION `Tt;(, t 0t -C;70-4, SDO
--+ understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must beset
back a minimum distance of IV from my area of riparian access unless waived by me. Of you .
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
ICY ✓ I do not wish to waive the 15' setback requirement.
(Property Owner information)
(Adjacent Property Owner Information
A $ 5,3/
(Ravised 6/18/2012)
AD j_AG NT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _(/ill& Fwm,c/'yI Lzi- ti
property located at (�:�PRA�9 4 61
(Address
on BAG _.��u!ur1 in.
(Waterbody)
The applicant has described to me; as shown below, the development proposed at the above
location.
✓ I have no objection to this proposal. .
Lhave objections to .thiss.proposal.
DESCRIpT1ON AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a:site drawing) .
I!,
'� 70 `-'� E�2-� 'Z�w'�.e�„ �'D S �C�li•t 'L O ;
+t•ke.uprs:Wa,nb tJC..
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INCluoialCr �[1z ��x�w.\1w4t�ri• ek 2 eD, 20,000 \h lbo 014 �1,.cv
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WAIVERSECTION tit. '?(q-C70-b D0
2Z6oE
- - -I understand that a pier, dock; mooring pilings
s; breakwater, boathouse; lift, or groin must beset
9
bade 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 16 setback requirement.
I do not wish to waive the 15' setback requirement.
tri upanny� %owner mTor/mauon)
(Adjacent Property Owner Informattor
RE�,EIVED
0o 1$ NAt
C1YY
A X 53/
(Reed 08/2012)
DocuSign Envelope ID: D3A387BC-2ABDAC50-8004-A84BA2BE5D30
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT ,
i hereby certify that Town property adjacent to ^ReI�L,LFi�I�I
n (Name.of Property caner)
property located at /& rf) ?A/)e p o;,*%rp'! 3 3 r )9i1�8
on, ,Sort,Jcl lA dress, Lot, i3tock, Road, c.)
, in.A64Rl{PBiS--�i9wtlr✓`
(Waterbody) (City/Town and/or County)
The applicant has described to tne; as shown below, the development proposed at the above
IQW. I have no objection to this proposal.. '
Lhave objectlons to (his•praposal•
DESGRIPTION AND/OR DRAW NG&�PROPOS-09VELOPMENT
o (Individual proposing develppment must fill 16 description below or iach a-slte drawing)
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Zt6ot
WAIVERSECTION 16t, Ttrf'e70:-L-,S00
- 4understand that a pier, dock; mooring pilings; breakwater, boathouse;• lift; or groin must beset
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 16' Setback requirement.
X 140 notwish to waive the i6 setback requirement.
(Property Owner Information) (Adjacent Property Owtior Information)
D..S19n.d by:
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care
(hOvlsed MV52WED
OCT T U18
DCM-MHD CITY