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Home My WebLink AboutKohls, Joan. WA / ❑ DREDGE & FILL No. 73977 A B C D NERAL PERMIT Previous permit# New OModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As aut orized by the State of North Carolina, Department of Environmental Quality j and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC - ElRuJes attached. Applicant Name �� I Project Location: County_ �: Y %/t Address Street Address/ State Road/ Lot #(s) 1r'2( % ��' ° e / City State _ ZIP ( l t c — Phone # E-Mail Subdivision Authorized Agent Affected El CW ❑EW OPTA El ES ❑PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes / no PNA yes /'no City (7 _ ZIP i �' Phone # O _ River Basin' /" Adj. Wtr. Body - (nat /man /unkn) f Closest Maj. Wtr. 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(Waterbody) (citylTownand/or County) The applicant has described to me, as shown below, the development proposed at the above to t' I have no objection to this proposal. I have objections to this proposal. \r ND/OR DRAWING OF PROPOSED DEVEI_Ormnnl �toc k P ,_,rArHopse � w:dkK.:r / LI rJo rernrelg { I Rom,) -- 11D DRIVE WAIVER SECTION I 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 lnformatjeh) (4,Q.¢ . C1. Signature R)c.,'AF2x)W, 1<10H1.1�,'"3K J'6JAN 1'V1LLyjL•LC- k'e1L.', Print or Type Name Mading Address ., v'6a 335 email Date S.//./ 'Valid for one calendar year after signature" Information) M AtdreYIIy,lle, NC Z85� CaylSttate2iip TelephoripJll�ulP(L�/erpat Ord Date* 11 (Revised Aug. 2014) 6DJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to 1� IC N)}R D w kUFlt S ryo (Name of Property Ownp!) property located at 1 • > +- (Address, Lot, Block, Road, etc.) on NoF st CREEK OnISLI�sI 'n �-,N.C. in TF1'ILScn� Ilr (Waterbody) (CitylTown andfor County) The app icant 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. nFSCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT._,__ F. , jy � ie„ere•$; I I (-iou SE I FtoAt7 ' 1�0 DCCYS1IC lll2t�[ I WAIVER SECTION I 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) (Adjacent Property Owner Information) Signatwe N t- A i-) W - KO H t . YF 'SOAK 0'1L LJi t-LF_ - kcoYil j KA Maifing Address ` 3 (Revised Aug. 2014) "Valid for one calendar year after signature" AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: -RICNfifzL) W-4U L` --P— Mailing Address: FDRLE5A-I L CO y ctt'd Tow.! IhWILLE•4,H0 S A F'ro0-0 VA gp� SSL/ Phone Number: 0-)- Email Address: K0 H LS C D C 1 I NE o P r L I certify that I have authorized BoB8,y -j--521&Hr jyl�{Q IWE YJoQ�� Agent / Contractor to act on my behalf, for the purpose of.applying for and obtaining all CAMA permits necessary for the following proposed development: tN5TA L( W cLK.WA`t -Dock . 2002005e IV4-0 Lil:r Lost I RUeP-i C/kNE at my property locatedat in D N S L -byV/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: v-v In ka- Signature ZtutRep hj . Y-OR,S 3-2 _1oArJ ftLViLLE - kOHI-S Print or Type Name f9GuVl8�' � Title Date This certification is valid through F i' �.i�:... Hurricane Florence and TS Michael Replacement/Repair Request Form Date of Request: t -el' Property Owner Name: �75K)6'n KC h � C Address of Property: I Otp clone siCcu- jar 2sae1Lgyi t(Q Telephone Number: a Or k-- L4-,�)-1 — c5,54 U Type of Work: wDQC' CU musA - ( �� ptx-1� oti� NOTE: The Emergency CAMA General Permit 2500 is for repairs and replacement of water - dependent structures damaged because of Hurricane Florence and/or TS Michael. The replacement, reconstruction and maintenance excavation activities shall conform to current standards and rules. All work under the Emergency CAMA GP 2500 must be made in the same footprint of the previous structure with no additions, expansions, or enlargements. If any portion of a structure being replaced is within the 15' setback of the riparian line or access area, signatures of the adjacent riparian property owner(s) must be obtained acknowledging the notification and waiver of the setback on the forms. provided by DCM. • Any maintenance excavation or dredging requires signatures of the adjacent riparian property owner(s) on the notification forms provided by DCM. Signature: RECEIVED MAR 12 2019 DCM-MHD CITY PROPOSED DEVELOPMENT: DOCK CONSTRUCTION 120 DOCKSIDE DRIVE 12X20 STATIONARY 1OX16 FLOATING DOCK nK 00 �I l� 10 HOUSE: 72 R WIDE (NOT TO SCALE( 25X16 FT BOATHOUSE WITH LIFT w (-j a0 fT TO PROPERTY LINE 2.R Ma L0106" O f Wiof O \yk.y Z TO CAP H=9F--0PROPERT ❑t.E 8 REF CONCRETE DRIVEWAY 26 FT WIDE ROAD:120 DOCKSIDE DRIVE;' Property Owner Information '04'. Signature R ch W. Kohls Jr.& Joan Melville- Kohls Print name 218 Foresail Cove Mailing Address Stafford, VA 22554 City/State/Zip rkohls@dcline.biz jkohls@dcine.biz Telephone Number TEmall y•ao • /I Date Adjacent Property Owner Infor X�c.f-- 1 au Karen F. Jackson Print name 136 Dockside Drive Mailing Address Jacksonville, North Carolina 28546 City/State/Zip 908-303-3729 Telephone Number Email x April 7-ofZOl q ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to property located at 7R }} party ( on OR.tN6A5fC(2e9 K (Addr An Lot Block, Road. etc.) N 7`Rct<sonlUi ��>�, ONstoW (v'o, N.c. (Waterbody) (CityfTown and/or County) The applicant has described to me. as shown below, the development proposed at the above location on, I have no objection to this proposal. I have objections to this proposal. SEE ATTACKf-D DQkwNG WAIVER SECTION 1 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. xI do not wish to waive the 15' setback requirement. (Property Owner Information) roperty Owner Information) - -" x-7 �S' t ir¢ IG W . OHL Tp— - nature _IQ614 rnE'"Lrr.- koHLS f ;Ag,� A, 65$D"S 5Tei$LiAt, Print or T e are Ph t or Type�v ame a►8 n2Es�i� Co�E I� (n J�CK5ioE �2 06 >3qa X 4-•::to•19 'Valid for one calendar year after signature' (Revised Aug. 2014) a8 wee PROPOSEC DEVELOPMENT: DOCK CONSTRUCTION 120 DOCKSIDE DRIVE ROAD: 120 DOCKSIDE DRIVE r=: Property Owner Information ��%�� bi at e Richard W. Is Jr.& Joan Melville- Kohls Pnnt name 218 Foresai' Cove Maling Ad re8s Stafford, VA 22554 City/State/Zip rkohls@dcli,.e.biz jkohls@dclire.biz TelepFone Number Ema /9 Date Adjacent Property Owner Information Signature Pamela A. Osborne Stribling Print name 116 Dockside Drive Mailing Address Jacksonville. North Carolina 28546 City/State/Zip MELAINTERIORS@ EC.RR.COM Telephone Number Email O Date ADJACENT RIPARIANPROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to RiWAeD1J IG7NL5,7R } locm&W Namg of Pr perty Owner) property located at a0 pOCi=.SI I�Lc -Pei V E LOT 11 (Address, Lot Block, Road etc.) on NO2rNEA5(C26tK �NclCt�aMIJi�L� ONSIoW�oN.c. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above Ioc to ion._ _a\<�7 I have no objection to this proposal. I have objections to this proposal. DRAWING OF SEF, AT-fACKCO VIRAWiOG 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 4.:.0.114 460 D 'H%9- 7YL 'Y'tr c. 303 •37 a1 JC "Valid for one calendar year after signature' (Revised Aug. 2014)