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Home My WebLink AboutManspeaker, Wes"LAMA / ❑ DREDGE & FILL NO. 75785 -. A B 'C D GENERAL PERMIT Previous permit# ONew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality , i f and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC Rules attached Applicant Name Project Location: County Address - r -1 State /' t ZIP , r/ Phone # ( :_) " %— ,r, E-Mail Authorized Agent Affected 0 CW DEW N PTA ❑ES ❑ PTS : 00EA ❑HHF ❑IH ❑UBA ❑N/A AEC(s ❑ PWS: ORW: yes / no PNA yes / rfol' Street Address/ State Road/ Lot #(s) J Subdivision M City ZIP ` Phone # O River Basin i;' 1 Adj. Wtr. Body _ (nat `/man /unkn) Closest Maj. Wtr. Body ... E■EM■■■■...... ■■■ M■■ ... ■■■■ No IMMEME No I Elm Is SEEN MEMO ■ ■'aw■111■■1■■11■■■■■■■■■■w■■■■■■■■■■■■■ ■EM��■EMM■■■■EM■E■■■■■■EMi■■■■■■��■MEN SOME ■■ME■EM■OM OEM ■■■■■OEM■S■M■ Is IS ■MEN MEMO M■■■M■EM OMEN ■■■■OEM■®®M■■I■M■■S■ ■ ■■■EM■■E■� Is MEN 00EE■ l■■■ii OEM III. OM■■■OM■■■■ ■■■■■■■■■■ ■IV■�■■■�■MRnIs Is�■�■�■I�Is 101E C■■■■■ OM■■■■EMS■E■■■■OEM NONE ■OE■■II■EMU l �i■i101111 MEN III ■■O■■ isiIs i�C■■■■■�i OEM■ ■■■i MOON ■ ONMM M E�■■■EMii ■i ■■■ ■E■■ ■■■■■■ EOM■■ ■E■■�I�SEE ■■ ■EMNEI EMM■�■ OEM ■■� ■EVllllm 11111E■:ill's■■■ ■� mom 'Elm OCC"��CEEE1111 0 In.■ a]. ■■ OEM �� 0■■11 �i■ ..■■. ■ MEN M�MEN ■OMMEN ■■EIME MErIEOME ■■■■■OEM Ii■■O SEE ■■■■■■■ IN OM■■■■ ■■■ ■OMEN ■■■■■ iEE 1n iiiii iiiiiiiiiiii 11 Agent or Applicant Printed Name Signature "Please read compliance statement on back of permit" Application Feels) Check # PermitOPocer's Printed Name is , J Signatu e Issui" g Oate Expiration Date CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER-NOTIFICATIONNVAIVER FORM Name of Property Owner: Address of Property: (Lot or Street #, iNQ— I�eo-Ui or Road, City & County) Agent's Name #:DiNNi s -Sops Ma-w&Cav4 LL('. Mailing Address: 109 Sea Lr9a. IJr Agent's phone #: L// - 0 62 Px°gi&� r% C\IG ,2f1516 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. o ort d rma h ri e ons`�n��' be3pr t d`Mit� eti Ir V I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notifythe Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. .Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at (252) 808- WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me, 02u wish to waive the setback, you must initial the appropriate blank below.) CEIVED I do wish to waive the 15' setback requirement. OCT 0 8 P019 i r I do not wish to waive the 15' setback requirement. DCM-MHD CITY (Property Owner Infornyation) Signature (/ b,kS MAA)Speae(, Print or Type Name 1�— ;6-) &A�<P-� �a Mailing Address U'e�tr��n�i NC 285/6 City/state/Zip 2 S,�- q- 4q - 6760 Telephone Number Tea �� 9 Date Ad' ent Property Owner Inform ion) Signature _ moc,.,4a <Y"— Print or Type Name I(,q Jld rns �a�i r f Mailing Address Ah t0l,)Or - NC-, -? $57I> City/state2ip . �,2 a- -/&4 g2— Telephone Number Date Revised 611812012 `y5, I! 3 �STC�1' «n Ni e Y uzBn.�l o-TiJ �}}- 444 t �44 111 , q 4 A F 52 i wr'i} i� > r ^ �{ 51 2, hf i4 Il H4 OAT e � NOV M.a vi�T . :1. k £3"IyJO.v�`i+%f��5•�.y i yam'? � {- , st 0c 0O �i 9�e 1.� DCM-MHDF I 7 u � d rt 0 RECEIVED OCT 0 S 2019 :M-MHD CITY TITLE: c>r I a p ENGINEER: CONTRACT NO. DATE: I J . TS-SP-1 CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT - - - -ADJACENT RIPARIAN PROPERTY OWNER- NOTIFICATION/WAIVER- FORM Name of Property Owner: Address of Property: 20 GrAP LAW— AA r� C� r leye4 (Lot or Street 4 treet or Road, City & County) Agent's Name #QenNrs-r-�zN S N%tr AAA C, ,vsl L -Mailing Address: �M for ' AIC Agent's phone #: a52 z vl -696 a - SS/ K I hereby certify that I own property adjacent to the above referee -pit property. The individual applying for this permit has described tome as shown on the attached drawine development they are proposing. WE VI i WIon 'r W1104 INT20 � o� s e��o��: st�thuith�=.th -ZI have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you mustnofifythe Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at (252) 808- 2808. No response is considered the same as no objection if vouhave been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, 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.) RECEIVED 1 do wish to waive the 15' setback. requirement, I do not wish to waive the 15' setback requirement. OCT U 8 2019 nrne_Aeun CITY (Pgrop/eily Owner Infor ation) I. 66 /1ArxnAbfl n Signature ' V (A' M>a�AJ5peaks;K Print or Type Name ,2(ri Mailing Address &AIA04 NC J25J6 City/state2ip a5L1 K7LI-620 Telephone Number 1 i�o%o C 9 Date r--� ( djacent Property Owner Information) & ignature � e T#gMf,5 e 5'w aa1�o�l S� Print or Type Name i Ty\ure)r R,&, Mailing Addr ss �ar't �Mahmau`C'h N'�•o�1g58 City/state/Zip Telephone Number �,\ 1014 II . Revised 61I M012 TS-SP-1 ' vn �— W� 17 'ittz }F T - NSF a 557 k ly< it -..d r a ! ,J. 1 uuC'�•f5 -yam Y�i` si 1R -..J 1. F1J. i yp ; £91111 �� 4ijj�k'•Y�% ryp •� -� RECEI� 4s ��x��€r2`u` .3EJaF •� •�' �,' IY r x'•is7 t�i\)S �As2 {rat ,'T'� - !e- xt� DCM-MH�T� ! 1 Ertl