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Home My WebLink AboutMcAdams, Redi NCAMA / ❑ DREDGE & FILL No. 75241-. A B C D �NERAL PERMIT Previous permit# flew ❑Modification ❑Complete Reissue ❑Partial Reissue' Date revi us emit issued As auth rued by the State of North Carolina, Department of Environmenta�auality I � , and the oastal Resources Commission in an rea of environmental concern pursuant to 15A NCAC t I - ❑ Rules attached. I ' 1 li //� 1 �.� .. Applicant Name ' A (% Project Location: County t Address l (i (_ ) ( _ ; l \ 1 _ Street Address/ State Road/ Lot #(s) City l tJ (l t State I -j _ZIP _ i t l t ti. Phone # (')- E-Mail Authorized Agent CW 0 EW ❑ PTA ❑ ES ❑ PTS Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A El PWS: ORW: yes / no PNA yes Subdivisions _-� City ;' Phone # (') _--- River Basin Adj. Wtr. Body- —"I (nat_ man unl<n) Closest Mal. Wtr. Body :MEN NEMEMME NEES I::EEME Sol 6'■'■'.'. .■■■■■■■■■■■■■■■ ■O\\■■■E■■■E■�■MEN .... ...■..■■...■.■■N■EO\t■■. MEMO. .■.■....■ MEMO ■■■EEO■■■■D!/I■1A■II�t1OO■■■■O■■■■■■■ME MEMEN EMOMMEMEM:■:M::E M MEN9:::::::MEMO ■■■■■■M■■■■■■■NM■M■■■■M■�■■K M� ME MEMO ■M■■■O■■....■■....■■.... ■■■M■ ■■■ ■MEMO ■■■MMM■■■■■M■MUMM■■■■■OEM ■MEN M■■■NENONE NEE ME M ....M■CIS►1i1 9in11�M■.•.�il�17■■■■■■ME MEN OMEN ..■ ■E■7E■ �IS�II1IMWM■1M E■■■■■E MEN SEEN ■■M �IISi�EE■EiSO■■■N■[�HMO■■■■®■■■OM _ OMEN M.�+�'OE '11MMERNMEN"':::::::::::: :� ®=■i i:tea MEE:::OS•►�..■...EO..O ■■ ■MlliENE N N■NOrlEbllrlN■■■■E■■SEE■■ • .J� No ENE ENE ENE :■■EEEENE i■■■EO& : —! iO■il■■! iR Ak%■■MMM NEE MM� W■ice::iEM■EEru.E■■■NNE MEN ENE ■:Eo■MMEN MMEM■■■ O■Elil■■E::::v::::::::::::::: :-EMEM:::::MM:OEM 0 0p�:::: MIN ,r Agent or Applicant Printed Name i Signature ** Please read compliance statement on backofpermit Application Fee(s) I Check# PermitOfficer's Printed Name i Signature 11h511g �AtD � a Issuing Date Expiration Date 02-09-'15 13:55 FROM- T-017 P0001/0003 F-056 1`1C[jE R North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis Governor Director date 6 / 5 '1 l Applicant Name �Zb fn dqr"A M S Mailing Address 6ZV- u)• W John E. Skvarla, III Secretary I certify that I have authorized (agent) 7F�be;h>rt to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) `DaG� -►— 2 �� 1� at (location) / 0 q -5�Mf —Lt+ �; —I TI1 cn►Slc `a� PCB This Sign. 400 Commerce Ave., Morehead City, NC 28557 Phone: 252-808-28081 FAX: 252-247-3330 Internet www.nceoaslalmanagementnet An Equal Oppodunily \ ARmiative Adon Employe ne . t t.�I:Carolina. �atura!!y ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to -p�D o'\ cA3) Af x� S 's /I (Name of Property Owner) property located at �a'I (Address, Lot, Block, Road, etc.) on f't fW n-A fl C-AWOL. in mi LW l o- -pr—* CA T-:F-T—_, N.C. (Waterbody) (City/Tow an nd/or County) The applican as described to me, as shown below, the development proposed at the above j N b 1 have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development mu tion below or attach a site drawing) kL P 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 a setback, you must initial the appropriate blank below.) I a K14k L%�� I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (A jacent Property Owner Information) Signature z ?tur Print or Type Name Pn t or ype Name Mailing Address City/State/Zip Telephone Number Date �ho�roer `r Date (y (Revised 611812012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent'to<,s jo t J � k _ (NaMe of Property Owner) property loc a (Address, bqt, Block, Roadyetc.) on MAO r/1MIL C-OAI- iR'L- in (Waterbody) N.C. The applicant has described to me, as shown below, the development proposed at the above I cation. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) �` (0 D QtOs�Q° ,b 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.) _0-M) Ado wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) Signature Sigratuu . Print or Type Name Mailing Address Clty/state/Zip Telephone Number Date A•Yden ,�%V C `LSSI � s 3YJ-355 TeLephofielNumber 7 1/•• 20� Date (Revised 611812012)