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Home My WebLink AboutPerry, Lewis-1CAMA / ❑ DREDGE & FILL No. 75949 � A 8 �.c D GENERAL PERMIT Previous permit# ❑New ❑Modification []Complete Reissue El Partial Reissue Date previous permit issued ,As authorized by the State of North Carolina, Department of Environmental Quality �� C and the Coastal Resources ommission in an area vironmental concern pursuant to 15A NCAC / j` ❑ Rule 7attached. Applicant Name I/ �� t Project Location: County Address (? �'� Y ✓ ( Y Street Adddrees'tVs//$, �at�eLRoad/ Lot #(s) e City , at.. a StatZIP 13c) GIV Phone Authorized Agent Affected r)RW AEC(s): DOEA E-Mail ;�W ❑ PTA ❑ ES ❑ PTs ❑HHF ❑IH ❑UBA ❑N/A ❑ PWS: ORW: yes no) PNA elyei no Subdivisi n Y Clty e' - ZIP / (l LL Phone # ( ) River Basin 1 f'. Adj. Wtr. Body elf N t /.an unkn Closest Maj. Wtr. Body cap '"' t. ? -. - r��Mrl MEMO ::::0■■1111FIUMMEMEEMEM::::MEMO . MM MEMMUMMEMS ME■NN■■■■■■■■ �� ....■■■...■■...t ■■. M■■O■O■■ ■ ►a■i■■■I/ MM■■■N■E�t:■■■ NONE M■■■ HAM RMU ►�■■®■■M,r ■ ■■■HE■■■■ ■UM HOE■L7H■ ' ■E■E■■M■N■ ■M■HEt'W■■1 ■■MHMM■■■\w11�1��'ja7�lrw ® �r �n�riI�rN:. 111111 ■ ■ ■■■■HOE .1`.`.H■.�■lt9■ ��i►/■■ �rI+�C:C :: i ■ 1�■N■Mww2E■■■■■tr1 IMM■■■ERNME■■H■U■■!t111t■■MMEEM■ WOMEN ME ■�■■■■■■ ■■ ■■tL!1■■ ■■ MH■■E■■■ ■ :C■H:■HHii ■ ■: ■ °i■E� �. ::�MINE=::..■■■■�N: aME ■■tt1■■■■■H■■■■�t11�1t1■■H■■■■■■■■■■ ■■:CC:C� MONME IMEEMEMEM ME OF no ::::u:■:iii�ii�i��i�::ii:::u■:Mi:::::: 0 Agent or Applicant Printed Name Signature -xx Please read con iancg statement on backofpermit** Application Fee(s) Check # 7 CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: or Street #, Street or Road, City & Agent's Name #: tga Mailing Address: N�A Agent's phone #: 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 drawing the development they are proposing. A description or drawing with dimensions must be provided with this letter. I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at httn.,//www.nccoastalmanaaement.nebweb/cm/staff-listing or by calling 1.888-4RCOAST. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must be set back a minimum distance of 15from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) -1z I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Prof arty Ow far "forma' i Signature Pant or Type Nam �065hedG-� Grr,z�' .� Mailing Address %�,-4 N<_ z-Ws3� City/State/Zip Telephone Number/ Email Address Date�� (Riparian Property Owner Information) OLSignature Print or Type Name -00L14 L4mrdtnc Mailing Address City/State/Zip Telephone Number/Email Address G Date / (Revised Aug. 2014) RECEIVED NO" 0 7 M9 (:)CM4% HD CITY W C ,31 45808.19 S.F. Q.05 Acres 39 `L vi v, \ 73002.16 SY f f. 1.68 Acres l ;! /r <1.'. .. a..--.- =� 14 ' r it Jr w �Ip y, w �4 `j` Vr RECEIVED NOV 0 7 2019 f rM-MHD CITY RECEIVED NOV 0 7 2019 LLCM-MHD CITY CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: (Lot or Street #, Agent's Name #: i✓�% i Agent's phone #: or Road, City & County) Mailing Address: A/% 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 drawing the development they are proposing. A description or drawing with dimensions must be provided with this letter. t11 I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at hitp://www.nccoastalmanagement.net/web/cm/staff-listing or by calling 1.888.4RCOAST. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must be set back a minimum distance of 15from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) G� I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. ( ro rty Ow r r In rmation) rgnatur Print or Type ame DE Mailing Address A �-Qa-A) L Z8S3 City/State! ip 95Y7(,)S 3ys�` Telephone Number / Email Address '5 �4ci Dn (Riparian Property Owner Infor ation) Signature rl c o,,� �1 ti9 or. rS��S Print or Type Name 6/7- fijkAar Mailing Address k c City/State/Zip 5Z,- af6 -9yz0 Telephone Number/Email Address b�—RECEIVED Date (Revised Aug. 2014) NOV 0 7 2619 DCM-MHD CITY Lot M , Al `. 45808.19 s.F. i.i�5 Acres u� •� \ wt 3G 39 73002,16 SY 1.68 Acres f (C.--- ~� w 41 Ip �i 1�� V� •y �. j RECEIVED NOV 0 7 2019 DCM-MHD CITY RECEIVED NOV 0 7 ZU19 DCM-fvMHD CITY. k :ii / tb �808.19 S.F. 4 u 1.05 Acres bc Lot so 39a 73002,16 S.F. 1.68 Acres J 14/ � I � c,+t ` / 14.. UP I `jl • 4 , 14, y � 9g`3` `y RECEIVED NOV 0 7 2019 DCM-MHD CITY GoMaps November 8, 2019 1:1,128 0 0.0075 0.015 0.03 mi 0 0.015 0.03 0.06 km U.S. Fish ara Widife Service, Nelioral&l rds"ShppATeam vstlands tean@frvs.9ov %$F: