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Home My WebLink AboutTaylor, Margareti CAMA / ElDREDGE & FILL No. 74455 -� GENERAL PERMIT Previous permit# A B (C D -iNew ❑Modification ❑Complete Reissue [-]Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality /�l and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC (-: L] Rules attached. Applicant Name_, a` \(� 1�%!/S Project Location: County U Address ((,? $� 1�q L� Street Address/ State Road/ Lot #(s) Phone # Authorized Agent A❑CW IEW Affected Afecte ❑OEA ❑HHF ❑ PWS: ].PTA ❑ ES ❑ PTS ❑IH ❑UBA ❑N/A ORW: yes / no PNA yes / no Type of Project/ Activity Pier Subdivision City ZIP — Phone # O - �rRiver Basin Adj. Wtr. Body ` '� % (7 j f ` C' t>' man unkn Closest Maj. Wtr. Body �y `'f +' may'y " V r (Scale: / — �(_" 1 ■■■■■■■■■ ■®■■■■ ■■■■■■■■■■■■ MEN ■■■Blom form(s) ENRON swoon go MME ■�■■■E■M■ENMEMENS� ENSUE MN■rMMENNENM ■■ MOOR■■■■■■■■■■■■ M■■■M■■■■■■■■SEEN■ ■■■■■■■■iumber ■■■■ME■■■M■M■■■ ONE ��N■■■■■■ME■■ e��r�irG7I. MONO■ ::'::::■m■::M ::::M010.M 1111 wi; distance offshore. max distance offshore ■EEE■■E■■■■E,■M�M■NlliIMwL'iSJ1M■MM.�MMN■MMME channel :::��rAm=m::IEMENI•MUSHWE IY%MMMMEEM -arnp...........■ ■.........■■..►�■..■..■■■■■■ ■■E ■M■■■■■M■■M■ ME ENSUE ■■ :� ■■■N■■M■ ■ ■■■:■■M■■E■■■■■■:■■ ■E■■M■M�■■■S■■■■:R 0 MENNE �+i1l■■■�■■■■■■ :::M:N�E:::MM■■ Bulldozing_[1�■N■ME MOM■■■■NM■N■■S■ ■MM■ OMEN ■M■S■MMEM■ MM■■S■M■M■■■NN■■■■■■■■■ ONE M■■=■■■■�■OEM■ MORE■■SME■M■■®■ENEM■N MEMM� ME ■MEN■ MEN 'E=Mm:::RENE ®:'.'.'.:'.:i: :'.'■::::o Boom tine Len- Is ■■■■ ■M notsure yes 7■ ■■■:■:■■■■■::M■■■■ ■ Is MEN M C/ :�[■IIRL��: ::M:::::iI GMlr::�vi■ IN ME i�il®■MrM■:0■■■NMt■SMi�I1j1�[1�f��SM■■■■ Fixed Platfor Floating Finge Graff l! length Balkh Basin Boat Boat Beac Othe Shor SAV: Moral n/a yes no Phot s- yes no Waiv e _ e /� J A building permit may be required by: \ f't ' 01f ( Note Local Planning Jurisdiction) Notes/ Special Conditions N.Xt`�i�:-(V il ** /Y 1 (i Agent or Applicant Printed Name Permit Officer's Signature"Pleasereadcompliancestatementonbackofpe.,tmi'�� Signa r Application Fee(s) Check# Issuing Date ❑ See note on back regarding River Basin rules. ( 0rIno// ted.Namey� Exoi ation Date CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: Address of Property: Agent's Name #: Agent's phone #: (Lot or Street #, Street or Road, City & County) Mailing Address: 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. 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 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 htto://www.nccoastaimana_qement.netlweb/cm/staff-listinq orby 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 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. t1 I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature Print or ype Name Mailing Address S�/),.,-,) i- al N� aka �rQ City/State/Zip J Le Telephone Number / Email Address S- - I - ��Iq Date or Information) �� 10 77cl Sec, &--cd-,�-p ar. Mailing Address No-c,�pcv -h, NC- �8S70 CitylStatelZilf Telephone Number/ Email Address n/ /ZPr Date (Revised Aug. 2014) CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: Address of Property: Agent's Name #: Agent's phone #: 141 (Lot or Street #, Street or Road, City & Mailing Address: 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 http://www.nccoastaimanaoement.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 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.) do wish to waive the 15' setback requirement. r"� I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature IA& awe-1- Print o ype Name -P6. AWL !7��-3-7 Mailing Address ,��l b- 11 rV a k sgo City/State/Zip 2?S2 -717 87+(o Telephone Number / Email Address S a -�-oICi Date (Ripari n Property Owner Information) g a`ture 1911/7 01na-Zl e-G3 Print or Type Name Mailing Address nletLOor+ N C. 6?85-70 City/State/Zip Telephone Number/ Email Address Date (Revised Aug. 2014)