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Home My WebLink AboutWade, JamesON CGE &FILL ON. 78437 A B C D FRAL PERMIT Previous permit# IModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality .---7 /�/ !' [7`j and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC I \ n r ❑RuI attached. Applicant Name J T'� � / t I C Project Location: County_ /-)✓i%( Address City p 7 e State A/( ZIP Phone # Authorized Agent Affected �❑�W ib EW ErPTA Li ❑PTS AEC(s): EA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes / no PNA yes /(n� Street Ad � ess/ State Road/ Lots) j it%Ir !11 Subdivision City ` ZIP Phone # O River Basin r- Adj. Wtr. Body /- / ' h n t man unkn Closest Maj. Wtr. Body i ■■■■■ran■■■■■ ■VA■F A■■ ■■� ■■MENEM! ■■■■■NEM! 34�Qa■■ur, a■ �!:j► UNi ■■■■■■■■ ■■ ■■■■ r;�i�j■■■ MEMEMEMC .. MEMEMEM ME aim ZM IN i ■'�'■SEMMESi F o �■■■■■■■ �iwsomm� ■iiiiiii■� �C::::: : ■Ir.■■ ■■�■■■■SEEN q■■■■■■■■ C..■■■E ■ ..■..■ �■■■■■■N .....■■■�®.G..... �■�C ■ ■ M. •••:C�CC : ®:� MEMO E.....�....��...d ■■■■■■■[ mW� ■ N■ ■ R l.0.... . ■B� a ME ®a ......... ME■■■■■■■■ ■■■■■■ ■■■■■■■■■■ EN ■■■■ a ■■■■mmm.zm= ■■ ■■■■■■. ■■■� ■0■■■■■■■■■■■III ®mIII =M i E6■�i� i��■Ir,� a::: -��iii■r�j � wi�lME wvl ■■■.��, Agent of Applicant Printed Name ' s-_ J/1 Permit Of f� 's riff ed Name Signature ** Please read compliance statement on backofpermit;; $ignatyf / � Application Fee(s) Check# Issuing Date 7 C. Date I hereby certify that INkKro\erty adjacent to S O 5 Q. LNf/E.sroFr Ty L% 's (Name' of POwner) property located at r 4a �-- r� s i i� �' o v (Z'r I7 oroper f2 t N (Address, Lt Block, Road, etc. on Gowia do-e K , in 77 619 ,C. N.C. (Waterbody) (City/Town and/or County) The applic has described to me, as shown below, the development proposed at the above location I have no objection to this proposal. have objections to. this. pro posaL______- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) FXi:�, T-iti3 �oaK nN� ?I' r 4z 0 0 P,0T®aQ d 53 Fe (ff 1 7-0 pdjHasWr L/'"a 9N rz by j I WAIVER SECTION I understand that a pier, dock, rhooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. ✓ I do not wish to waive the 15' setback requirement. Property Owner Information) eo S�i$ ature ')o Me5 Q UDf1c�e Print or Ty Name I So EM-S It, g C VuILTI at -ng Addregs- V%t0`�p.5_gV- - 7 `f 9— Telephone Number --j_�ati �U Da — -- - Date Property Owner Information) Maili g Address �� wr_ ,2�5 75 CitylSt- 66- Tx �) -A-9i 1 — Teiephone Number i---------RECEIVED Date (Revised,JAN8/V($18 ZQ DCM-MHD CITY I hereby certify that I CN %Roaerty adjacent to&itVA)9%h p`- FRI'Cli CAPpfjft2s's \\!� ,, /� (Name of Property Owner) property located at / Pz 5 / ITCv u6L 1 pt (Address, l�oX, Block, Road, etc.) on J�0gty—S CQa a l� —,in `�( u f>f$fZT N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I hatie objecton.s_to this_pr_oposaL______ DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) �. I —Fit pi pi of pTjCK AN � p S3 ler, rz 7n i Of9cJJ'ra c � N % L 4d _ I WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, li back a minimum distance of 15' from my area of riparian access unless 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) �c Si nature (Z 1 e PrSQt or T e Name ll cres 114 Cm--)&T ingg'& A,),-C Ci /StatelZi �a .�y8--�()(/9 Telephone Number Ta- tom9 - a19 Date or groin must be set waived by me. (If you (Adjacent Property Owner Information) ECEIVED 13 2020 1 (Revised 6/1 / 1) DCM-MHD CITY GoMaps January 14, 2020 1:1,128 0 0.0075 0.015 0.03 mi 0 0.015 0.03 0.06 km U.S. Fish aM NUOlife Service, Naiomt S�SgWtTear,