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Home My WebLink AboutWoodall, RonnieCAMA / ❑ DREDGE & FILL No. 75998 GENERAL PERMIT Previous permit# A B D C EiNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality J t and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC Q�tules attached. Applicant Name ' ° � Project Location: County n,1 ' /,11, , r, Address 'o t n Street Address/ State Road/ Lot #(s) ��7 /� IfE'S _`-aNf' Y 1, Phone#( If'h %(D`1`' Authorized Agent AffectedEl OW El EW El PTA �S ❑ PTS AEC(s): 00EA ❑HHF ❑IH ❑UBA El N/A ❑ PWS: ORW: yes ///no�' PNA yes /- no i Subdivision - City ..')I C, zip �12 Phone # ( ) River Basin 4pt, tom'` t7 Adj. Wtr. Body &A) % ' A 6ai %than /unkn) Closest Maj. Wtr. Body MEN ■■■■■..NE■■■■■■�C■■■■i■■NMEr�M■■EEC■■■ ■■NE■■■■■■E ■■■■■■ ■■e"rF AMLot ■■■■ ■ ■■■ ■■■■■E■■■■EE■■■■■�NMENOMO■E■■�C■■■ ■■■■■ ■EME■E■E■■O■■■■■■ ■■■■■■OMEN■ MEMO ■■EEO■■■■■E■■MM■IN IN ■EN■■■■E�■■■EMEE■■ ■� .u■■■E■■..�y:,,., -:��:�.■m�oN■NNME E �■ ■■ MENNEN No IN 11111MI■■ ■■■■■■■■■■■EN■E■■■E ■■ i9.ir, ■■ p SEEN N■�'JEms NO■NONE ENEONE 11 E ::: ■■■NN■N OEM ■■N■■M■■■.®■.� ME ■■■■E■■ MEN ■■.■■■■■.■■. C.■■.C..■E■.■■. ■■M■ ■■MEEENEM■MO ■a■■E .■■. ME SEE ME■■ ■■Emu ■ENMEMO ■■■■■■SEMEN MENMEE■ ■■■■NNEM■YI■ WK1111E■■■NEE■E■■0� ME ME ■■■■N■■MEN ■■■ Iai_ WHEN ■MEN IYi■ ■■■■■■■■■■■ ■■■■ ■ ■ M■■■ ■■■■ ■■■ Mom■■ ■■■ E■■■��.M.I►EC\MEN " .■■EE .CEO.■C...■ .■NONE ME■■M■E■E■■■■E■■■■EE■■E NNMEENE■NEEE■E■ • M■M■■ ■E.w SEEN ■■■SEEMS MEN E■■ C�E�NE"■ ■■ OEM ■■NM■■■■■■■■■■■■ 0�100 :EE NEEEEEEEIN EIE 0 EE= MOMEN EEEEEEE E®GGE EE SEEN EEEEEEEEEEEEEEE :EEEOEEE EE )pl'ica t Printed Name Permit Officer's Printed Name •*Pleas read c6mpl' nce statement on back of pe it'* Si najure Fee(s) Check# Issuing D to Expiration Date I AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: __kon n I LC )ood o I Mailing Address: PD %U- -*8fl Phone Number: % III - A - ?Sqi Email Address: I certify that I have authorized / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits aril necessary for the following proposed development: wrnkonlla i.(.kt I I ksm -U),Il at my property located at I U ail VP in 0175IOW County. I furthermore certify that / am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property nor In, �y�c fll�6�4l1 Signature �JN�t G t0644-11 Print or Type Name EK.QJ �U Gy' Title l I_I oho Date This certification is valid through I I DJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to fC � /l l�l I c, t dooe c( I) 's Name of Property Owner) property located at �r/ �P r5t 6 & D/ I Vr (Address, Lot, Block, oad etc.) on l f-U) i UPY in =`J) e, f 1 P�eFrCI N.C. (Waterbody) (City/Town andor County) Theapplicanthas described to me, as shown below, the development proposed at the above to atba"-- �a� I have no objection to this proposal. low 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) cc r0 c. l oyS i WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, 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. n Date Owner (Revised Aug. 2014) 'Valid for one calendar year after signature* L�Lt� ADJACENT RIPARIAN PROPEf/jTY QWNER STAITEMENT I hereby certify that I own property adjacent to K T 11/1 I E' 1 (l ''od lI ] 's (Name of Property Owner) Property located at /P, (Address, Lot, Block, ftoa , etc.) on � E ' ') ) le {r{r in 7 /�r�(�I EF l rU , N.C. (Waterbody) (Citv/Town and/or Cauntvl The applicant has described to me, as shown below, the development proposed at the above location. t1 I have no objection to this proposal, yet pp2 _ 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) WAIVER SECjION I understand that a pier, dock, mooring pilings, boat ramp, 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.) a� I do wish to waive the 15' setback requirement. r\� pc10' 1 do not wish to waive the 15' setback requirement. Date (Adjacent Property Owner information) S�Jpl ttYg or 3 np�tr1[erup 7 �C" %� q 63) - Teleo one N ber/emai address G2t1 L4? ' O." O Date `Valid for one calendar year after signature- (Revised Aug. 2014) 5ign-P Cernio lele