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Home My WebLink AboutMurray, Vicki H.❑ CAMA / ❑ DREDGE & FILL O N. 78495 A B C D GENERAL PERMIT Previous permit# 7. ❑New ❑Modification ❑Complete Reissue ❑Partial Reissue ` kao Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission' an area of environmental concern pursuant to 15A NCAC J 'El Rules attached. Applicant Name V j L+ I i" i I� `; ( E: �l "(i''I Project Location: County ; (.l f' t-t )a Address (� �. - jlf {,(, ;6' j i (? Street Address/ State Road/ Lot #(s) City-t�€'.i l i - State 1 V ry' ZIP ,-✓ ! - t. "i i t Phone#(-'lh` `� Subdivision _ //E��-Mail Authorized Agent l f 1 f- i ,r: �,�./�-<'�;}tom j (L) I" G' City x\�`j`lI'1 ! ZIP / ❑cw EW PTA ❑E5 ❑PTS Phone # (rr 1 t River Basin l i 1. t i E L- Affected ❑ OEA AEC(s): ❑ HHF Q IH ❑ UBA ❑ N/A Adj. Wtr. Body b'*' C8`1 �-_.t�i:✓j uc `7 ti (nat •/man /unkn) PWS: ORW: yes / no ,+ PNA yes / o Closest Maj. Wtr. Body r t E■■■■■■■■■�■ ■■■■:■■E■�■ SEES■ MEN NEI MEN on M 11000011�� ME13 IN IN •®■SEE■MEMO EH■■ ■■E; ME 2 MEMO ■■■■■■■E■■ UP. OEAN■.....■.. ■ES■ILVi?.IIEEEE ZONES ■taN• MEN so511 NE■N ON IMEM■■�■■■■■�1��if�uw■■■■ MEMO IN ®■■■Cll! miff, j►n, SEES a...... IN MEM .IN .... •■■■■■■■■■ NEW �H■■■■■■■■N�■■■■■■■ ■.■■■U m.■■■.l■■ NIN E■EE■E■■EM IEEE■■ ■�■.... SEEN ■. .....■■N vSEERNIIF■■■1 ®.■.■■N■■G1E ■■■■NNNE■■■■■ gNEEM1ia'OS®E �lIEE:EEI� ItS!!J■mm■.■_■■■■■� ri rN SS® E..N 110-1 E■��■■nfil■E■■= ■:■■■ ■■u Elm ■■. : ■:■■:■ IN 1 . r::... ::E:■■ :':: : �:■:■■N:: ■■ ■EIE■■■■:� r Agent or Applicant Printed Name ' �r( Signature ** Please read compliances t tement on back of permit •• _ _- q05 r2 Si nat re - � -- Issuing Date Expiration Date Application Fee(s) Check # geclweo AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION JqN 8 2020 Name of Property Owner Requesting Permit: 1 8 L IJ r I"A I Mailing Address: Phone Number: Email Address: I certify that I have authorized C&'2 - 7 /q y5i7 r I to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: Cle(t 14601 liar) -,4 i at my property located at in County. I furthermore. certify that I 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 Owner Information: ��76 Signature %okr. )4. Yu cz2� �l Print or Type Name Title Date This certification is valid through I ADJACENT RIPARIAN PROPERTY OWNERSTATEMENT hereby certify that I own property adjacent to D?/,v- 1/1 fit rli V ,s (Name q P/ope Owner) property located at �l U i% /CI ( L Us-z- U),AV ��(d on Z��k (Address, LQQt, Blo , Road, etc.) (Kin ICE in in F( `?? /7�7n 2ep/,)e-l) , N.C. '-J(Waterbo ) ( ty cFwn and/or County) The applicant has described to me, as shown below, the development proposed at the above loc fion 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) RECEIVED JAN 2 8 2020 DCM-MHD CITY 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.) T:7 % I do wish to waive the 15' setback requirement 'x f I do not wish to waive the 15' setback requirement. (Property Owner Information) Cimmtvro Date *Valid for one calendar year after signature* (Adjacent Property Owner Infc )-gs I.? Citylstatelzip Telephone Numberlemall address Date* T (Revised Aug. 2014) I hereby certify that I own property adjacent to IWI AtlU� ' // ti L4'—vv' (Name ofProperty Owner) property located at it (Address, Lot, B k, Roa , etc , on in It N.C. (Wat rbody) (Cityrrown and/or County) The applicant has described to me, as shown below, the development proposed at the above location. i, 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) Kc:giyl=11 JAN 2 8 2020 DCM-MHD CITY 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. (Property Owner Information) /1261z 2 'Valid for one calendar year after signature` (Adjacent Property Owner I f mation) fSign ure* C enny Print or Type Name Mailing Address Clty/State2ip Telephone Number/ email address /2l126 (Revised Aug. 2014) RECEIVED JAN 2 8 7020 DCM_MHD CITY RecEl el) BAN 2 8 2020 ADJACENT RIPARIAN PROPERTY OWNER/TATEMENT �� AN 2 8 2020 I hereby certify that I own property adjacent to -� 'r slat l �( s n, (Name of Prope Owner) property located at J/L' (Address, L9t, Blo k, Road, etc.) on in f `'a r tl'ilc%7 N.C. (Waterbo ) (�wn and/or County) The applicant has described to me, as shown below, the development proposed at the above location. A /j 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) 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 (Property Owner Information) (Adjacent Property Owner Information) ? ,.... ; �-iL GjLCli.i.C(r!^ l rn k `I 4 Signature Stgnalm e* rnnt or type tvame r.�(' ) K/1)4 c!° K /(w Mailing Addres . Telephone Number/email address Dare *Valid for one calendar year after signature* Type G 1 2. si 1 Z /Ai�t G r'hck 1�� City/state/Zip Telephone Number/email address -j,7k Date* Ir (Revised Aug. 2014) r�ecel,,b ADJACENT RIPARIAN PROPERTY OWNER STATEMENT BAN 2 8 2020 1 hereby certify that I own property adjacent to i)CAI'�n® olry (Name of Property Owner) property located at (Address, Lot, Block, Road, etc.) on , in N.C. (Waterbody) (CitylTown 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 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 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. r I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Inf •mation) Sr$nature Sign ure* r` icdk, R Alai-lt<" �el�nclh Print or Type Nafne Print or Type Name Mging Address n I%S� S Mailing Address /State/zip City/State/Zip Telephone Number/email address Telephone Number/email address Dati� _ Date* t C' /12L1Zc _ /- G' 2 (Revised Aug. 2014) 'Valid for one calendar year after signature'