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Home My WebLink AboutNorton, Ronald�CAMA / ❑ DREDGE & FILL N9 78915 A B C D ENERAL PERMIT Previous permit# ew ❑Modification ❑Complete Reissue OPartiarlfeissue Date prIevio)us permit issued As author zed by the State of North Carolina, Department of Environmental Quality t .)4'1 I '' and the Coastal Resources Commis ion in n area of environ ental concern pursuant to 15A NCAC , ❑ Rut ched -_ Applicant Name j,1f�! 4 `�� Project Location: County ` F, �/ Street Address/ State Road/ Lot city l I [_ t 1'1(a b Y Sate IVL, zIP/(L/ 11Y ? / / ().L.( Phone # ( ii) )h Ate' s `4_&il — --- -- Authorized Agent City 1 " = %L ZIP ❑ cww Affected \PTA ❑ Es ❑ PTS Phone # ( lJ / ve r Basir 11 OEA b HHF AEC(s): ElIH ❑ UBA El N/A Adj. Wtr. Body —0�— ORW: yes / 20 PNA / r�o Closest Mal. Wtr. Body—�{ -.- �MmiLi ai■ MEME i® iNIL, UMEM ■I■V■3/N■ ■E■■■ C■O■I� n�� ■■■■■ MEMO. . ■.■.NE■ ■■EE■O■■NN■URE � ■0�..::IONN ■■■■1.A ■Or!U MU■I■■■■■. l EfMEEE■■■N N■\/7rnfi��Nl�mAIMI■■OE■f►. ■ME■■■■� NEE\V M �rri�ll'�1 ■■■OOON■■■■O■■■ M. N■IS ■■■ r7■■E�1��C�■ M. ■■ �®�YEEI SBN O■�� !Illllmlmm��mE 0� ■ I � ■__ �5i1� RR 11 i[/1r®rlE IEMAMAaO�■p■■■■■■■�■ • �N■E■■■NiA _ 7�NONMEMBENR►■�lE.■�N■■ N■■■■■■■ /NME■■. fARU P P,° �'IZE SEEO �EllMUZZ L• - aimom ��iMii■ ■N �M MiA,t®I■l�M'■111 ■■■■■ NC■�COR��j ■■ii�3tir11�IA�� NN■Nii■■■■■■ .. nommm �Mili■■� mN�o■mimm� on NONE ��■■■ MA en or Applicant Printed Name Signature "Please read compli nce statement on back of permit" lauq Application Fee(s) Check # AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: � On a d 0 r—+"0 0 Mailing Address:C kia'hu0c-'(4 ST 6 rct h o- rC. a r7 a� Phone Number: 5 I (p • Q y g Email Address: corn I certify that I have authorized Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: at my property located at AqT Old in Cq2ef-e-� County. l 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: Signature TOPI cc IV O rl c) /N Print or Type Name OtA3ner Title D c� Date This certification is valid through RECEIVED FEB 18 2020 DCM-MHD CITY I hereby certify that I own property adjacent to �or1ct I J 1 v b r +G rr 's propertlocated at ( ( // (Name of Property Owner) y �� 1 U l cZ it S e L. ' (Address, Lot, t31ock, oad, e on in 8} IG_r (j � �Y a C J1 N.C. (Waterbody) J (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. kaddl 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 descpiption below or attach a site drawing) I 4Y 4 ry�F ,' t z _.� LA AlL -a - 11 WAIVER SECTION I understand that a pier, dock, mooring 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 Info ation) (Adjacent Property Owner Information) Si nature Signature _Kenai d �f r) r PType Name II, or Print or Type Name Uej M fling Addrass ,`/ SS � ,ar�� NL '7 3 0� .moo AI ` 27278 Gyyt/St te/Z! rty/State/Zfp ITleph one Number Telephone Number uu�ml>�Y• Dale Date ®HW-IN00 (Revise 8/2012) DZU 91 H ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to 'RO na I d Iy o (- orl s property located at A -12- U 16 C-a (Name of Property Owner) (Addres: on I)ntan hp,, )+ 13aq , in N.C. 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) y M WAIVER SECTION I understand that a pier, dock, mooring 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.) ✓ ` 1 do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Inforl, ation) Signature Ronco � Noy-+n n Print or Type Name ,21_9,1 5, NC HiAujau; E 4+ Mailing Address I Date (Adjacent Property Owner Information) Date f- -2� 9tazd 2A?IR Lf (Revised 6/18 ffg2i 8 2020 DCM-MHD CITY 0 0 rtL1Gt1 $AY4=CALL x 0 s - a ® ; j a w N a M15' •��,�\� ``\ £ =vwo m 1-� o \ \ S v g '\ im, \\ s'\ No �✓I 5p tlM13��• NO o of w `C `o�S1 PH 3° aya Lae wean Y v p$F O £go O W LU �Y3 g arcuw_ V T" :fig Y°a �or> W w n> "§ ME LL V { gg� a`ap II dYX 3]u]tl333tl e>5�%ao�v�€ � 1=4P Qg rjYa3 -.aY'§a c YW;:6835 (pit LY $jI� tl§ a5SFm51ursixINNIxltlox i§ scsai- L � „, ..aSisass:ues_ueSe