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Home My WebLink About74755D - Brandt'��CAMA / DREDGE & FILL NO. 74755 A B C PERMIT Previous permit# �ENERAL lew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality !' I� 07 4 and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Applicant Name V� !` N t ❑ Rules attached. Project Location: County FTE:N Address 32 O L- f TT LE 10 S7 (4j tS - Street Address/ State Road/ Lot #(s) City State N ZIP Phone # E-Mail Subdivision Authorized Agent � N/Je7-i ( �M/' ► wc- City L' ZIP El f�' ' EW PTA ❑ ES El Phone # ( �—�Q� % River Basin W Vvt.�sz o(,t.ft Affected AEC(s): ❑ OEA I HHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body /fa man unkn ❑ PWS: ORW: yes / (,no PNA A / no Closest Maj. Wtr. Body�cJ.a Type of Project/ Activity L/ A 5 -1 /( /' n-C-OJ Gt '� /= Fixei Flom Fingr Groi Bulk Basir Boat Boat Beac Othr Shor SAV Mor Phoi Wain (Scale: ■■■■■■■■■■■■■■■ ■■■�•■■■■I�1■w•■�■■■■■■ cubic yards_ ram Mom= ■�i■l■ 'J■■■f�IlwiiJ■■N■■■■■■■■■®■■■■■■■ ■IIIM■■ ■■M■MM■ ■;��■■ ■■■■■■■■■■■■■■■■ • ■��■■■, ■■ ■■■■MOif MME■�■w■�■■ AMEN Bulldozing GO i ■■■■■■■■■■�■■!�I ■■■� ��■�■■■�■■■■■■■■■■■■■ ■ ■■■■■■ ■■ arc �+�r.i�� -��w■w w�■�w�■■ ■■■■■■■■■■�■■■■ I■I�J�=l�ii�111.�1�■�:■Sir��e�ir'�c��■[�7■■ Length not ■■■■■■■■■■�■I■�■�ViW�■�s■■��;iY'itl�% ■■■ sure yes■■Jine FIS: yes, ■■■�\lb1�I Rill ■`� // n■' �1�f!I1�;":111■■■■!'�!'■■■■■■■' . , - . o , . /1'�SI�■i1li.��'fiir�L«lf�lfl■ii■11 i I■■■■rltl■■■■■■■ A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions -6c 2sp of � s /1 _ ( f/ ❑ See note on back regardin River Basin rules. I'FXISi i 9- /F► 1119;0 6rry Tffy � or Applicant Print rin d Name ire ** Please read compliance statement on back of permit D 7HF IN Printed 0'0,2S-- fc Z•Z,c,--Za Issui g Date Expiration Date Application Fee(s) Check # Project Subject CC By Page... Of Ilsom . ........ 4- 014- AA 1-4 --Age ADJACENT RIPARIAN PROPER I hereby certify that I own property adjacent to _rn t , T �. N Ltd y property located at 3.�0 .l.-'TT G (Name of Pr�� Owner) .cam (Address, Lot, Block, Road et, � �t1 , in �: �4t , N.C. (Waterhody) (Cttyt7own andlor Countyj The applicant has described to me, as shown below, the development proposed at the above elocation. __.4_ I have no objection to this proposal. t have obJwXons to this proposal. DESCRIPTION ANDfOR DRAWING OF PROPOSED DEVELOPMENT {Indiv/dual Proposing development must f711 In descriptIOn below or Attach a site drawing) WAIYEf3 8EC_ TION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 16' from my area of riparian access unless waived by i� me. (if you wish to waive the setback, you must initial the appropriate blank below.) fill —�< 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) Signature Pant or Type Name P0 i", ox 2 Matting Address Crty/$tate2ip �� ra Ho orn Talep ne Nam /small address uprf 'Valid for one calendar year after Signature" Signature'" Pn or Type (tame Marling Address co`y/ls__tata/Z,p Te/e hone Number/email address Date' (ROv4*ed Aug. 2014) Date Received Date De aped Check Fom Name Name of P—I( Holder _ Vendor Check Number Check amount P—it NumbenCommnda Recel t w Refut WwOocated Columml Col~2 Column3 Columnl Column5 Column8 Column? Column9 Column9 7 I.Idt P #74755D ADJACENT RIPARIAN PROPERTY P ! hereby certify that 1 own property adjacent to )'_?�✓, TnG Ha� l-� s �/ (Name of Props Owner property located at .3�►p .l.r�TT� ) on ,� (Address, lot, Block, Road,etOg f in �/1�,,�` t� , N.C. { (Vtlt rbody) (Clty/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. 1 have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT t 1ndividua( propaaing development must Ml In description below or stfech 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 16' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) 00 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) Signarure � Srgnanrre • .o (= 1 � i'� N D " i G�rf!,pirl�- .�;: !. 'moo ✓� Pnnt or Type Name P ript or Pd t3oxy j�7�pepamq 2- Mal 1117 g S n MalA/I p Address Crty/ytatelzip b� CitwstatelZip Te/eDhane Nu- r►'r_tWT/small address 're/e hone !lumber/email address Dare' (R6v4sed Aug. 2014) 'VaAd for one calendar year after signature* ADJACENT Ri MAN PRtSPERTy OWNER 1 hereby Gertify that i own property adjacent to S r, yyg. s ,s (Name of Pro rrty Owner) property located at .Z.t'ittria� .� (Address, Lot, Black, od aton �j In N,C. (Woterbody) (C1ty/T0wn d—kr County) The applicant has described to me, as shown below, the development proposed at the above I have no objection to this proposal. 1 have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Indhrldua( proposing development must fill In description WOW or attach a $Me drawing) WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me, (If you wish to waive the setback, you must initial the appropriate blank below.) 411-1 1 do wish to waive the 15' setback requirement. i do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner ormation) Signature Si Lure * ,n D' Print or Type Name Pd x lr � Print or Tye Name co� 3 _ � Marling Address Mailing Address L# S �'�% �� 1 L Clty!$tate/Zip CifylStstellfp t }by r a v Sno i r� rs�(� Teiephne Num r` email address Te/e hone Numb Date / amafi egdress c� (} 7 ` f ``� *Valid r {Revised Aug. 2014 for one calendar year after signature t, ;