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HomeMy WebLinkAbout73535D - BeckhamCAMA / ❑ DREDGE & FILL GENERAL PERMIT (XIN�w ❑Modification El Complete Reissue ❑Partial Reissue No. 73535 A Previous permit # Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 011 N . 12 CIO s ❑ Rules attached. ('.. Applicant Name AV W, gsc K+WA Address Irl CIAQ%N CIRCLE City MVATL4L- 15C ACA State CSC ZIP 2-A S 72 Phone # (,9*5) 449 - 741IT E-Mail NIA Project Location: County $Tz�1J5WtCK Street Address/ State Road/ Lot #(s) 24 RAC:fcy-y 5-N-MI :T Subdivision HJ& C Q Authorized Agent WAAVA 604CF- _ City (ktAfJ SSLX BeALR ZIP -2-2 (f 9 Affected ❑ CW 'gPTA ❑ ES ❑ PTS � Phone # (9116 ) 511 -gM 5 River Basin (- k,, qr� AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: Agent or Applicant Printed Name Signature* Please read compliance statement on back of permit 02Uo 13073 Application Fee(s) Check # Adj. Wtr. Body CA)VAI-- (nat /man /unkn) ri .tee.. M-; W., Q-A., A Ian/ bpi rY I'MC- Permit Officer's Printed Name Sig 2o1 to 7 Zo19 Issui g Date Expiration Date A�� NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis Governor Director John E. Skvaria, III Secretary AGENT AUTHORIZATION FORM AGENT i ON FORM NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis Governor Director John E. Skvarla, III Secretary Date: (/ _ 29 -)(� Name of Property Owner Applying for Permit: I'�1A 14 Ct1_k)J0A7 Owner's Mailing Address: � ­i eii C i/i1 cp IATIE 6-tI01-41 C Lr)S7L Name of Authorized Agent for this project: 61?1a- Coluou,47;6,A-1 Agent's Mailing Address: Phone Number { aIL 3y b ~ 74 .� Phone Number L_ I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct the following (activity): lib_ 0,04C !n <_t)tr/;L, ` ;.Y 241EFei/tl) S� pt&-/)r-. 1�t y 127 C3rdmal Dnve ExL, Wkr*VW, W: 28405 Phor* 910-798-7215'' Fix 91N395-3964 Internet: www.mcoa-wimarw4 mew.rw Ad: -ou4 ,-=a Lnq , A Auliur Enarc- For my property located at qk�W ft . a 6? emc.11 This certification is valid thru (date) . 9 YW Property Owner Signature Date C' .Ja C CERTIFIED MAID, • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: �C�w' ' ! ISL'Cky� on Address of Property: 2L� 4Q( (Lot or Street #, Street orlRoad, City & County) Agent's Name #: Gr ICE �hS�ruC�ly� Agent's phone Mailing Address:"+� 1QQCh Dc &g-Ar):�Q �NC 2-,64�U I hereby certify that I own property 9djacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached orawing0he development they are proposing. A descrintion. o ,with dimensions, m4t.ktebrovld6 with this letter. I have no objections to this proposal. _ _ I have objections to this proposal. K you have objections to what is being proposed, you must notify the Divislpn of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspo"Aiae should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represent can also be contacted at (910) 796-7215. No response is considered the same as no objection lfyryld'Jt" been notified by Certified Mail. 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 Information) �0 �MRZ d LqgQ6- ) Si Ynature co,C-0� R, Print or Type Name n C �')q,-), (2, C Mailing Addreis City/S te2ip SL�3 LH9 -1 �1 S Telephone Number Date -- ------ (Adjacent Property Owner Information) Signature l 11C1 _ �^ Print or Type Name P o �> 6;,,- �-, ( ( Mailing Address City/State ip F S-tl) - u Telephone Number Date Revised 611812012 CERTIFIED MAID, RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: Cckr-O �+ �eCk�qm Address of Property: ' G �� �� 5 C co-n5�( (Lot or Street #, Street orlRoad, City & County)- - Agent's Name X— r ict �'R �uC��ly(� Agent's phone #: %U + 57- Ci O95 Mailing Address:WD &QC\IA D— kxt� N( 2,6%q I hereby certify that I own property Eidjacent to the above referenced property. The individual applying for th permit has described to me as shown on the attached Irawing�the development they are proposing. I have no objections to this proposal. _ I have objections to this proposal. �. if you live objections to what is being proposed, you must notify the Divisfpn of Coastal Manage�`1,ent (DCM) in writing within 10 days of receipt of this notice. Correspo taw" ce should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representAdVAM can also be C contacted at (910) 796-7215. No response is considered the same as no objection ffydillis +s been notified by Certified Mail. WAIVER SECTION I derstand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a i 'm m distance of 15' from my area of riparian access unless waived by me. (if you wish to waive the tb 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 (Property Owner Information) ,�An MRL'd LgCrA> ,Sinature T �af-0 � �e 1 Print or Type Name n C�)qp�C�rc Mailing Addreis City/S te2ip Telephone Number Date Property Owner Information) wg I ture C- 1 Print or Type Name -F6X 66L-t Mai 'ng Address ��(')+-, 10� 2�3Z� City/State2ip L9(6- 3�'�--�,22'5 Telephone Number U-�O-1� Date Revised 6/18a012 ■ Complete items 1, 2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: �CA)(1 42n 1A kz r- ��•��n I�t� Z��Z`6-311U I III' III II I II I I I I II I IIII IIII 3. Service Type El Priority re ❑ dull Signature ❑ RegisteredMail- 9590 9402 2219 6193 1046 53 El Adult Signature Restricted Delivery ified Mail(D ❑ Registered Mail Restricted �2elivery ❑ Certified Mail Restricted Delivery �+ieturn Receipt for ❑ Collect on Delivery Merchandise 2. P nu,- — rr,—f r fr— — i— r.tion ❑ Collect on Delivery Restricted Delivery ❑ Signature ConfrmationTM ❑ Signature Confirmation 7 017 013130 0000 7487 0184 estricted Delivery Restricted Delivery PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt 0 fiVTO r_9fit'_ 0000 0990 zToz n =� ■ Complete items 1, 2, and 3. ■ Print your name and address on the reverse P" so that we can return the card to you. ■ Attach this card to the back of the mailpiece, I or on the front if space permits. N1. Article Addressed to: \ SJ Oil- `C6TO 2-9fiZ 0000 0990 LTOZ �4 ❑Agent ❑ Addressee B. Received by (Printed Name) C. Date of Delivery D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type n Priority Mail Express® I IIII III II (II I I I I II IIII IIII ❑ Adult Signature a Registered MaiITM ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted 9590 9402 2219 6193 1046 46 jCrCertified Mail® ❑ Certified Mail Restricted Delivery Delivery a94aeturn Receipt for �____ •- •• ❑ Collect on Delivery - elivery Restricted Delivery Merchandise TM III Signature Confirmation :_,_ .,.. �__ r____�__ _ _._ 2, 7 017 0660 0000 7 4 8 7 0191 . Restricted Delivery ❑ Signature Confirmation Restricted Delivery I (over $500) PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic - curn eipt i Z-4 CcvN,cA-� ME Lrdu We be z ct5 "7Z � Nod to Scu�P ct-� -�- �t� p zz_ INC :2:u Z T3 i Date sited Check From Name NameofPermifHolder Vendor Check Number Cbeck ount Permit Numb—r—rnanfa Recei t or Refund/Reall-ated :--i—Colu-2 Column3 ColumM Column5 Column6 Column? ColumnB Colamn9 Grk:e Constnxbon of wick County Im Carol Beckham IBBBT 13073 200 00 'GP #735350