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Home My WebLink About74367D - ConradI 1;AMA /IE IPREDGE & FILL NO. 74367 A B C D ENERAL PERMIT Previous permit# ew ❑Modification ❑Complete Reissue ❑Partial Reissue 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 a vironmental concern pursuant to 1 SA NCAC I Rules attached. _ �, Applicant Name 4' `^ V-�n / Project Location: Countyyl%) � Address LA C � �Z U � 1 V V Street Address/ State Road/ Lot #(s) City StateN.0, ZIpc�>'--) L-1 0+ z7j Phone 1 \ Authorized Agent , V L } ❑ CW CJW �*TA ❑ ES ❑ PTS Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes / no PNA yes / no Type of Project/ Activity Pier ( tw- I )( Fix Float Fing Groi Bulk Basin Boat Boat Beac Oth Shor SAV: Mo Phot Waiv Subdivi_$ion zip Phone # ( ) River B n 1, i Adj. Wtr. Body a na ma unkn Closest Maj. Wtr. Body J (Scale: 1 /� n r pier(s) ■■■■■■■■■■■■�i��li■■■■ ■try■■■■■■1��■■■■■� , length ■■■■■■■■■■■■■■■■■■■■r■■■■■■■■■r7I//,�■■C%■ iip ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■I��i�y ■■■■■■■■■■■��■■■\■■■■■■■■■■■■■■■■u■■■ ■■■■■■I�■■F_■ � =all■!!■I ■■/I■■■�■�i■■■■■■■■■■i;■ ■■■■■1t,■ii■ ■ tliiiiliil\■%■■■/�R�'/'/J\■■■■■/�7■■■i■ ■■■OR. lML■CAS i■n:�r� ■■■i►:��hCl'iG1NUME■53MU■■V1!■ ■■i!:,y1t�l►ioJ■[i ■ ■■11■�%� ■[i■■l�■Ylilur■1■C^��a1i■■■�11! Bulldozing ► ■■■■� ��i��i��■��■vim■■■�11�R� �!�■■■■ �J■■1.'��I'iill■■■■■■■■11■,■■■1�■■■■■■■■■■■■■■■■■ - :....l�®■■■�■■►r.��,►►■►r� err■■■■■■■■■■■■■■■■ LW A building permit may be required by: ( Note Local Planning Jurisdictioq Notes/ Special Conditions —AY G Agent or Applicant Printed Name /) ul Signature ** lease rea compliance statement on back of per �jt ** ��-- hi -1 re ❑ See note on back regarding River Basin rules. ApplicationFee(s) Check# IssJing AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: Phone Number: �' -%9 - 5� Email Address: oA"�i I-�1G1 Sr✓o�o C6 ! certify that I have authorized U ,\ , ; dA\kmr� M G�afVC (V Aaent i Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: - J at my property located at i '�.� ti in • ru`n LU i L County. 1 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 Owne nfor do Signature p Print or Type dame �� ..J /)G Title Date This certification is valid through —LUG 11 i CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Marne of Property Owner: Address of Prop-edy: J20 Sw 23r b I of or Street Street or Road, Citl& C Linty', �- Agenfs Narle #: [ Se OVA, I iriaiiing Address: 5___r_ , l �Ui CCu dl I hereby ceni J that t ot':1 property adjacent to ti?e above referenced prope:'t'y. The individual ipolyin�7 for this permit has described to me as shown on the attached drati.in; D the deve!oprnent he are Drop ing. A description or dratvina. with dimensions. must be provided :with this letter. I ilil� l' !?t1 t n,ccttOns io this propoi ial. i?al!`c ilihCl'tlO1?s 10 lhltti t, (liht)s;ll. if you have objections to what is beingproposed, you must notify the Division of Coas .-/ ffanagement (DCPd)in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext., Wilmington, AiC, 28405-3845, DCh1 representatives can also be contacted at (910) 796-7215. No response is considered the same as no objection if you have been notified by Certified tdail WAIVER SECTION i 1indersiand that a pier, dock, mooring pilings, breakivater, boathouse, lii. or groin nliist be set back a minimum distance of 15' from rely area of riparian access un!ess viaived by me. (If you Wish to �:aive the setback, you must initial the appropriate bank below.) _ I do *ish t•7 vvaiva the 1 setback requir enlerll. I do not vvish to waive the i b' setback requirement Pro e ( p rtY or a " nr Taln r4ar!)r �{ � 1 � � r � � r�2jlcT•.S; •r: �tiStai� j?ir. -5-7'' L - Tak,phovu.- it'.:n)}i r (Adjacent Property Owi,*r Information) 7/7 pr)r)t Or 1 '. C f •':dl?)r; - ---- y�vJl 'It0 —a o!— IOSZ. Toic-phuni' i'la nli:'1 z'l" Cl CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATiONIWAIVER FORM Narne of Property Owner.-_ address of Property: 120 SW 23 \ln� kv(-��b5 t :?t//or Street =r, Street or Road, CA,., :. Coant•l? Agent's Name #: (�i S G O ivt2iiirlg Address: Se UP 1 9 � •�r Lul Ct:� �f .'geni'sinhorlefr: I hareby certify that 1 o::n property adiacent to the above referenced property,. The individuai applying for this permit has described to me as sho vn on the attached draw inr the deve!opment they are proposing. A description or dratvina. with dimensions must be provided %vith this fetter. i h;l1-e 111.1 ohik-ctiotis io this propos- '.� ! 'OM-C 011;CCURIi?S 10 U11-6 l if you have objections to what is beingproposed, you must notify the Division of Coastal ftanagement(DCfii in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ezt.. Wilmington, )VC, 28405-3845. DCM representatives can also be contacted at (910) 75E-7215_ No response is considered the same as no objection if you have been notified by Certified !hail WAIVER SECTION 1 understar:d that a pier, dock, mooring pilings, breaktvater, boathouse. li`i. or groin niust be set back a minim. in distance of 15' from my area of riparian access unless aai��ed by me. (if you Trish to vmiy a' tictback, you must initial the appropriate bank below.) _ i do :Nish to vaiva the 1: setbaoV require nien . ___- I do not .Nish to ~;naive the t 5' setback requirement 7 (Property or a' ( 'a nt Prope er Information) Data:! na T; �r. t>;�rt.•iF Print or Ts;rt r:aam L Ji4 j . U }" (r jlcTS� zir 1 Tei'�Rhf-'N: ikfunl ;,•±a 1,:1:!• 1:2 Kll� laik::i! Address _(f� To.lephunr: M , . f n o r-n Ci n-0 Dale Received Date De aHad Check From (Name Name of Permit Holder Vendor Check Number Chec untk P.—It NumoeNComments 4Column9 Recel t or Relund/Reallocated Columnl Column) Col-3 Column) Co.., Column, Column] ColumnH 1 1 -bO C —d F-t CW— Baok 06 00 00 GP a76367