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Home My WebLink About72712D - DixonI 1 r'-C611VIA / DREDGE & FILL NO. 72712 GENERAL PERM IT GkM� ��l Previous permit # A B C XNew L__�Modification ❑Complete Reissue El 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 environmental concern pursuant to 15A NCAC G % }-{ 2 J C (-I Rules attached. Applicant Name Address _I 50 { C'AVrnID►s►_k Co,g, City C1AAR(.oTrr= State ZIP .2 ?2 11 Phone # (ILA) 2 4 1 - 5378 E-Mail )1I 1A Authorized Agent -'T;Ac E'y FAR rAry- ❑ CW XEW %PTA ❑ ES ❑ PTS Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A ❑ PWS: ORW: yes /'no" PNA yes b no` Project Location: County 13WtAN Sw t c K Street Address/ State Road/ Lot #(s) 1-4 1,N SOA/ S-r 2ct:-r Subdivision City Oc r- A nl L- 5Lc Yr A, t.i ZIP 2 F4 (p c Phone # (A 10 ) 44 3 - 779 3 River Basin L-k r`lrzr R Adj. Wtr. Body C A n/A L (nat tan d/unkn) T Closest Maj. Wtr. Body A j W W Type of Project/ Activity R E L. A c r- -D cr-, C I t ,y (-, TA c r L r; v r N 7- x r S T r N C, Fixer 1 Groi Bulk Basir Boat Boat Beac OtN Shor SAV Mor Phot Wait N rI e7 1 (Scale: I " � ZL , ) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■�\ i� . ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ length ■■■■■■■r�■'�■■■■■■■■■■■■^■r�■�■■■■■■■■ ■■■■■■■�i�■�■■a■rr�■:�:■■c■c�c■c�■■■■■■■ ieJLi,'iprap length max clist�,,ce offshore cubic yards ramp ■■■■■■■■■■■■■■■■yll■■�i■�11■ ■■■■■■■■■■■ louse/ Boatlift■■■■■■■■■■■■■■■■1■■�■��►�`:r� ■■■■■■■■■■■■ " • ■■■■■■■■■■■■■�■�1■■�■1i■`' 1■ ■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■!■■1■1 MEN ■■■■■■■■■■■■ c'L9M■■■■■■■■■■■■ill■■�■■lI■■tI■� ■■■■■■■■■KCI*J �■ ■■■ ■■■1■■ ■■■I■■I■■■■■■■I■ ■■■ ■■■I ■■■■ MEN ■■■■■I■■■■■■I■■I■■■■■■■I■ ■■■ ■■■' fline Length not sure yes els: yes m Attached: _m■■ M■■■■ MEIN IIIININITT-AMMEM ■■■■A■■■■■■■�■■■■�■�■■■��■■■�■ ■■■■�■■■■ ■■■ ��■■■■■■i■■ ic�a■:�■■■■i■ ■�r I A building permit may be required by: —To—Liti Oc_ BA'F-tz A,.,A ❑ See note on back regarding River Basin rules. ( Note Local Planning jurisdiction) Notes/ Special Conditions 011 14 � 12 O (b AnID ALL O —1 N rr M L of A L_ � A—f rr AAIO FT'- Dt= C2 AL_ RT" C,tALA , ic--^ - A PPL-I/ . Agent or Applicant Printed Name Signature* Please read compliance statement on back of permit Application Fee(s) Check # Permit Officer's Printed N G /(c Signature 22 2019 5 22 2019 Issu g Dat4 Expi tion Date IFA NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management 'at McCrory Braxton C. Davis Governor S 01 S Director "r �lz AGENT AUTHORIZATION FORM Date: / - �- l `1 te of Property Owner Applying for Permit C � nmer's Mailing Address: , lone Number John E. Skvarla, III Secretary Name of Authorized Agent for this project: Agent's Mailln Address: Phone Number( ertify that I have authorized the agent listed above to act on my behalf, for the purpose of applying and obtaining all CAMA Permits necessary to install or construct the following (activity): it my property located at it- L-ALL 5611 5i — [)rDA,, Zs LO lam, /U(— is certification is valid thru (date) Property Owner Sig oture /- Y/- Pi Date 127 Cardinal Drive Ext., Wilmington, NC 28405 Phone: 910-796-72151 FAX: 910-395-3964 Internet: www nccoastalmanagement. net NorthCarofina Nahmally An Equal Opportunity 1 Affirmative Action Employer DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM Name of Individual Applying For Permit:411ri Address of Property: (Lot or Street #, Street or Road) (City and County) 1 hereby certify that I own property adjacent to the a ov : n: ere o,ced property, The individual applying for this permit has described to.me as shown on the attached drawing the development thev Are proposing. A descr' tiori or drawing, with dimensions, should be provided with this letter. I have no objections to this proposal. If irou have objections to what is being proposed, please write the Division of Coastal Management, 127 'Cardinal Drive Extension, Wilrnin;ton, NC 28405 or call 910-796-7215 within 10 days -of receipt of this notice. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION understand that a pier, dock, mooring pilings, breakwater; boat house or boat lift must beset bck a minimum distance of 15' from rriy area of riparian access - unless waived by me. (Ifi.ou wish to Nvaive the.setback,'you must initial the appropriate blank below.) x Sig— M. Ne c / o f/ I do wish to waive the 1 5' setback requirement. I do not wish to waive the 1 5' setback requirement. Telephone Number with Area Code Date r NCDENR rwARQ.-L-r µo NCUI1 A9.I6WCLt r r 5 DIVISION 4F COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Individual Applying For Permit: l Address of Property: Sl _ (Lot or Street #, Street or Road) (City and County) hereby certify that I own property adjacent to the above-refirenced property. The individual applying for this permit has described to.me as shown on the attached drawing the developmentthev Are proposing. A description or drawing, with dimensions, should be provided with this letter. 1� I have no objections to this proposal. If Srou have objections to what is being proposed, please write the Division of Coastal Management, 127 'cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215 within 10 days -of receipt of this notice. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION understand that a pier, dock, mooring pilings, brealnvzter,.boat house or boat lift must be set bck a minimum distance of 15' from my area of riparian access - unless waived' by me. (IfNIou wish to waive the.setback,,you must initial the appropriate blank below.) I do wish to waive the 1 5' setback requirement. I do not wish to waive the 1 5' setback requirement. Sign Nam Date L) acw�lf T-� Print Name Telephone Number with Area Code K ;A NCDENk C.ARG.-am µp N.CU AL ROCURCca ■ 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: tow R-Z-Ar- 4f� �a RC>x C,4l(oA <SC- 121 � 701-/ X❑ Agent ❑ Addressee B. Received b(Piwr�Name) C. Date of Delivery � D. Is delivery address different from item 1 T ❑ Yes If YES, enter delivery address below: ❑ No IIII III II I II it II I I I I III II II I III I II III J. Service Type ❑ Adult Signature o Priority Mail Express® ❑Registered MaiIT^' ❑ Adult Signature Restricted Delivery ❑ Certified Mail(D ❑ Registered Mail Restricted 9590 9402 4036 8079 7369 44 ❑ Certified Mail Restricted Delivery Delivery El Return Receipt for 2. Article Number (Transfer from servira bhAn O Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery Signature ConfirmationTM 7018 0680 0000 7024 7549 Insured Mail El Signature Confirmation -- Insured Mail Restricted Delivery over 5500) Restricted Delivery Ps Form 3811, July 2015 PSN 7530 02-000-9053 Domestic Return Receipt r ■ Complete items 1, 2, and 3. A ■ Print your name and address on the reverse 114 so that we can return the card to you. ■ Attach this card to the back of the mailpiece, B. or on the front if space permits. 1. Article Addressed to: Zs9t11ne— l / e4,C� IIIIII IIII IIIIII II II I I II I I IIII II IIII I I -90 9402 4036 8079 7369 51 7D18 0680 DDDD 7024 7556 PS Form 3811, July 2015 PSN 7530-02-000-9053 Ip OAgent J1ax& %`U Addressee by (Printed Name) C. Date of Delivery D. Is delivery address different from item 17 ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type Cl Priority Mail Expresso ❑ Adult Signature ❑ Registered Mail- 0 Adult Signature Restricted Delivery ❑ Registered Mail Restricted ❑ Certified Mail® Delivery in r—tified Mail Restricted Delivery ❑ Return Receipt for ect on Delivery Merchandise act on Delivery Restricted Delivery rTT—nsured ❑ Signature Confirmation— Mail U Insured Mail Restricted Delivery ❑ Signature Confirmation Restricted Delivery lover $500) ern Receipt I I '701L tgA wQ� � oN 1� r �► , off - �� Date Date Rec.Ned D Cheek From ame Name of Pamdt Holder Vendor Check Number Cheek amount Pennk Number/Comments Revel t w RetundNReallocated _ Colw l CokamT COIw 3 Colu-4 aolu... Colun_rn6 CaN/mn7 Column8 Column9 1/27/2019 1 Steven or Tracey Farmer I Karl Dixon BB&T 5166 $ 200.00 I GP #72712D TMc rct. 7728D