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Home My WebLink About74570D - FutchCAMA / r: DREDGE & FILLS NO. 74570 A B C( D J ENERAL PERMIT Previous permit# New Modification ❑ Complete Reissue ❑ Partial Reissue Date previous permit issued As a horized by the State of North Carolina, Department of Environmental Quality / Z 0Q and the Coastal Resources Commission in an rea of environmental concern pursuant to 15A NCAC CJ 1 Rules a ched. Applicant Name t/ & - Project Location: County Address City 77 Phone Authorized Agent Affected ❑ Cw !iwA 1pT AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ PWS: ORW: yes /(f—,> PNA yes v146d Stree dress/ 5me Road/�%oof #'(ss) , State, y.3 � �i�- V l • tail 41�ubdi i ion City ZIP '. //, ❑ ES ElPTS Phone # River Bas'n l� i/ 4 ❑ UBA ❑ N/A Adj. Wtr. Body I Fnat an unkn Closest Maj. Wtr. Body no -sir■■■■■■■■■■■■■■■■■■■■■�.■■■.•��:■��■■.. MEN n■R■ ■W■MME■■■■■■■iOMERKA ii■i■i■■UwM. 14. ■�■■■■i■■�■��iiwi�i■ice■■■■ii■■■■■■■■ ■■■■■■■■■A■®■■■■■■1111■�/■■■■■■■1f�/1��1R IMENOMMOMME92 M. M. ■ME■■■■■M■■■ ■■■■ui■■■R N I1MI NN M MENEEM %■ •■■■■■■■i1►1■■■■■■■■■I�1�1■■■■Af/�"i�!■r■�tmii■ ■�� Ong ■■�'I' ��wst��■■■■■ ■■ No IlL16�!►i7Ll�J[�ii: �■ �!i�/uu�,►'-'�u��st[!s!�� -- ' ■�rl'J� � ��Til�� "i� G"irr ,■■�i'��1�� ■■■L ■&1kw Ai6&O.1;X �iw��i��w iii�i�■■ ®i�iiiiiii® � Printed Signiure ** Please read compliance statement on back of permit ** 200 -- /(�L)z Application Fee(s) Check # n AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION fame of Property Owner Requesting Permit: KCtWAJC,4-k. W - 1-�_L47 c_% Mailing Address: / �Zc c l< u 41C wZ Phone Number: 63 / D - 2 -.-"2 _ 3<D y Email Address: K ; I • C-eC rn 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 in 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: C4j �f�- Signature KeAly -e—A V �/ '(4 i CJ' Print or Type Name rn e- -42 Title C� /�/ � 61 te Da RECEIVED This certification is valid through 0CM WILMINGTON, NC ■ 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. I. Article Addressed to: v ❑ Agent B. ecjrby (V1 to e) I C. Date of Deli v K.., I .� (- I i ._ D. I delive a dress different from item 1 Yes .i m If YES, ter delivery address below: No L45 yJiI✓)IIL4 ajC II I IIIIII IIII III I II IIIII I I IIIII 3. Service Type ElPriority Mail Express II III II I IIII III El ❑ Adult Signature El Registered MaiITM 9590 9402 4454 8248 2295 21 ❑ Adult Signature Restricted Delivery ❑ Certified Mail@ ❑ Registered Mail Restricted Delivery ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise 2. Article Number (Transfer from service label) ❑ Collect on Delivery Restricted Delivery ❑ Signature ConfirmationTM 0 ❑ Signature Confirmation (} �7 �7� _ 7019 070i�/777'~l/��l e,'��7/�r/iti111,11fthlPPj"//I/, Restricted Delivery orm;R1111, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt ; ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to c,q .j,L \/I/ �`(�`cCG` property located at 3(C> Ciz� 1� (Name of Property Owner) IG GG i� (Address t, Block on �71 ,Road, etch) (Waterbody) , N. C. (City(Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. i -r 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) +f_6c �ruui i n Shout i I Gn 17 -fo LAY-1) 0 S fxk/1 sr G" ( 13 50j'5cxJl'h t Je1 l- 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. roperty Owner Information) �gnature Print or Type Name 1 L cc I' e LL' Mailing Address Ciy/State%Zip Telephone Number Date rty Owner Information) v1 n c' Print or Type Name Mailing Address Slateizip - �-Z11f IK-yRECEIVED Telephone Number Zol`i Date JUL 9 5 '019 (RevisAih6MJNGTON, NC n r a�N1al�7►a��?J� '�I 7.vQ, " i, 1 Date Rew/vW Date De shed Check Fr um Nome Name o/ Permit Holder Vendor Check Number Check amount Permit NumberlComments Receipt or Re/und/RaalbcatW Columnf Column2 Column3 Coi-4 Column3 ColumM Cnlumnt ColumnB Columno 8/21/2019 Land to Sea Construction, LLC Goodman Middle Sound LLC First Citizens Bank Coastal Marine Piers Bulkheads LLC Mark Carter Wells Fargo Bank Kenneth W Futch & Be T Futch Wayne Futch Alliance Credit Union 89 $ 200.00 GP #74375D GP #74584D GP #74570D PA rot. 9167 PA rot. 9166 JD rct. 8797 8/21/2019 22963 $ 400.00 8/2 /2019 10652 200.00