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Home My WebLink About74541D - Grayi AMA / ❑ DREDGE & FILL NO. 74541ENERAL PERMIT Previous permit# A B C ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality (' t and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC Q l ��. Rules attached. Applicant Name i ti...' ,r Project Location: County �✓1_'_ Sw �— Address City w 1 1. AN Phone # ( t(>)_ Authorized Agent Affected ❑ Cw AEC(s): ❑ OEA ❑ PWS: State N C ZIP -IS'-U -ho ` E-Mail 61"a4, G-,•r 11 XEW PTA ❑ ES ❑ PTS ❑ HHF ❑ IH ❑ UBA ❑ N/A ORW: yes / PNA yes / <: Street Address/ State Road/ Lot #(s) Mot%"-e' SA Subdivision City 0 C?a,n (c,1# &4,ch ZIP -1 Phone # (90 ) S 8'Ll 7 (c,9'-1 River Basin Lv �••� l�< i Adj. Wtr. Body rA -K.- ( (nat / unkn) Closest Maj. Wtr. Body A 1 %AJ V{Z Type ofProject/f i�1. 11A• ■■■■■■■MEN■MIME ■■■■:■:�■:■■■■®■■■:■■■ NJ 1TWEIIIIIIIIII 00 I mom lawsm ME - ■■■:■■■■■■■■■■■�■■ice■■■�■■■:■■■::■ ■■lor"I""Em �■■:wNww"KIIIIII ■�■■■■: MIN■■■■■■■■■■■IMMEMEMEN�� ■■:N:■■■■■■■i■■■�■i: G��iI■■:■■■ ■■� ■ ■■■ ■■■No I■■itulir;�::��■■■■■■■ ■■H :■■■ ■Vi1■■ ■310i1101 MMww__qEw2F' am PEE MOP■■■■■■■■■:■■■■:■ No .��•-- �I�r— M. ■■■■■■■F1111111EW ■■■:■ 02TI ■■ ■■■■■■■■■ 0■■■■�■■■:■■■: .nW■■■■n■■:■■:�■ M. - ■■■®■■■■!'CIA■■■■:■��®■■: • - ■t�� mom ■■li!►11■®■� ��ij. .�Jitiii■■ :■ :■■:■■■Iii�l-ii ■��!TrJt�r ■■■ ME • ■■i:��I��■:■:■:■■■:■■ limmos�m:::i■::r �i■■■m■■ pffil"■ IN 0111111 �m AdalwAIIIIIIIIIII I ME I ME ■■■E1O■■■ ■ E■■■■ME■■■®■■ NOMINEE■: m �':::�:■i::�::smm■:�m :::■ IN w • • \ ■ Agent or Applicant Printed ame. Signat a ** Please read compliance statement on back of permit* n �, <<J Appl tionFn Fee(s) Check # le /uC Pe�mitL3iGt_ J ame.__ Signature Issuing lbate7 I ExpWation l5ate iZml% z -)� " ' w 1�.� } Zz�L - bQ� L -Z - Q �o� kAc)a ,3b b��u� vv a1 s� sR� Imkv, \ Cl 01 L hL qL 9�1 411 t 4 dlpDS 'D4 JON 7)(- NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis John E. Skvarla, III Governor Director Secretary AGENT AUTHORIZATION FORM AGENT AUTHORIZATION FuRm Date: Name of Property Owner Applying for Permit: N ;e, of Authorized Agent for this project: Ti„%%6i;'- r C C�n L Owner's Mailing Address: S(r2S ,Aw.dr'c..�r R.tsa� Lo.� Phone Number(gto ) S$y 1 G qy Agent's Mailing Address: \\ l.t, D VJ) 4e Z — SW Phone Number ( 0J S% c(-Ctk)gS 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): For my property located at iYiJ n ro S�, d i r This certification is valid thru (date) , \Ub QJ�N'nrne.0n Property Owner 61nature Date 127 Cardinal Drive Ext., Wilmington, NC 28405 Phone: 910-796-72151 FAX: 910-395-3964 Internet: www.ncoDastalmanagement.net An Equal Opportunity { Affirmative Action Employer a a u1.11 1 i DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROP11M OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: Grctq _-�7t Address of Property: 1 tD 1 ` 1yS1i`Q �:-/-Jn.LS�C' ---- (Lot or Strveet *, Street or Road, City & County) Agent's Name #:G(-1Ct RS i'Ll(� riy,l Mailing Address: t1 U 62COA Agent's phone 5: `\\o-1�-1fA"g� � — �. �XJ►r� 'S� H( 2,%u V? I hereby certify that I own property 9djacent to the above referenced property. The Individual applying for mac- this permit has described to me as shown on the abched n the development they are proposing. C � P ! I • �3•zo�s have no objections to this prolwsai. I have objections to this proposal. c if you have objections to what is being proposed, you must noffy the Dfvlmkn of Coastal Cr Management (DCM) In writing within 10 days of receipt of this nodee. C v houid be malted to 127 Cardinal Drive Ext., WHminpton, NC, 28405-38I8. DCM rsprese also ba contacted at (910) 796-7215. No response Is considered the some as no objection WW ** t+ven C nodN*d by CerdNed Mall. WAIVER SECTION V'j 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 a' setbar,}�, �3o9iate blank below) 15' setback requirement. I do not wish to waive the IS' setback requirement. (Property Owner Information) Signature Print or Type N e--- Marling Address hit Z$�iUC city/stat&7 QtU--S�y -`1(0cm Telephone Number Date (Adjacent Prop" Owner InformatknkL sibnalure r. Pnnt or Type Name �•�- 8��ra61�,>� �E Meiling Address �09 Cit)6/state2ip ' Telephone Number Date Revised 6/782012 N CgRTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION Off POASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner:, \G7(-Qo1 {�/} Address of Property: ` CiyicC —+'6`� y"j`�"� 1 (Lot or Street #, Street or Road, eity & Coun4q-- l , Agents Name #: �r tiCt � i'1�.Cr�l��1 Mailing Adddress:Wb �f\ Dc— Agent's phone *A*- *- rJ��'gb9rJ �n -� 61Q Lw. HIL 2-116 Q 1 hereby certify that I own property adjacent to the above referenced property. The individual applying for -^ this permit has described to me as shown on the attached Drawing the development they are proposing. ditiec�intigri ar drawing w(lh imerrtal ps. inumfomvided wish this l got .r I have no objections to this proposal. I have objections to this proposal. CrIf you have objections to what is being proposed, you must notify the Divigion of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Convspoiiipt4 hr a should by mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM rvpreseo� can also be contacted at (910) 79&7216. No response ►s considered the some as no objection ffy+oOftw been C notified by Con led Mall. WAIVER SECTION V1 I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) / 1 do wish to waive the 15' setback requirement..; Aq!'t?6= -ttJ 5A 41 I do not wish to waive the 15' setback requirement." (Property Owner Information) �A" Siignalwe llmOWkJ G'�'�V Print or Type NA(ne i Sk040 F�nd(-ems Mailing Address cilyistateiz, Qw- S M-`1(0CN Telephone Number Date (Adjacent Propgo Owner Date Revised 611812012 ostal Service"'FTIFIED MAIL° RECEIPT F stic Mail Only ivery information, visit our website at www.usps.com AV:5W!.wj1 • 1t CC Certified Mail Fee J . _ 0 .� ... ... 0470 -I- r` $ 9� Extra Services & Fees (check box, add res all))NIer/Ye) ❑ Return Receipt rLle� C:3 (hardcopy) $ ❑ Return Receipt (electronic) $ • f Postmark CJ ❑ Certified Mall Restricted Delivery $ � n . Flo Here C3 C ❑ Adult Signature Required $ ❑ Adult Signature Restricted Delivery $ O Postage $ 0. r5 `° ,� $ 06/10/2014 Total Postage and Fp�ss O� iQ E3 .O.I rr-1 Sent 17 ��`� ----- ----- - - Cr fate ZIP+4® -------"--""- ' " `7(Aw