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Home My WebLink About72718D - HorneCAMA / DREDGE & FILL GENERAL PERMIT �AA+Atl IWO 1W XINew ❑Modification ❑Complete Reissue []Partial Reissue No. 72718 A B C 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 I SA NCAC 017 N I 1 O C) ❑ Rules attached. Applicant Name CN/IPLESOc PA-ry.1c,A HaR/yF_ Address 2 044 3 Ugayoye a 'RD City CNAV I.pT- r=_ State ZIP282 I1 Project Location: County 12,,Z- L, At 5 w % c Ic Street Address/ State Road/ Lot #(s) 1-27- 11 At.•k(=F A/3LAF_c3 S:rR ri V__-r- Phone # (7�4)3(a3- 3441 E-MailehOmeQharne-nlec+rc, , Subdivision AVA Authorized Agent 6191 cr- COW _S-r iz fAc T,oA/ City Ue EAA/` :MF_ 8CJ M ZIP 2 $4 h c' Affected ACW ❑ EW ❑ PTA ?(ES )(PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A ❑ PWS: ORW: yes no PNA yes /® .Ac,t NTPhone # (4l0 ) 579 - 90915 River Basin Adj. Wtr. Body CA/VALL (natnat m Closest Maj. Wtr. Body Al W W Type of Project/ Activity C M2JAL4_ AJ6 w 13ta L icN c A ►D I Al I s-r-iaic, ALIC,un-AeVr (Scale: h =ZL ) Pier (dock) length \ Fixec Float Finge Groh ulkl Basin Boat Boatl Beac Othe Shon SAV: Mora Phot, Wary MENEM Platform(s) ng Platform( ■■■■■■■■■■■m`r`■li/�iifi/i�■`■ 1■■■■■■■■■■iiiiil ■■■■■■■■■■■ ■MEN ■■■■■■ !�■■_■■ ■■■■■■■ i length number ■■■■�1■■i■■■■■1■■■■■'1■■�11■■�■■ ■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■111f1■'�IL�! ■ ��1■■■■■■■■■■■ ■■■■■■■■■■■■1■■■■■�liiii Gill)■■■■■■■■■■■■■■■■■ ... lengthmax ■■■■■■■■■■■■■■■■■111■■_ �I I1■■ ■ ■■■■■ ■■■■■■■■■ avg distance offshore ■■■■■■■■■■■■1■■■�■lil liai�.�l l i1■!� ■ ■■■■■■■■■■■■■■ distance offshore— e% ■■■■i1i ■■�■■■■ 1■■i�i�illrfltilli■■i� I■ ■■■ ■■■■■■■■■■■ 10 Bulldozing i +�� rr�w�tit•<rt•r•rat•afa�f:lfifiri�t•fa�t•rt•�wttt• aalalaalalalatalOalfa •`fat•\ t•��t♦,�fT 7R1t• t•t• � �r�Malalalalalala . ■'isiVliiiiil3i�:�ti411E1��a\\\■■►�■■\ ■\\ ■■■■LWE L■■■■I v1�E1 ■■■P1■'■■■!.1■i OWEMMUMNE—■!I■`■■.�! ■■■■%r7■■■■ - � ■■■��'�i�l�ltilrisll■■■■■S�L'�'iL■I�■■■■■■■■�iii■■■■■ A building permit maybe required by:--raWA► DF Qc r M i-s,e. SrACA ❑ See note on back regarding River Basin rules. ( Note Local Planning jurisdiction) Notes/ Special Conditions 0714 . 11 n C) AND ALL o-rAr LU t AL t STA'r� ,AN 17 r0flE'RAL WC6aAL_A-r<nNs APPLY. WQ k-\� cl � 1 ( �U Agent or Applicant Printed qariae Signature * Please read compliance statement on back of permit $ 400 �# 12760 Application Fee(s) Check # PermitO ficer's Printed Name Signature 2'Z4L2o19 C./412019 Issuing Date Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Cha�l�� = a�� t�.' Z Mailing Address: 2o� S &L'Y/d//1V�l� C1Jwr/o, � '�(' Zall Phone Number: 7( ' �� 3� 3 �rl ��7. Ik Email Address: 'ei'''ml--e&hO'`1l(-caw I certify that I have authorized G-CQ '3m(IbW l (�u n L Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: 4er kNO/ 4_7/ ';�_7Z T_I�/F) 1!l tl_ at my property located at in /3WYISWII County. 1 furthermore certify that 1 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 Ow r Information: // Signature 1 camel-eS � - //o�//�/ 4);- Print or Type Name Z.)"160 Title Date This certification is valid through CEAJIFIED MAIL - RETllR"ECEIPT REQUESTEQ_ DIVISION OF COASTAL MANAGEMENT - -ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: Q�a Address of Property: 2Z �-4 ll(1 pU , uf 2Q �, Ckv— q6 [2 (Lot or Street #, Agent's Name #:Cyr rN:*UaIv() Agent's phone #: %0-- q o95 or -Road, City & County) -- Mailing Address:Wg lsz � NC Zhu I 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 Irawing the development "e are rp oposing. (Y a' I have no objections to this proposal. I have objections his -proposal. H you have objections to what is being proposed, you must notify the Di n of Coastal C Cr Management (DCM) in writing within 10 days of receipt of this notice. Corres � 'e s off► uld-be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 284gr3845. DCM repress ball also be • C contacted at (910) 796-7215. No response is considered the same as no objection y�ii►reeen notified by Certified Mail. WAIVER SECTION (._understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' fro of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) PI do wish to waive the 5�etback requirement. - -"— I do not wish to waive the 15' setback requirement. (Property DwnerJnformation) "` & %b-dLCt9e4A� i nature Print or Type Name 2D 'A 5 l�Jer e� RcI Mailing Address C%AtA-e N�- City/State/Zip 7A lcgg Telephone Number (Adjacent Property Owner Information) Signature�%� Print or Type Name q a ---/ - vd kd Mailing Address b� rN s �-en - 541e,,LL, N �2 -7 City/StateiZip Telephone Number Date Dare— Revised 611812012 --= A r-iall rq Ln For delivery visit our � o NC 234 : l 3 r- Certified Mail Fee $3.45 $ U 75 Extra Services & Fees (check box, ❑ Return Receipt add fee �, rppgate) $ t tt! 0 (hardcopy) ❑ Return Receipt (electronic) $ ti'l . CICI C-3 ❑Certified Mall Restricted Delivery $ Q nn E3 ❑Adult Signature Required $ t A nn 0 ❑Adult Signature Restricted Delivery $ O Postage $0.50 -0 $ _a Total Postage and Fegs $6.70 E3 $ rq r R r\y�e m, �� C. and---t--- o� P Box N---------------------- r3_ you sr r— C�r Sr�teP+4i l.. ),�Mn�nc. . .5 A CIO Domestic Mail Only rU Ln o7Receipt cc s7I �- es (check box add feedcopy) $ 1L V ) C3 ❑ Retum Receipt (electronic) $ E3 ❑ Certified Mail Restricted Delivery $ $0 00 o❑Adult Signature Required $ __ $0 0 ❑ Adult Signature Restricted Delivery $ �0 �� 0 50 and �710`3(_� r O^. A------- No.`, o O Bo f� iJUC�\\�r� 0470 95 Postmark Here 01/03/2019 is 1, 2, and 3. ie and address on the reverse i return the card to you. ac Is card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: 233�� y 5r L 9590 9402 2219 6193 1035 33 2. Article Number (Transfer from service label) 1 7017 0660 0000 7487 0511 Ps Form 3811, July 2015 PSN 7530-02-000-9053 0470 95 Postmark Here (1/03/2019 -- - ?--dI ---------------------------------------- NC 2 -7 (C) LP is 1, 2, and 3. ie and address on the reverse i return the card to you. rd to the back of the mailpiece, I if space permits. )d to: kltN� � _V3 r ty 33 `-AzcA G-oks),VO \�,6 �Otn53v 5Atry, N( Z`71Np A. SignMico- X LS gent LJ Addresser B. Received by (Printed Name) C. Date of Dpeliven '�-i i D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Priority Mail Express® ❑ Adult Signature ❑ Registered MaiITM ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restrict( PMQttified Mail® Delivery ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery ❑ Signature ConfirmationT" jail ❑ Signature Confirmation jail Restricted Delivery Restricted Delivery Domestic Return Receipt A Signature ` X yl/ ❑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 I I I I'I I�I'I I II I I I I I II III IIII 3. Service Type ❑ Priority Mail Express® ❑ Adult Signature ❑ Registered MaiITM 9590 9402 2219 6193 1035 40 ❑ Adult Signature Restricted Delivery }1QCertified Mall® ❑ Registered Mail Restricted Delivery �❑j_Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise 2. Article Number (Transfer from service label) ❑ Collect on Delivery Restricted Delivery 12 Signature ConfirmationTM 7 017 0660 0000 7487 0528 Insured Mail Insured Mail Restricted Delivery ❑ Signature Confirmation Hestricted Delivery (over $500) PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt b11 r U-C q2 2?4Q3 011 111111111'G' 1111i I HE i FAIN !11111111 Date Received Date De shed Check From Name Name of P~ Nolder Vendor Check Number Check amount Perini( NumherrComments Race/ t or Refund/Reallocated Columnl Column2 I Column3 Column! CdumnS Columns Column? col-8 Col-9 1 onstrixlion of Brunswick Cou Inc —1- and P - sT 12760 <�QIVVII TMc rd 77