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Home My WebLink About74240D - Hern-. 151CAMA / C-1 DREDGE & FILL NO. 74240 A B c GENERAL PERMIT Previous permit# XNevi ❑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 environmental concern pursuant to 15A NCAC n 7 H . 2 u ❑ Rules attached. Applicant Name St 0- :T u F_RN Project Location: County R I ck Address 891 V (AAyoo. AA111-1- C I1t cLIE— Street Address/ State Road/ Lot #(s) (P City CJAAcX1--rTF State JC ZIP21r7-1 O Ad -J .ST Rt r: Phone # (913) Sy 3 - 3234 E-Mail %kV C aA 737Q WrtA`YCOMSubdivision Authorized Agent R c- K U r--ST ` City OC F-Ael --CM- BEAc N ZIP 264651 Affected ❑Cw XEw )(PTA [1 ES ❑PTS Phone # (904) -3(3 - 0(tO River Basin Lt^Mpr v- ❑ OEA ElHHF [IIH ElUBA El N/A AEC(s): Adj. Wtr. Body CAJAt, (nat ma /unkn) ❑ Pws: A 1 W W � ORW: yes / no PNA yes / no1 Closest Maj. Wtr. Body Type of Project/ Activity Rr-Pt.Acr— f—�XIST14Ci DocY-tw/C, FAcjL,-ry & :ZUST LL- A 4E ►a R / X .20 ' �L.� A ..NC, l�. � � (Scale: 4 "= I ' ) Fixei (i Groi Bulk Basir 10 Boat Beac Othr Shor SAV Mon Phot Wai\ /a,._I,N a,.....1. i • ,' e i length number ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ a\fg distance offshore max distance offshore ■■❑■■■■■■■!�I!■■■■�■■■■■■!A■�■■■■■■■ ■■■NI■■■■■■+.11iii�iw�,�+v■i��►Yifa�1��■■I■■■ cubic yards ■■■■■■■■■■...��■■� ■■r1■■��■■■■Ii�TiE�...l■■■■■ ■■■■■■■■■■u■■wi ��%�i►ii■■■■■u■■■■ii■■■■■ ■■■ ■■■■■■■■■tsar■�M■■1 �■ ■■■■r�■■■■Il■■■■■ Bulldozing■■■ ■■■■■■■■■■Ri■■■1 �■ ■■■■■■■■■■■■■■■ - rLnot r■■N■■■■ ■■■■■■■■■■■■■■■■■■■■■■■1■■■■r fline Length sure yes � ■�!'■■■■■■■ ■■■■■■■■■nw�■■■■■■■■■■■■11■■_■ ■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■Ills■`■. ■ torium: yes ■■■W7■■■■■ ■■■■■■■■IiAp"nM�&=■■■■■■I IVWMt.A■■ • no _. , . .r■■■��■■■■■■�S■■■■■■li ■■■�■■■■� ■■■■■■■■■■■■■■■■■■■■■■■■11�■■■■ ■■■■ w A building permit may be required by: QGFAn1 :--T SLE +3CAc 0 ❑ See note on back regarding River Basin rules. ( Note Local Planning Jurisdiction) Notes/ Special Conditions 6'7 N. I Z O O gt A Lii� J -rH E R V e c A t- '; rA T r- X i=r.DEIr-Ai, RC C,LkLA-1IONS APPLY. Signature "Please read compliance statement on back of permit" $2(30 -0 5499 Application Fee(s) Check # riLER Mc ClttIRZ Permit Officer's Printe Name /� /-lc Signature 15 Z 1Z a 1 9 Issuing Date Expiration Date about:blank AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit l r n TT f"T e ✓- t" Mailing Address: Phone Number: Email Address: k C ra 1 72 ) 6 ho 1,"4o ; (. Cow I certify that I have authorized Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAM /A permits necessary for the following proposed development: at my property located at o1A J �. �c�Pat ti �S e �c➢/,�'% in R r t4 h S U,;eP- County. f furthermore cen`ify 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 Owner Information: Signature sro H Z--- 149- r i,-, Print or Type Name True 05-1 Date This certification is valid through 1 1 1,vli q 7 DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: �� ` '� G 113 -'V C '� 6 (Lot or Street #, Street or Road, City & County) Agent's Name #: 4',, -64A 4i �xS Agent's phone #: MailingAddress: / �� % A �'�` `` c'o�u- 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 drawing -the development they are pro sing. A desuri�tion or drawing with dimensions must be provided with this letter. Aqo 'have no objections to this proposal. I Have objections to this proposal. d you have objections to what Is being proposod, you must notify the Division of Coastal Management (DC* in writing within 10 days of receipt of this notice. Contact Information for DCM otltces is available at http 11www nccoastalmanagemeni net/web/cm/staff-listing or by calling 148&4RCOAST. No response /s conskkwed the same as no objection Nyou have been notified by Certllled Mall. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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, yoL*jMMkJjW the appropriate blank below.) _ i do wish to waive the 15, setback requirement. I�4L - �—� I do not wish to waive the 15' setback requirement. (P. Irtf anon) Signature -�� Print or Type Name Mailing Address City/stata,zP (;,)l -�--Jr`�J Telephone Number / Email Address /-/ Date (Ri rlan Prope r ormation) Signatu "nt or Name lgag Mailing Address lex r , itylState?rp 3`3l 3� �� l �• . Telephone Number / Email Address rive rw/ I" Date (Revised Aug. 2014) CERTIFIED MAIL' RECEIPT Domestic For delivery Mail only information, visit our webs ite at www.usns cn.n' r-9 ri _o m r-i 0 0 0 0 x M M r-1 0 M1 ROGlCIl M"j.' Mt 2a3?9 Certified Mad Fee s $3.50 :xtra rv,ceS ees (disk b" and r» ❑ RHum R.c.pt (lybropy) e ❑Return R.c prt..W" s--SgTAC1- 0 Certiaed MW Reelected D.lve,y 0Adult Siino—ReguYed $ iV ❑ AeMk siinw.. ReetNcted D. wwy = $0.55 f6.E5 C— 2 s ■ Complete kerns I. 2, and 3. Print your narne and address on the reverse so that we can retum the card to you. l! Attach this card to the bad* of the matl)feoe, or on the front N space permks. Md. Addressed to: 0570 11 Poshnark Here 05/03/2017 a C3 0 0 0 _a M 0 CO ri 0 t` a X B. Received by owe A** CERTIFIED MAIL" RECEIPT �rnestic Mail Only For delivery inrormation, visit our w ebsite at www.rrsps.com`. ❑R.um R.q;pt Ni.cuanfc) ❑GNirtad MeA Re.ryi� S �un�� Cla AdO SgWU %qg ,WO—y — Adult SWtuft %.tr aD. Me $ DStaW $ f0.55 f6.85 ❑ Agent I:' / D. to deinrery address diffe wit fmm Neat 11 ❑ yes e YES enter deivary address below: ❑ No IIIIIIIIIIIIIIilllllllllillllillillll Illlllll ❑ 90 9402 3923 8060 2979 73 ❑ �`"" ° �'° Ma Res61r pad ❑ OWNe�wryy Dduwy ❑ paturn for Ak,r,gr fThlrrshlr from ❑ Comm*lowcx an 7 p 1 service dabsq ❑ kreued aM DoWay ritetrkW DMrwy ❑ Siptahn C ,ft,,UmD 036p pp01_3611 658p �P.WI.edD,.y ❑ � I�i�111111��1, � 2M 5 FIW 753D-M --- - DorneetiL Rtatum .+ mplete Items 1, 2, and 3. A. nt your name and address on the reverse X that we can return the card to you. ach this card to the bad* of the maNplece, on the front If space permits. cis Addressed to: D. 25377 /"fovadby trodn r,, Ic. DCrt in deivety address differs frilrr Aem, , H YES, enter delivery s ddran bebw: r � " a � IIIIIIIIIIIIIIIIIIIIlIillIIhlIIIIIIIIIIIIIII ❑ A" SpvhrReehir�d Delivery ❑ mzYed Melpadd& 9402 3923 8060 2979 97 ❑Cred Mle9590 0 4sMoll nsseit.•6ed DelMry ❑ for ❑ cored on DerMery IMarcA�rd4s ❑oeect o COW DeYMSY Restricted Delvery ' D cle Number (TnVMW from servke rebe4 7018 0360 0001 3611 40 6597 UM Pasittrictedoellmy �s 11 Postmark Here 0 5/03/2019 ------------------------- i---------- fill 4:,� F/C>4 -6, Aj oC-Y K ou T dqN //��es �-�� (�,�sF CALL Gj Date Received Date De oslted Check From (Name) Name or Permit Holder Vendor Check Number Check amount Permit Number/Comments Recei for Relund/Reallocated Culumnl Column2 Co1umn3 Column) Co1umn5 Column8 Column? Column8 col-98 019'! IAMW Docks antl Marine Consta on Im Scott Hem 8T S488 .0 P #74 40D ITMc rd. 8484