HomeMy WebLinkAbout74504D - Kramer;.dAMA / ❑iDR�[GE &FILL NO. 74504 A B C D
GENERAL PERMIT Previous permit#
New ❑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 I SA NCAC 1 A. %LO0
❑ Rules attached.
Applicant Name a(;L\c. _ 4 my K & A— e ,L
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Address r '2 p l. E N.) I
, -A 1 i�.
City �A*kAvJ
State_ J (, ZIP
Project Location: County ' \!1 V N
Street Address/ State Road/ Lot #(s)
(? r-KEENS \3020 ST
Phone # �1Uy) S}�} �a�$ E-Mail GVOW TSk2AmatltcAe Subdivision
Authorized Agent H c1 CuN S T'4'1C_ 1 ' uN City H (k-pCw1 EACH ZIP 2. s i lDZ
Affected ❑ Cw )tEW ETA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ 1H ❑ UBA ❑ N/A
❑ PWS:
ORW: yes /� PNA yes / Q
Phone # (�2041 S73 !?QW River Basin (--f (L
Adj. Wtr. Body C4 "J'n L (nat :n� /unkn)
Closest Maj. Wtr. Body A%%,Jw
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Agent or Applicant Printed w+e--r+•�,�__
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
"_Rele ^-A (A CIK
Permit Officer's rinted Name
Signature
3 11 q 111312.0
Issuing Date I Edratfbn Date
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY-0—w—MER NOTIFTC rrON/WAIVER FORM
Name of Property Owner: r Ck r-� � , ) t." � ± ri-I C.K
Address of Property: I SO lrr2�n5 Lcoro - � z1 � �� 2-d 7�
(Lot or Street #, Street or Road, City & County)
Agent's Name #: H5 Construction
Agent's phone #: 910-880-4381
Mailing Address: 2164 Holden Beach Rd.
Supply, NC 28462
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 proposing. A description or drawing, with dimensions, must be provided with this letter.
P-1— I have no objections to this proposal. i have objections to this proposal.
tf you have objections to what is being proposed, you must notify the Division of Coastal Management
(DC* in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at:Ihvww. ocoaorbycalling 1-888-4RCOA S T.
No response is considered the same as no objection if you have been notified by Certified Mail.
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, you must initial the appropriate blank below.)
� A `�-,7 _ 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Property Owner Inf mation)
Signature
W(J r--k A rmt --
Print or Type Name
Mailing Address
W O'X u ") NC.
City/State2ip If
_ldy - S1'7 — 90sy
Telephone Number/Email Address
A
Date
(Riparian Property Owner Information)
t
Sigrt tune
2f
Print or pe NeFniel
Mailing Address
City/State2ip
503-7-7,�-Wg'
Telephone Number/Email Address
Date
(Revised Aug. 2014)
FWARW
ow abovo ruiWOM" lot
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H5CONSTRUCTION, LLC
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---------------------------------------------- Greensboro St. -----------------------------------------------
Not to scale
Dete Re 1-c!
Date De sited
Check From Name
Name o1 Permit Holder
Vendor
Check Number
Check
amount
Permit NumbedComments
Rece/ f or Re/und/ResHocated
Columnl
Co1umn3
Column3
Columrw
Co1umn5
Columns
Col-7
ColumnS
C.1-9
9/1 W2019
9/16/2019
H5 Construction, LLC
Allied Marine Contractors LLC
Mark and Judy Kramer
BUT
2361
$ 200.00
GP #74504D
GP #74817D
GP #74558D
BB rct. 9111
rct. 8538
�Tyomc
rct. 9149
9/1 2019
9/16/2019
Robert Spell
iWayne
_
First Citizens Bank
7898
$ 200.00
9/18/2019
9/16/2619
Wi ne's Backhoe Service Inc.
Smith
First Bank
3341
600.00