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Home My WebLink About74736 - LeeCAMA / DREDGE & FILL NO. 74736 A B C GENERAL PERMIT Previous permit# ANew ❑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 0-3-H . 2y C 0 ❑ Rules attached. Applicant Name TA4 Z (_LC Project Location: County<< - Address 101 A a.Ro,-J NEi41 OtZ . Street Address/ State Road/ Lot #(s) (�7-- CityC_U ti -TU State _NC_ ZIP Z M2-b CcJ2O S Phone # (U)ggo 312I E-Mail - r-e-t 10 (2rec r S,o-, kw,1.cw.Subdivision Authorized Agent Mp, 7-I Hu"�J HS �6Vs TR,&c9k_)N Cityt'IUZIP Affected ❑ CW EW pWTA El ES ElPTS Phone # ( / 0) g� U y 3 31 River Basin w �. a e (L AEC(s): ❑ oEA HHF ❑ IH [IuBA ❑ N/A Adj. Wtr. Body OA wA L (nat®unkn) ❑ PWS: ORW: yes / o' PNA yes Closest Maj. Wtr. Body Ai � w / 0 Type of Project/ Activity „JFi 6 v2 r N�(o e T A E53 piE2 TJ t/[ .., L-A v s� fACr- `/'xry A.AP (Scale: Pier Fixe( Flom Fingi Groi Bulk Basic Boat Beac Othr Shor SAV Mor Phoi Wain n Platform(s) length ■■■■■■■■■■■■■■■■■■■■■■■■N■■■■■■■■■■■■ number ■■■■■■■■■■■ 1�� ■I ■■ I !�7■■■■� ■! 1■\�■■■■■■■■■■■■ avg distance offshore ■■■■■■■■■■■■■� ■I ■■ I [.�� ■■N■� ■1■■ ■■■■■■■■■■■ max distance offshore ■■■■■■■■■■■!�■■■W f;i■■■■■■■li■■■■�3G�R[�■■■■ ■■■■■■■■■■■■■■■■ =q MMMMMM-y■■■1I■■■■■■■■■■■ cubic yards ,ate► ■■■■■■■■■■■■■■■■ �■i■■■■1!1 �■■��■■■■■_■_■■■■ - .:� ��_:�.._��.��.:� ■■■■■■� �� ►�n►�■�■�■■■■ter.■ ■ ■�■■�■■^^�■■�■ tt�tttt�t�tttt�tt��M �,■�r FM Am Bulldozing ■■■■r.■�r�■ate■��s�� ■■ ■�■�■■��■r. �..._..�,__.�._.._ _.__ ■__� . I : �i�_I�_■_I_��_i ��_ ��_ll�_ ■■ �8�� I:i�_�r� AV■■■■■■■■■■ _�■_ -line Length +not sure yes ■■■■■■■■■■■�■�■■■■■■■w■w■■■r,�■■■■■■■■■■ ■■INN■■■ ■t::� tryom'' ■�■;;r■■■■�■■ ■��n■■■■ ■■ #3M.W9.�'1G�?� .�■■�WiC.�'i7T' ITT torium: yes no ■� 111 Trf �■ wls: yes ■ � _ R�:S �t■■■■■■■■■■■■Non ■ ■■■■■■■■■■■■ I■■ ■■■■■■ _ r • . 1-A • . ■ I■■■■■■■■ A building permit maybe required by: T6W� G x �"+oL 0, C-A GA ❑ See note on back regarding River Basin rules. ( Note Local Planning jurisdiction) Notes/ Special Conditions `Y 'ptl.(, coif, ►--" v... j Ot- 0"�TN1 . 7-0000 ( GL^ LI ST/1 le 4v+1,1� iC-C r-,tA AL_ n rvivS I� T �� _<e_L;-Ac_ ec Agent or Applicant Printed Name Permit Officer e Signature ** Please read compliance statement on back of permit ** Signature 10/ w ZV -� /G 12-0 2 C) Application Fee( Check # Issuing Date Expiration Fate AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: 3�ck- Mailing Address: eQ Awl.d w Phone Number: 1 t0 - 0,94 �13 Email Address: G� ti e - e�3IchnAm1. co certify that I have authorized H5 Construction LLC Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: i ��[ec� 3, W%Ae �-(QU R t,3 (-Ctw ,_ Face deik. OTe.55 Qv-1 rno•+-- Cd Y. at my property located at in County. I 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 Owner Information: Signature —ra <f (ee, Print or Type Name `/ls�y7°r Title `1 I ) (0 1 l Date This certification is valid through / CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONlWAIVER FORM Name of Prcparty Owner iCtCE_ `------ �Lfr Z P,•i4:as3 of f=rc•Pa,.y: 182, Cfeemo (Lot or S?. O 8. St:: _ 1 of I=:: ri. C.ly L Cc^..ir) Agent's Name #: 1-15 Co::ctruct;:•n Agent's phone #: 910 S=J-43fi1 Mail,tgAdlre_s. 2164 }ietr,en Be-h Pd. S�.riiry, NC 2b .C2 1 hEreby certify that I own p;_,pe1y adj?cent to the ab• le rc;eio c d pr_r•e,sY The ir4i4+du31 applying for this pe. i,:it has descrn,ed to me as shc�.+n on the attached drav r:g the degthey ate --'- A descri titan or drawl wish diner>.-,ns must be wdh r etded this le -- to 161, _ 117.:LC no i.t}Ie�ir •!:<IU IIi:.i re••�-.,- _. _._ ifyouha:eobjeclionstoKlatisbaingprope=rd,yoLmustnotify theWOLionofCeastalMar„J r..ent (OCM) in wr;tirg within 10 days of receipt of this notice. Contact inforration for OCM oYrces is available at hftF tw nccc� �almaraq r "nt ri =Jw+b='m'staH-/icting orby calling 1-E:3-dRCOAST. No res . arise is considzr d the same as no objection d ou ha, a bran notated b Cetiliad Maif. WAIVER SECTION 1 undefs!and that a pier. dock. mooring pilings, bo-at ramp. brie%::a!er. t_aihe^se: or tilt must be set back a minimum distance of 15, from my area of riparian access unless wa,.•ed by me. (II you w' :3ive the set_-=c.k. you must initial the appr=�priate blank I do wish to waive the 15' setbacA reZ:.irement. I do not w!sh to waive the 15' sr - back rFquirertient. (Property Owner Information) (Riparian Property ownerInformation) ' .� ,.::�• T �tiv �� S ��L '-SfL-97 Prirlt or Typ--- Name l� Piiof or Type Name ✓ o /� mai.7r, Ss Ci,- i"S�,yt-tiP i 1 Ci'.:'-�ip -1(s tile ` a-4iSire,-a1D,.001, � �ri`•,��1 �d'C'�� Telep�3!te Nrirr?>:•jr/ Erralf A�Kir-_s Tet-c•r;_rg Nui?;bar/Email A.7ji<<s It—�- (Rc..,-_d Aug. 2014) CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner. (e, L- 1a(L ` l e- Address of Property: lsz QKc-Za-br7�co A- (Lot or Suaat #. Sl:.rt or Itr ed. C+!y 8 County) Agent's Name #: 115 Construction Mailing Address: 2164 Holden Beach Rd_ _ Agent's phone #: 910-380.4381 _o Supply, N( 28462 I hereby certify that I oven property adjacent to the ?l;ovc referenced property. The individual applying for this permit has described to me as shown on the attached drar..ing the development they are proposing. A description or dra itin, , ►qvith dimensions, must be orovided with this letter. ✓ I have no objectiviis to this pra}x�>;il. _ I h:::c ohjcc:i. !�� to this plopo.'sl. if you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 90 days of receipt of this notice. Contact information for DCAf offices Is available at httn:llwww.necoasta!manaaement.neLweblcnNstaff-/istin or by caningl-888-4RCOAST. No response is considered the same as no ob'Cetfon if you have been notified by Certiffed 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. (it you wish to waive the setback, ycu must initial the appropriate blank belo•.v.) C-� I do wish to waive the 15' setback requirement I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature I an& — Print or Type Name Maili ddress Citylstate0p Te!eohone Number/Email Address Val (Riparian Property Owner Info ion) Siq;tcrl::;•c, Prir7 or Type Name C� L M4149g S� Add ss 2 �3 Ca City/State ip r 3 Te .,phone Numb r Email Ad ress (Revised Aug. 2014) a ul: =H5= CONSTRUCTION Holden BeacifCANAL PROJECT: 182 Greensboro St., Holden Beach P/L t'_ ----------------------------------------------- GREENSBORO ST.•----------------------------------------------- Not to scale Oate Received Date De sited Check From Name Name of Permit Holder Vendor Check Number Check amount Permit NumberlComments Receipt or RefundiReallocated Columnl Column2 Column3 ColumM _ Column5 wum. Column- Column8 Colum. 1 Contruction C Ta ee T 720000 UP 4 1