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Home My WebLink About74881D - Lawrencey CAMA / -- DREDGE & FILL No. 72881 A B C /D GENERAL PERMIT Previous permit# 5s&ew DModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality 0 V" and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 95AM t= Rules attached. Applicant Name l!2d1t7#00" Z- 1-)9 AlAlCL-" Address 6 b/ A C D R. %�O/ a/ /�✓ , city /ygt*rlrle state, C ZIP IV Phone # (7/0) 6 / 6 `I -Mail Authorized Agent ,i+l/ Q L VrQL to,.,i / �✓ e Affected ❑ CW 4EW j+TA ❑ ES ❑ PTs AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ WA ❑ PWS: ORW: yes /,,66 PNA yes / no Project Location: County ff /y 1- Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # ( ) River Basin �j�, P 6 Adj. Wtr. Bodyd ""s . �i t"//Y /W%✓ (nat /man /unkn) Closest Maj. Wtr. Body G1l�y Type of Project/ Activity i /. ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■raw*w��■■■■■■■■■■ ■■■■■■■�■■■■■ICI■■�!'=��=%■■■■■■■�■■■■■■■ M. ■■■■■■■■N■1 IL'7l/r/L/iGs/l■■■■■■■B■■■I■■■■N■■ ■■■■■■■■■■�!i%11■■■■■■ ■■■■■■11■ira■` ■■■■■■■■ ■■■■■■w■■■■i - - � ■■■■■■[1(i■■■�'�■■■■1�.�•.■III■■i■■■■■■■■■��■■ '�■■i�ii�iii■■■i■■iiiiii■i■■i■■i■■■■'i�i i■■■■i i■■■■i i►ii■i■■■■■ate■■■■■■■■ ■■■■■■M■■■ Age o App icant Pri ed e gnature Please read compliance statement on back of permit" Application Fee(s) Check # D p jg� L✓, LS'fr Pe�Officer's Printed Name moo` e Signatu e ' Issuing Da t Expiration" ate AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: /nar- L Mailing Address: i, /, I L_' Jk^ru 12in 11 Kd PaYl�f�� Phone Number: Email Address: Co -)LAG r 1KR �n7 I certify that I have authorized 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 at my property located at in J7Zyy r 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: C� Sign re Print or Type Name Title 3 / DO lJ_ Date This certification is valid through I I .Q1-.1 L9 � �, one l7iF'.w' atom 'Now w'vw 'fit` wqlw we., - V-" Lam , Al boot AVJP rt- s gft lw o low AWN r saw f mow poar.s"w.f y i tNrtM:i Ati�f " '�i'+F a s i� �k "ow4p wobw Al.r a Yr-•trw t 71pia f � r MOW # �'� � a F t iw irw��7► i .; , _.y . MOW 'a Y Ali i R= 1 + �. ,•w' �"7i ,."P'?E" �. .' 7./t :y -, fijltt E 9� f{ A'lrr ,t ADJACENT RIRIAN PROPE TY wIdER TE ENT PA 's I hereby certify that I own property adjacent to IVIt r O,gr) IName0 Property property located at ( ddress, Lot, Bloc Roa etc.. , N.C. on t �n (CltytTown and/or County}) (waterbody) The applicant has described to me, as shown below, the development proposed at the above location. rl X I have no objection to this proposal. 1 have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in descripdon below or attach a site drawing) WAIVER SECTION 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 setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (p p®rty Owner,lnformation) (Adjacent Property Owner Information) n Signatu e Signature Print or Type Name Mailing Address City/statelZip Telephone Number D&e (Revised 6/18/2012) z co ccjj W,: IMA VCJSMVWIAM* OWWW" #MOO 40 01 I%WF# OW30W rl, it alv,. is, I't"ralm Ile *Pow* aftwo lXAJ qo%p*WAf ppi w#=64 "'%W PnOod" 4 AM6 odft jW*,&jW*m" * ~* ftmo wo*,,&M W& ~ 04ft am .Am* w •aWwia dftkwMlpPmmmW,'** 0 W ONIft 4~ W 4106 Of MPOW 41P WA* gd*b* &wuggqoop_o ow-** 40 modw 0, - 04OW %Ad *ki, 0100040kl* I* =MAW $WAS 4WOUWSVMWMMAW ON AW4000ftlft JW _fr# &a "" fa.40 4%*,FW oil% %w - — �- &AMA ww*p ~oaft bmw� dt-w %s *0 to roftwo ft also ONO W,* 01 **,Am �Nft 4 vm"w I Sk oftv %L dw%.* Ww maw mfiww ol&n 4Amm,-, Ag any kv. AU/ r /Ir •v v sOL -f� Date Received Date Deposited Check From Name Name o/ Permit Holder Vendor Check Number Check amount Permit Number/Comments Receipt or ll.nd/Reallocated Column? Column2 Column3 Column4 Columns Columnli Column? Column8 Column9 5/6/20191 Valentine Construction !Martha Laave a TD Bank 1917' 00.00 'GP M72881 'DW rct. 8155