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Home My WebLink About72312D - MartelXCAMA / ❑ DREDGE & FILL GENERAL PERMIT XNew Modification ❑Complete Reissue ❑Partial Reissue No 72312 Previous permit #_ Date previous permit issued A B C DO As authorized by the State of North Carolina, Department of Environmental Quality �y and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC (� - / H .11- 0 0 n Rules attached. Applicant Name T M g KAFLI A.*INA Mpom- Address 312- Wil.DWOOD "Du►w-r 1�4. City K)f2?t.E ?WAC44 State TC (S 7 Phone # (M ¢S7 • &4G0 E-Mail +r4&r♦GI ASc, rr.Covn MAt"F�I MarSA PIMA �qMA. . COM Authorized Agent Project Location: County 'g Rtiplsld 1 CK Street Address/ State Road/ Lot #(s) .4 1 9 W, CA V,4 L A vr_,► iA E. Subdivision /1/ 1A city zip�284G8 ❑ Cw XEW X PTA ❑ ES ❑ PTS Phone # (9145) ZZZ — 47-17 River Basin 444AMtst=1L Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body 141 W W (na /man /unkn) ❑ PWS: ORIN: yes / no PNA es / no Close Maj. Wtr. Body A I W W Type of Project/ Activity CO,1/STRu►CT A Al % -DO CKIAtG 1::�AC1L►Ty 01AT __r,NTo AM C S A! RAC A /►L WA -Mr -(Scale: _J "' = 30 �) r � � xe oat g Gro Bulk Basin Boat 46A Bear Oth Shor SAV: Mo Phot Waiv ■ length ■■■NN120! ■■■W�Y�C=l�i��*�i�■fii��■■� ■■■■■■■■C9'wil 11■1■11 I■■■■ i'� I■■r �■ ■■■■■■■■■■■N■■ max distance • ■■■■■■■■■■■■■■■■■■■ ■ ■■■■■■�iiGiifl■W■■■■■ //■■ ■■■■■■■■■■■■■■■■■■■ ■ ■■■■■■■■■■■■■■■�'B■■ Ell ■mom ■■mom ■■■■■■■■ :■■■■■■■■■■■■■■�:■■ cubic yards ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ram ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ Bulldozing/ ■■■■■■■■■■■■■■■■■■Gl�ll■■■■■■■■■■■■■■■■■■■ . Ax ■■■■■■■■■■■■■■■■■■■ I■ ■■■■■■■■■■■■■■■■■■■■ lineLength not sure yes ■■M■ .!wlz ��ty■ ■■■■■■■■■■■■;ssi�s:■■■■■■■■■■■■■I lr1Al • os: yes s �x�■ ■■■■cn�■��.- ��s��■n�rrR �3 M■i ■�WV :� u A building permit may be required by: -AWN oG Sv&w1SET BF�-to ❑ See note on back regarding River Basin rules. ( Note Local Planning jurisdiction) Notes/ Special Conditions 0714, 1200 AND A L Lt oTyW,. Pt� LOC.i1{.. ,. Ste, $, FM0Z4L AL_ RR_ c-, Us_,* T, o.4 r AD P W, _r"rL 6,A T- 4S e 5 AA LL_ W oT t4A "x & Rr_ a V-1 a V1 no - it or Applicant Printed Name el Signature Please read compliance statement on back of permit S-Y.ou _* 4?&&3 Application Fee(s) Check # 1YI.F�Z µOGun84w— PermitOfflcer's Pri ed Name Signature 9 /,?,.3g /z3 bozo Issuing Date Expiration Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to 12"- 's (Name of Property Owner) property located at --719 4/- / � ._— (Address, Lot, Block, Road, etc.) on _,G. C L1,' , in 5 -; key c-4 , N.C. (Waterbody) (CityrTown and/or County) The applicant has described to me, as shown below, the development proposed at the above location I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site drawing) ,/ . O C%n c mac_ c v .• �h /`�•� tz fl. x r WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, 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. (Property Owner Information) (Adjacent Property O ner Information) it- �� Signature Sign u Print or Type Name Print or Type Name 217 W Cam, n e ( AVt M fling Address Mail' g Address Cr y/State/Zip City/State/Zip �IIy 508 fo zg I Telephone Number/email address Telepho a Number/email address V21 / o Date Date (Revised Aug. 2014) *Valid for one calendar year after signature* ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to /e j 's (Name of Property Owner) property located at 2-1 S— (Address, Lot, Block, Road etc.) on !�✓ , in S. v � `a�"s �E�c- 1 -1 ��./G� , N.C. (Waterbody) (City/Town and/or County) The applican as described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must rill in description below or attach a site drawing) z C .r, Ls" L9 WAIVER SECTION ' I understand that a pier, dock, mooring pilings, boat ramp, 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. 1� I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjac Signature Print or Type Name roc 11al,,ya z W -fit-a e Mailing Address ylState/Zip Telephone Number / email address Date Owner Maili ddress City/StatelZip �- Telephon Nu ber / email address Date* *Valid for one calendar year after signature* (Revised Aug. 2014) .9 4 w 00 I I I r I Dare Received Date Deposited Check Fmm Name Name of Permit Noider Vendor Check Number Check unt Permit NumbenCommenrs ' Receipt or ReWnd/Reallocated Col-1 Column2 Column3 Column! colom5 Columnd Column7 Column# Column9 9lMA19 _ 9/24/2019 Marianna and TOM Martel _ 9/2412019 M Tom and Marianna Martel TC Bank NA _ 8663 200.00 GP 9_12112D TMO rCt 8276 47