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Home My WebLink About72767D - Mahewu CAMA / 'i-_ DREDGE & FILL NO. %2%E)7 A B C , C EN E RAL PERMIT Previous permit # XNew []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 15A NCAC (attached. attached. Applicant Name �( PAC Project Location: County ' Address Street Address/ State e R�el Lot #(s) / n City 1N [t M StatZIP 10 a ` li(/� Iry 141/ Phone # l)7/�Fi'- US�f9 E-Mail Subdivision Authorized Agent ✓ 1 tw/ City li ZIPAffected Z �( ❑ Cw '�EW [/ETA DES OPTS Phone # River Basin (/ — AEC(s): OEA ' ❑ HHF ,L7vIH ❑ UBA ❑ WA Adj. Wtr. Bod A21445 IY&O-t/a"t an unkn ❑ PwS: ORW: yes / PNA yes / n�o Closest Maj. Wtr. Body Type of Project/ Activity ' ✓ �/ Pier i Fixec Float Finge Groir Bulk[ Basin Boat Boatl Bead Othe Shore SAV: Mora Photr ( ., �■■■■■■■■■�■■NIA■■■�■■\■■■��■■■■■■■■■�;■ NONE■■■■■■ ■■■ ■■G.:r\■■■■■■■■■■■■■■■i�> i length■■■■■■■■■■■■■!!!■■■■1 number [�!\■I !A'1.��■!AAW ■■NOON ■■■■■lfl�lrJRIYO■E��r■■■1 ■■■I ■■■■flrli■rN■lEi�iO■EB ■■■■■■�IId■■■■■Eli■■■1■!!!".�■■■■■■■■Si■■■■■■■■ ■■■■■■■■■■■I:�II��IE■■■■I■I■■■■■■■■■■■■Chill"/■ii■■ dozing MEN ull ■■■■■■■■■Eli■�"—.__��.■�■■■■� �■NNE■■■■■■■ NEE\�i��3"ice■■■iww�wii■■■�iiiitiiii■■i ■■■��rii��r�■■■■■■■�ww■■■■■■■■■Nww■■■■■■ WIS: yes �+ ■Nl,��y�■w■■■■■■■■■■■■■■■■■■■■■■■■■■E■■■ Waive_ A building permit may be required by: J� ( Note Local Planning jurisdiction) Notes/ Special Conditions v Agddvr�r Applicant PH d Na ig ature PI a read compliance statement on back of permit Application Fee(s) Check # ❑ See note on back regarding River Basin rules. 7erm'itOfffili er'sZPrinted:Na�me�� Signt 3o M 30 �� Issuing Date Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: a �amyUNc 4"" +t- �4G�c�c1 Mailing Address: ( [ 4 S • rd W ulyYbu'►.ol 1�yt N c 2S 4D Phone Number: gig -9 4- q- O 1 S �- Email Address: C11CSC1(1C- (9 fvmr ck- ' C-Own I certify that I have authorized "C� bthou.sc "-ZLV to C- , Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: do-- lc_ -a* -?O& F3 <f-.VL-ay4nc1 ew-A I "—["opw,ip FZ5r-4cl. �-j C 2?) 44-15 at my property located at D D t E5 C3irmn r- I E�U d , —TTo FZ5Ca 41, M C- in County. 1 furthermore certify that I 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 Print or Type Name O Uu n V/"- Title Date This certification is valid through / / We -we looks -k VrWC[ -to w%A<o h yo(t ��dthe1/1/� �r r►t�#--� �h c�1 9(9 -949 Ja �54 -'Josh- A fmtf- ` h g 19 - 444- -M -- 2- ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to d 4.OA • "ice' cu- 's (Name of Property Owner) property located at 700 E� <f-)AtMnd 16W l6 al(4 , (Address, Lot, B�ck, Road, etc.) on Qy1Y.3 r ►AlM1YILii' , it -F,3tdb" LX N.C. (Waterbody) (City/Town 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) Rewt'l iv dock to O • 2p l Restore�4c�a�1 dock-�d � ' 'f� Add boat- 110 IL-m� kA 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) (A jj��gpt Property Owner Information) Signature Print or Type Name 6 (4 .5. 31 MailiAddress nVVg ir"m - w Nc 284� I City/State2ip 919.949•8154 Telephone Number/email address 1 Z/, A 8 Date /5 ate/Zip 16 V z�3 hv>n �1 . tX�_ Telephone Number/email address !Z-3t-LY Date *Valid for one calendar year after signature* (Revised Aug. 2014) ■ Complete items 1, 2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: ". " IL) V- ray 6 l O a- A 2 �-S �4-- am �� X �T- B."Received by rioted Name) C. D. Is delivery address different from item 1 If YES, enter delivery address below: ❑ Agent ❑ Addressee ate of Delivery (., ( `/ ❑ No 3. Service Type ❑ Priority Mail Expresso II I I III III II I I II I I III II I II I I I I ❑ Adult Signature ❑Registered Mail- 0 Adult Signature Restricted Delivery D Registered Mail Restricted D Certified Mail(& Delivery 9590 9402 4554 8278 4596 21 ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise 2. Artirla Ni imhar /Tranclar from c—i— i�)en n Cnll—t nn Delivery Restricted Delivery D Signature Confirmation- ❑ Signature Confirmation 7 018 1130 0001 0150 9407 ul ail Restricted Delivery Restricted Delivery -�(t7Ve'F�5iiu) PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt ■ Complete items 1, 2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. Article Addressed to: f-3,lt Glnev PoF'5m--:�? l -rO rrW E� il',j G 2- 0 Agent ;B. G ❑ Addressee Re ei ed by rited Name) C. Date of Delivery ir . Is delivery address different rom item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type II I III II IIII III I I II III III I III II II I II II III ❑Ad gnature du t S� M l turre Restricted Delivery 95-90 9402 4554 8278 4596 14 ❑ Certified Mail Restricted Delivery ❑ Collect on Delivery 2. Article Number (Transfer from service label) D Collect on Delivery Restricted Delivery D Insured Mail 7018 1130 0001 0150 9391 l Restricted Delivery ❑ Priority Mail Expresso ❑ Registered Mail- ❑ Registered Mail Restricted Delivery ❑ Return Receipt for Merchandise ❑ Signature Confirmation— ❑ Signature Confirmation Restricted Delivery PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt Date Received Date Deposited Check From Name Name o7 P—dt Nobler Vendor Check Number Check amount Penult Numbento is Racal t w M/w d4ftellocated Columnl C01~2 Column3 Cot—.4 Columns Columns Column? Cokmed Cokmm9 P