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Home My WebLink About74262D - Poole)4CAMA / ❑ DREDGE & FILL �'1 b•%K No. 74262 '1ENreli)... L PERMIT Previous permit #03 C �w ti Complete Reissue L]Partial Reissue Date previous permit issued (� As authorized bytorth'Carolina, Department of Environmental Qualit y and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC D-?A (0 0 f • j'Zrf::> l- /I ❑Rub attached.. Applicant Name Y► b I'U G 5 �G10 / Project Location: County Address � � O At5 Street Address/ State Roa / Lot #(s) City State �C ZIP G �� l ,� Phone # (A� 77' E-Mail Subdivision I Authorized Agent if ✓% l City �' ZIP Z S Affected EI Cw XES ❑ PTS Phone # (� ) River Basin + o AEC(s): ElOEA ❑ WWF ❑ IN El USA El N/A Adj. Wtr. Body A 1 S . Cif a m unkn ❑ Pws: V r- !l So ORW: yes / r�i PNA yes /,�? Closest Maj. Wtr. Body Type of Project/ Acti ity 1,141 (� yr '/'R � � �K/ � /iv t , (Scale: = 7A' ) Pier Fixe Floa Fingi Groi Bulk Basir Boat Boat Beac Othr Shor SAV Mor Phot wain = ,clock) length ,s g rr■car.■■%�� i■■��■�■■�■■■■■■H■■■■■�w■ . ill ��,.��Infa�u■ �i■■■■■■■■�iiH��i,J■�H■■■r■■■ ng Platform( i length numberw■■■■■■■■■ LSi■H■■■■■!�Y■■trl��vs!■■■H■■■■H■■■■H■ ow■�:■rrz:��■ti��■ f■ �w■■■ ■■■O y■■■■■■A■■�'..� Ii�Wa■ ■i■�®l��■ ■ t �icibb%liifilr�/■■■■ l^"i■■■7iZ7,YHE'tl�:■RA■■■f�.. -ad/ Riprap lengthor avg distance offshore � M■■'H■■■H■■■■1■■■ �■ ■ ■■■■w�■1■r�ww!■ ■■■■wf�ln■r■ I■ f■ w ■f ■ max distance ■■■r-EcLc:w■■ I■ iwmu ■ ei ca■Q■■■r��rr�tii� ■■LL�,'rti�ibCY■G l� I■■■■ �' '��I■■■ ■ i■/�■AH■■■■■■■ cubic■��;■i�iilli■i'iilliliiigbill�■1�®��il■—i=■Yrii Ham' ramp !■■■■■■/Jtf■I 11'ii■■■■■■■■■■■■■■I I ■■1 ■�■■■■■■■ MEN �► j r iY! �W■■■■■■■■�ii ww■■■■■■■■■■ricer■■■NAME 1�i�Ti�i'r/ ��H■�H■�■�HH�■HH■■■H�HHHHH�HH■HHH■■H�� 08 HH■HH■■H�■■HH■H■■■■■�HH■HHH■H■�■H�H�HH fline Length %6 not sure -r1s: ��H■■:�C=HCH��C�HHH■:�::H:::HHH :HH�HH:: • ■■■17�'a1��11�i��ltiTii■■■�i■■■■■■■■H■®■■■■■ yes ■ws�r•■■■w■■r■�Iw■■c�»■H■■■■■■■■■H■■■■■■■ zx Attached: es . J:1fi1��9 �Y�il■/Iii :7,'!+I■i:■:iYJ�i■■■H■■■H■■■■H■■■■H■ A building permit may be required by: r'7 C ( Note Local Planning Jurisdiction) Notes/ Special Cons1W' 1 [k� +Wb 1'Z b✓✓h/[�l or Signature ** Please read compliance statement on back of permit Ap ' ation Fee(s) Check # U See note on back regarding River Basin rules. Printed 77 12, 1� 1?, /2 '/1 Issui g Date Expiration Date ✓��,�11 4 - U-i9 Ovt,,-- Dam Recelwd Dste Dpolfd Check From Name Name of P~ HokM Vendor Check Number Ch.ut amount Permit Numhx.Commenm Receipt or Rdun&W sNo fed Columnf Co1umn2 Column3 Cok-M Column Columns Column? Columns Column9 PooleP 4 - I Name of Property Owner Requesting Permit: Trl_IU-11.4J -t'pQ l� Mailing Address: Phone Number: Email Address: V D 16la c ?J )6.✓j I certify that I have authorized r / f' i(I�tll �� ✓�%%i�i �uG �,r(e�lG �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: 411-1 f 14 at my property located at /D3 q ll s 7�,&v f 11 �,� , j in 4&ZZ W County. l 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 Pole, Print or Type Name Title S 1/0 I /g, Date This certification is valid through 11 wn MEff RIPARIAN EROPER/TY OWNER STATEMENT I hereby certify #fiat i own property adjacent to 4h9 A C /&-Af ._ I (Name of Property owner} property toce�ted � U/D � Gl ,�� 4 �c c� tAddr+�s, mot, relouc, ) on , In N.C. (Waterbody) (Ctty1T andlor County) The applicant has described to me, as shown below, the devekspment proposed at the above j v' "'IV L2 I have no objection to this proposal. I have objections Ito this proposal. DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT (indtWdual proposing developnrek musf ffil hFdescnfpilon below or attach a site drawing) WWNER SECTION I understand that a pier, deck, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 16 from my area of riparian access unless waived by t I me. (If you wish to waive the setback, you must initial the appropriate blank below.) fP10 T W / 1 do wish to waive the 15' setback requirement I do not wish to waive the 15' setback requirement (Property Owner Info rmad") (Adjacent Own r kinformation) , r: ,t-'C gnpw,e 0 n�e Type n�� °? CR'`p 9 to - 4T - P 1 ?, Tate ! 1 &MW address Telepboae M9nber/smelt address IT- A0-1:5 U-10-IR Aft Dal.• (Revlbad Aug. 2014) 'Vatd far one calendar year after si ure• ADJACENT RlPARIAN PROPERTY 9WER STA //��TEMENT 1 hereby certify that I own property adjacent to ]Aohl 'Sb 6014f, is property located at 4A s7L (Name of Property Owner) (Address, Lot, Block, ) on �� /� , in N.C. (Waterbody) (Clty1T and/or County) The applicant has described to me, as shown below, the development proposed at the above 1 have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must Hit /n description below or attach a site drawing) WAIVER SECTION 1 understand that a pier. dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or grin must be set back a rr*imum distance of 16 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 16 setback requirement. I do not wish to waive the 15' setback requirement. petty Owner i } (Adjacent Property Owner Information) Si a Signature* O 0 to i Parr or We N Print or Type Name of �3 6/0'e. 00.vd �, 1,; , —G� w�l cad ivaft Address Telephone Number/emM address Telephone Number 1,6mall address Z'- /D—/ 11 Date Wa<id for one calendar year after siorrahxe* Date* (Revfsed Aug. 2014) --� wj ""19yag I-- a[ CAMA / 0 DREDGE a FILL No. 74262 GENERAL PERMIT Previous permit # � -� 03• New DModff catlonmplete Reissue ❑Partial Reissue Date previous permit Issued—j As authorired by theState of North ka, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC UO D ir Applicant Nam-qn- /'LtQS Project Location: County_ Address f t 0 eto[ City StateffA2iZlP phone # tq� a- A s:_M�n Authorized Agent r Affected 0 Cw '7"w. /ram.:ry e OPTS AEC(s): o 0EA '" ^^F " 0 to a USA a WA ❑ PWS. ORW: yes / C) PNA yes /4 1 j pe of Pro)WU 6 Pier (dock) ktnrdt A Shm SAV Mor Pho w10 Street Address/ State Ropw Lot #(s Subd on City ZIP Z—c -S Phone # ( ) River Basin WlxdU Adj. Wtr. Body A 01C Closest Mal. Wtr. Bodyse)vow- 4 1 move . . . . . . . M NEON M 0 so Ills Ml IlglO6E No A building perm* may be required b)r. .01 �- ❑ See note on back regarding River Basin min.( Note Local Plartrtktg jurisdk ow)l� Notes/ Special Conditions or backof pwv* *• Check Air IssuldS Date Expiration Date