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Home My WebLink About71842D - Rose11 CAMA / ❑ DREDGE & FILL N2 71842 A B C OD ENERAL PERMIT Previous permit# `7i-) ❑New ❑Modification ❑Complete Reissue IPartial 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 V ❑ Rules attached. Applicant Name ` r, Project Location: County Address U11 ► �}C� 1 City State ZIP( 1�� Phone # ( ) I FlMail • Authorized Agent Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes / no, PNA/ yes)/ no Type of Project/ Activity Pier Fixec Float Finge Groir Bulk[ Basin Boat Boatl Beac Othe Shore SAV: Mora Photo Waiv A bu ( Note Local Planning Jurisdi Notes/ Special Conditions /h. Agent or Applicant PrinttgdMName �atpy * \P ase read coliance statement on back o��it_ /05j) Application Fee(s) Check # Street Address/ State Road/ Lot #(s) V Subdivision ij, + ^ City U ZIP U1 Phone # ( ) River Basin Adj. Wtr. Body nat man unkn Closest Maj. Wtr. Body (Scale: r pier(s) i length ■■�■■■■®®®■■�_■_ ■■®Y■■�■■■■■■��■■■■�..�.■ number - ■■■■■■■■■■■ire::�r>.i'7■tom■■I■■■■■■■■■■■■■■■■ ME ■■■■ ■■■■■■mn■�i;��■■■��■■■.r��arr��-�.�■■■■■■■■■■ ■■■■■■■■■■■W■■I/.1/11■■■■■■■l'G■1MI, WH■■■■■■■■■■■ dine Len h -�ti ■■■■■■■■■■■■■■■N■■■■■M■EM■■■■■■■■■■■■■■■ P3 to Al Y V I (VI 4Ig��a u� c - v I Issue g to Expiry on Date (VI •_. _. -'--. 3 t r h R., �t.1 l .j ra i�'.,. ..$ '� t .:4. i�'H r'... eV, a r S ' 1, � "' C .� '� '. C S� � J 5„� ? �K• ^y '3' S't'� � j�- �,. :�,` a �"'��i `� ,°� £r "�a'�*�„•�' `? .'fir;.+= '� .r nw�.�e�xaY"`` �ao � .,lk1t:4'..i .'Y �'..- k. r•#',n, ,�.. �' -. .,��r..•�-.tn. v,u.�v,. s*.':sx..ss.v_c .r'+Y�... FS^ S` ' •y' pj� IRS MINE Ing , �' . Mims &ai4hV F � ' ni�pr ' .y►�a ti p� MOOR �� i 61bt �.. �ppy�?■�{ n�yry u.v�fJ." + l i aa .i 04 alms /ssal 5 ViLvad vOAQ-xdMEG *usad snofnaid $ Eff ft Uf ou wo 3ua2v pazpo-41 aYc iuermxvd ujaxt= jau+4LUUO.+tJA Io VQ-m ktt 4 UOM%kIAuo:) IRa S8� tp , JMO Pu;"s'° "!° U`4' dad `e 40-MD WON n? anis �Nl XQ anssr t�f 'd attsx{ay a)a{dwo, -t F'0 'W. s CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT � ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM Name of Property Owner:f Address of Property:lp (Lot or Street #, Street or Road, City & County) Agent's Name #: ,gIlij %nrirf►no, Mailing Address: R"� Agent's phone #: 9/0 30 1 /0,W, 5L,� fU L o gq8 } hereby certify that own property adjacent o the above -r-eUerenced property. The m ivi ua applying for this permit has described to me as shown on the attached drawing the development they are proposing. A description or drawing with dimensions must be provided with this letter. I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at htt,p://www.nccoastaimanagement.net(web/cm/staff-listing orby calling 1-888-4RCOAST. No response is considered the same as no objection if you have been notified by Certified 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. (If you wish to waive the setback, you must initial the appropriate blank below.) (r I do wish to waive the 15' setback requirement.° I do not wish to waive the 15' setback requirement. a r (Property 0 n formation) r :5�e Signature ; Aoki As-cl Print or Type Name _ lr'/in L45� Marlrng Address City tate/Zip Telephone Number/Email Address /0/-D61/C1 n�• (Riparian Pro arty Owner information) p Signature n 5', 1111-4-) C- 1+/r4- X 1 e- (r+. Print or Type Name 169 F- Mailing"A�ddress 1 City/State/Zip /o,2%9--7- q-7 Telephone Number / Email Address Date (Revised Aug. 2014) AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: _ �jr�jg^� koilf., Mailing Address: Phone Number: Email Address: I certify that I have authorized � X kj , Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: dn)-c 01,0 at my property located at /ix 4-A, -'rs I /J-1 in $,j'mo 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 Print or Type Name --�"— Dates Thi"rtification is valid through �; � ,ems' .. _ .�:..a � � .> . . S.„r7 Fes'- _"R�._,� b••h'�P• :. CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: (Lot or Street #, Street or Road, Clty & County) II ,r Agent's Name #: /f lt'r1 /j%t,�, Mailing Address:�- Agent's phone #: — 916-'� hereby certify a own prope y adjacent o t e above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are proposing. A description or drawing, with dimensions, must be provided with this letter. I have no objections to this proposal. I have objections to this proposal. /f you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact Information for DCM offices is available at httP://www.nccoastaimanagement netlweb/cm/staff-listing or by calling 1-888-4RCOAST. No response is considered the same as no objection If you have been notified by Certified 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. (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 O n formation) Sig azure/ ' t�l a! pas- -, Print or Type Name Mailing Address 4ytateZip�� yes Cie1q, Telephone dumber/Email Address �o . �I Date (Riparian ope Owner Information) r C S ►n/ Signature Print or Type Name -- Ma 1 nMa g A dress 7rc.1 / �-- City/ tale ip 91()- q- I�,3 Telephone Number/Email Address u) I aq liq Date (Revised Aug. 2014) Dab Deposhed Check From Name Name or Pemdt Holder Vendor Check AkNnbK Check amount Permit NumbeNComments Recelpf or Rehrn&Raallocated Column2 Columns Column4 Column5 Cokm l Cakum7 Columns Column9 Allied Marine Contractors LLC Curbs Corder First Citizens Bank 7815 $ 200.00 GP #74763D GP 974380D Tmac rct. 9081 H5 Construction LLC Te-anetteSpear BB&T 2407 $ 600.00 BB rct. 7942 Warren Fischer _ Warren Fischer USAA Federal Savings Bank 1039 S 400.00 GP 974780D TP rct. 9495 Allied Marine Contractors LLC Richard Rose First Citizens Bank 7728 $ 200.00 GP #71842D _ Tmac rct. 9076 Allied Marine Contractors LLC Dan Taylor First Citizens Bank 7809 $ 200.00 GP #71844D --- --- - Tmac rot. 9077 Allied Marine Contractors LLC Robert Evans First Citizens Bank 7814 $ 200.00 IGP#71806D Tmac rct. 9080 F and S Marine ContractorsInc. Amy DeVenoge I PNC Bank 8170 $ 200.00 1 GP 074548D TMc rct. 8296