HomeMy WebLinkAbout74545D - Sunset,' ❑ CAMA / r 7 DREDGE & FILL No. 74599 A B C
GENERAL PERMIT Previous permit #
_ ew 'Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
Asiuthorized by the State of North Carolina, Department of Environmental Quality /
and the Coastal Resour Commission in an area of environmental concern pursuant to I SA NCAC
Rules ached.
Applicant Name swe ✓ Project Location: County
Address
City rAl St;
Phone �-t-Mail
Authorized Agent r P��� / lj/f_ fjj(,( � ( j
Affected ❑ CW XEW NPTA ❑ ES ❑ PTS
AEC(s): ❑ OEA C HHF ❑ IH ❑ URA ❑ N/A
❑ PWS:
ORW: yes no PNA yes- no
Type of Project/ Activity 6L
Street Address/ ate Rom/ 1pt #(s)
Subdivision
City ff'/~S" Alx ZIP y
Phone # ( River Basin W— ('•
Adj. Wtr. Body ,'1� 1/1� of an /unkn)
Closest Maj. Wtr. Body�lfl�
(Scale: —�
Pier dock len h
Fixed Platform(s) .. l
Floating Platform(s) 4
len6,th
numbe
maxdistanceoffs re -
Basin, char
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yards
Boat ramp
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Beach Bulldozing
Other
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Length
SAV: not sure yes
Moratorium: n/a yes
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Photos: yes
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
DiLt �l.0 ❑ See note on back regarding River Basin rules.
Signature ** Please read<compliance statement on back of ermit **
Iwo 1
Application Fee(s) Check #
io-31 •/9 _;-�-Zt�2
Issuing Date Expiration Date
Letter of agent
ri.1t} have retained Mark Clements DBA, Clements
Marine C nstruetion Inc. to akc application for any and all permits needed to start
construction on the work requested for our property or properties.
By allowing Mr. Clements to make such applications I do understand that this will in no
way relieve me of any obligations to perform all work according to the building codes of
North Carolina, CAMA. DWQ or any other state and or county ordinances.
ICI `L Qke 1:
Print 0a
ire
Signature •
9'.�
Contact utfixmalion
I'\V ur'1V`1• 1 1%$1 r4s%.1V. 1 1\V. -. . -.-. - ... - - --
Name of Proaer?y Owner I f"; J r ��' �-; ► %�' k�-- -- - .
AdareSS pf Property.
�—L -- -- - -- --� -- -
(Lot or Street #. Street or Road. City & County)
%I _
Agent s Mar? e tt ��'/��� >� L �L'i�.Z� t I� t�taiiiny Address lc o ire
Agent s hone r - y .
I hereby certify that ! awn property adjacent :o the above referenced property The individual
applyinq for this permit has described to rr•? as shown on the attached drawing the development
they are proposing i . esCription r,. -,ra w!th Curienslons must be Droyided w!t', this ietter
�V _- I ha'c n1, �'blccllonN to tIt!'s 7roposai. I ha\c 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 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
understand that a pier dock, mooring pilings breakwater boathouse. lift or groin must be set
back a mirimum distarce of ' 5' from my area of riparian access unless waived by -re iIf you
wish to waive the setbacK. you must initial the appropriate blank below
do wls^ to waive the setback equ remert
k' l do not wish to waive the ' 5 setback requirement
i
(Property Owner nformat'on)
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Print or Type Name
Mailing Address
City,"S atePr
THiephone Number
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(Adjacent Property Owner !,00rmation)
I r 1 t �J a I I t -•C
Print o+ T Pe Name
"J O q fa . � �11'it
r✓talling Ai7dr s
9 /c) 2-_c1. 23 --
Telephone Number
Revised 611612012
shakespear rip doc for dock.bmp
10/16/19, 12:29 PM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner. I r !r i-N! `
Address of
/(Let off Sheet a, SU}tlM or Road City d Ccuaty)
Agent's Name 0: ix rid L 1[ n1E1�1 ') Malslg Address: ; l2 C:I- c I / ,-
Agents phone p: �1 /!) 7i7Zr Q5 � f{iQ�c s L>c� 12e 3
I hereby ceAity mat 1 own property ad*—t to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing-"* davekapment
they are p osing. A daisctt ron or drawiny- with dimensions must ba provided with this letter.
x i Gave ao oI jmtiona to this proposal. I have objcctions to thin pmpnsat.
Nyou have objections to what is Wimp proposed, you must nodly are Divlsbn of Coastal Managsmsnr
(DM In waling wntdn ro dWs of receipt of this ttotico. Conpct information for DCM oJAcos is
evapable atwww.nccoastatmanaanment.nryfonfact den—, him or by ceiling f-aed-IRCOAST. No
resnonce is cohaidend fin same as no ob/ect/ow W n N you haen notifhd ev CartNMd Asp.
WAIVER SECTION
I understand that a pie+, dock, mooring pilings. breakwater. boathouse, OIL or groin must be set
back a minimum distance of 16 from my aroa of riparian accaas unless waived by me. (If you
wish to waive the setback. you must Initlal the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the IV setback requirement.
(Property Owner forms)on)
Signuntre
�"lit•r Ci A,1i75
Prad or Type Name
i 1Z, C/rG / c% r
Meeing Address
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Tektphoim Number
tuir
4(Aas em Property Owrter ItNormotion►
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Prim! or Type Name
SISd AA Lie
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Name or Po—U Holder
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Check Number
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