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Home My WebLink About74253D - Saundersj CAMA / XDREDGE & FILL NO. 74253 GENERAL PERMIT Previous permit# A B C �D XN ❑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 0 7 H , I I O 0 & ( 2 O (D ❑ Rules attached. Applicant Name tDAV IT> SA%.A JD1—tus Address 422 (9 L LA VT-/ / C T City H IC N ipot ^/T Stated ZIP 272 U Z Phone # ( .) (089- 9171 E-Mail aow�J & becelnc.com Project Location: County ?--*,AA S W � GK Street Address/ State Road/ Lot #(s) 1.47 .JCoTcAA Vo/JNET 7DRtVF_ Subdivision /V 1A Authorized Agent M City N o LtiyN SEAc N ZIP .2 8 4 (r2 Affected ❑ CW X EW (PTA ) dES )(PTS Phone # (91 d) 44 3 - 4 89 8 River Basin LtANAy e m ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A AEC(s): Adj. Wtr. Body CA�/At_ fat /_ .an) n) ❑ PWS: 7ej Ile Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit * 600 1-3 s"4 Application Fee(s) Check # IyL Tn.R MC_ 6LA1cE._ Permit Officer's Printed Name 1.4 Ac d_- Signature 51, c' 20 l q 9 10 ?019 Is isu ng Date Wiratio4 Date AGENT AUTHORIZATION FOR CAMA PERMII APPLICATION Name of Property Owner Requesting Permit: -DCil(IT� 77—�Iat jrr1F.2S Mailing Address: 2z IG LLAP"fZn C I Pa � NC a-7a ---I- Phone Number: S3(- (Aq - 3171 Email Address: Ni 16 P be c nl ry, ,. C o ry-) I certify that I have authorized �� 5 dal `W'4 LE2 ,'44A 2 LA" Agent i C. ntractor to act on my behalf, for the purpose of applying for and obtai.iing all CAMA permits necessary for the following proposed development: ,,� �=heocA� i P 'r at my property located at 143_n: in EYirts oiclL 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 Offiver and their agents to enter on the aforementioned lands in connection with evaluating information related to this Signature DIAV I D L-. S WU &) Print or Type Name Title O 3 / ?, 9 /— I., i— Date This certification is valid through I / '�t ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to D aV I C So I 's 1 (Name of Property Owner) property located at I LJ 3-, booI ne (Address, Lot, Block Road, etc.) on �0.k , in 1 M cr , P & , N.C. (Waterbody) (City/Town and/or County) The a li nt has described to me, as shown below, the develo m nt proposed at the above (U �'1 0 I have no objection to this proposal. htf 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) 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 `- +meyL 4wis/h 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) Signatur 4. Print or T p Name M ing Address A C�ty/S t /Zi Telephone Number/email address Date Adjace,)it Propprty-Q*nq� Information) re* 7 Print pe Name -� p i"'n'g4AX—ess) UAC,14, C,� 442, 4�Clty/Stat i S�, I f ele`phone u ber / ema ss PT Dale* `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: }Pau I P. 0. �blI( ViCLU1�� A. by ❑ Agent ❑ Addressee Date of Delivery D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No Vie N11 a II I IIII II III I III II I I IIII III I I III III 3. Service Type ❑ Priority Mail Expresso ❑ Adult Signature ❑Registered MaiIT^' ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted ❑ Certified MaW Delivery 9590 9402 4910 9032 6175 18 ❑ Certified Mail Restricted Delivery O Return Receipt for ❑ Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery 0 Signature ConfirmationTM 2. Article Number (Transfer from service label) ❑ Insured Mail ❑ Signature Confirmation Restricted Delivery Restricted Delivery 7018 0680 0000 7029 4260 PS Form 3811, July 2015 PSN 7530-02 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. 1. Article Addressed to: ❑ Agent X �� 1� ❑ Addressee B. R ceived by (Printed Name) C. Date of Delivery 4 _ - � 7 D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: [3-No 3. Service Type ❑ Priority Mail Expresso ❑ Adult Signature ❑ Registered MailT^ II I IIIIII III II I III II IIII IIII I III I I I I (I I ❑ Adult Signature Restricted Delivery ❑Registered Mail Restricted ❑ Certified MailO Delivery 9590 9402 4910 9032 6150 02 0 Certified Mail Restricted Delivery ❑ Return Receipt for Merchandise ❑ Collect on Delivery ❑ Collect on Delivery Restricted Delivery Signature Confirmation- K1 ether (Transfer from service label) ❑ Insured Mail ❑ Signature Confirmation 7 018 0680 0000 C Insured Mail Restricted Delivery Restricted Delivery 7029 4277 500) PS Form 3811, July 2015 PSN 75._-_--_ _ Domestic Return Receipt 141 ` Ttw-BONNGN- DPA= s aDoPeS BerD Twell, 139 SCor04 804der m V ". ::S-oII --'Ms Y6 KEMOv9 srrAVL R*M P AN 0 VJ &-K WAY A NID X-nrSTAi . VXWYL \A),J,L BE7"r Q cmjWc,Re U, Ilto $x zo f��A&-D NEW R,+MP . CN g6ll 1, � . Al EXISTING- T:LCWTTN4 4- i 6,AjC � S� T r l t D P CAI T6?fA $ D NEW V iN Yt w III-L- �43 - SCOTCO 30NNCT C� e. UAU 9Z2ko LU PToN o NC.. 2'724Z FL Date Received Date Deposited Check From Name Name of Permit Holder Vendor Check Number Check arraunf Permit NumberICommen(s Receipt or Refunal—a/kxated Columnl Column2 Co1umn3 Column4 Column5 Column6 Column7 ColummR Column9 5/1412019 HELM 0 L C Da,d Saunders BB&T 1354 S 60000 GP a742 T rR. 847