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Home My WebLink About74607D - Turner-CAMA /,ADREDGE & FILL GENERAL PERMIT New -,,,Modification ❑Complete Reissue ❑Partial Reissue No. 74607 A B C( Previous permit # �.�/ 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 n . I 00 + (17 . /_oUC� \ ❑ Rules attached. Applicant Name �r� �� `�✓ Jr . Project Location: County C �J6_"J Address Street Address/ State Road/ Lot #(s) w031 y J"t.. S4 City r , it State-CX ZIP Phone # ( ) 1 E-Mail < ✓^ 4 Authorized Agent Ck"Ift ` if t Al 4 Affected ❑ CW ;�( EW XPTA ❑ ES ❑ PTS ❑ OEA n I414F n 114 n URA n N/A AEC(s): ❑ PWS: ORW: yes PNA yes / n)� 69"ub—d City � ( 111 ZIP '�2aIS: Phone # ( )&I /'r River Basin JJA , '�' k- Adj. Wtr. Body eo c-t e C SC. (nat / /unkn) Closest Maj. Wtr. Body s _.A_ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ' ■■■■■■■■■Lei■■�■■■■■■■■�_;1w[�l■■■■■■■■■■■■ ■■■■■■��'I�_l■1■E■■■Y=■■■■■■■ENE - .. _ ■■■■■■■■■■■■®■■i►�■■/ail■milli • �� ■■■■■■■■■■■■■■ ■■m■■■■■■m■■■■■■in iii■■■iii■n=■■■■m■■■■■■ ■■■■■■■res- ate! -- - ■■■■■EMENE� ■■INMI■■■■ ■■■MM■■1 ■■M ■■ . . �- ti{ ` `-7 /v IN Signature ** P;GZ ead compliances teri�ent on back f permit ** 3S Application Fee Check # Issuing uate txpiration uate AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Blame of Property Owner Requesting Permit: Mailing Address: Phone Number: Email Address: I certify that I have authorized �h 1 � Ji LL;5_13 -13,2 Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: .at my property located at in � S D GJ County. I furthermore certify that l 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: M rruT I Sign A��ere - Print or Type Name C Title l 3 l� Date This certification is valid through 1 I 745 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to W ' 0-v"k 's (Name of Property Owner) property located at 4o (Address, Lot, Block, Road, etc.) on 64Nk.- in 'S(4e-* 6A , N.C. (Waterbody) (City own and/or County) The applica t has described to me, as shown below, the development proposed at the above location. 1 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) 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.) f I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) Signatur w, f &fa I u r rcry ,17,✓, Print or Type Nam 4-031 �-57�f Ma ing Addre,7s ge, 28 4 `lS City/State2ip rl3- 914 -4zzq, v--k~vc wQ llG.cowL Telephone Number/email address 2,1 Zq/lq Date V "F W r Signature* Print or Type Name t 91�1/� Mailing Address CitylStatelfp Telephone Number/email address Date * *Valid for one calendar year after signature* (Revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to () •a.n�u-�� . T-,V' 's (Name of Property Owner) property located at � � 3 � 41 � �11Z.�•%r (Address, Lot, Block, Road, etc.) on CQ,h41 in : ,- , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above z o I have no objection to this proposal. 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 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) SignatuPOLIA8 �- W , IIhr Kay- rSe- Print 0 3 �pe N��" M?leWM . t4G Z 8 44 5 City/State2ip Telephone Number/email address 3Iut III Date (Revised Aug. 2014) *Valid for one calendar year after signature* Check Date Received Date Deposited Check From Name Name or Permit Holder Vendor Check Number amount Permit Number/Comments Recel t or Refund/Reallocated Columnl Column? Column3 Columns Column5 Column8 Column? Column8 Column9 7/3/2019 _ _ 7/3/2019 Li hthouse Marine Const/Darrell Ern Rand Turner, Jr. Coastal Bank & Trust 2735 600.00 GP #74607 JD rct. 8526