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Home My WebLink About72744D - TraskkCAMA / DREDGE & FILL No, 72744 A B C GENERAL PERMIT Ct� Previous permit # 9New ❑Modification ❑Complete Reissue ❑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 I SA NCAC T ❑ Rules attached. Applicant Name ��y -4% k Project Location: County / JtAJ ar, to a+ - Address_-ZG-Q j_tX,,J. _loop Street Address/ State Road/ Lot #(s) City_ State /J(- ZIP -- Phone # (QLO) j; 4y -Mail — Subdivision____ Authorized Agent Affected LJ CW KEW K PTA ❑ ES F1 PTS AEC(s)• ❑ OEA EI HHF r7IH CI UBA Cl N/A D PWS: ORW: yes / r► PNA ye / no City ZIP Phone # (_) River Basin _CF_ Adj. Wtr. Body__ _ -1 0 Wt CA Wp Q /man /unkn) Closest Maj. Wtr. Body - 4!T7tVP NMI +■ ■■■■ ■■■ MEN ■■■■ MEN is ■■■■■ �,,,■!112i No ■lowt!7 ., ■■ ■■ 0 mom =-■ ■■■ ■■■■■■■1i■■■ ■■ � ■ mom am ■1■■'�■■■■■■i■i■fig-:' �� ! _�.i�■ram, — �. Will! NOW �tr�!!�Umoa ■ ■■■■■ i ■■■11.1 ■ ■ r /MEMMEMM■■■■LiiJ� ►'I �1 ■ ■ ■■ ■■_r _■■ ■■■■■ 1■i■■�iji�■w■■■■ . i s ■■ ■■ 120, A ■ �Vi�Xl�1h1 • .• . . .. l i • ■ �c_�i�_Y r - - -- ---- Age—nt or Applicant Printed fthi : i► ** ase rea mpliance statement on of permit*'" - -- - 6ybn pw444'' k() ---- - - PerrilitOfficer's Printed Name • Si722- z _ Issdincy Date I M Exair ion Date 4CAMA / ❑ DREDGE & FILL No. 72744 A B C GENERAL PERMIT Previous permit# XNew ❑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 I SA NCAC ❑ Rules attached. Applicant Name ,1 Trask Project Location: County /J{,_Un in e__ Address 601 SounJ 1- ocP Street Address/ State Road/ Lot #(s) City ; Stated ZIP 2541 SA rnt " Phone # (Q) Z' -Mail Subdivision Authorized Agent City ZIP Affected ❑ Cw IWPTA ❑ ES ❑ PTS Phone # ( ) River Basin 0 'C IQ AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body 44 "A cAlk k 0 at1/man /unkn) ❑ PWS: .,. ., 41-r-1. uJ Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit Application Fee(s) Check # _DPkr}- --i). G✓, Lei„� PermROfficer's PrintedName Ln.Y ✓ - `� Sign atu 2/ZZ4 Issuing Date Expiration Date ort e- 'Ti-rve-, Aj a -Te q4 'L 1, - ri.-Wr AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: f . A t l o ►c Ib Mailing Address: ui / Av,K Lo kJ . X4 c , 2 V 411 Phone Number: Email Address: I certify that I have authorized Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: A 6.0 t %ii / /,9 A-2 D 1 A//_/ /A-,I/�) /� r%C 9- at my property located at �� KJ inCounty. / furthermore certify that / 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: ignature Print or Type Name Title Date This certification is valid through / I / �i 1A--� ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to property located at (Name of Property Owner) I (Address, Lot, Block, Road, etc.) on , in , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must rill in description below or attach a site drawing) WAIVER SECTION I understand that a pier, dock, mooring pilings, 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 Own Information) (Adjacent Property ormatio i l ; - Signature / Sture Print or Type Name Print or Type Name 0111 Mailing Address Mailin Address City/State/Zip Ci /S ate ip Qe 1l� �� z. Y�� 7 � � V Telephone Number Tele one Number Date Date (Revised 611812012) CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM Name of Property Owner: Address of Property: Agent's Name #: Agent's phone #: (Lot or Street #, Street or Road, City & County) Mailing Address: I hereby certify that I own property adjacent to the 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. 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. Correspondence should be mailed to 127 Cardinal Drive Ext, Wilmington, NC, 28405-3845. DCM representatives can also be contacted at (910) 796-7215. 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, 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) Si ature Print or Type Name `-CoO t /" -5 Xokl� Mailing Address City/StatelZip` Telephone Number _ 7� AJ Date (AAjacent Property Owner Information) Signat#re An(.-�(� (cc A[ Print or T pe Name JJ Mailing Addres 11 )�'l tin I n/A�A /V( ity/State&ip � 10-- 6;D4 - - Ll Telephone Number Date Revised 611812012 Date Date Received Deposited Check From (Nome) Name oI Permit Holder Vendor Check Number Check amounf Permit Number/Comments Recei t or RefundlReallocated CoWm1 Column2 CohNIVII3 ColumrW CoA-5 Cdumt6 Column7 ColuRttQ Column9 1/27/2019 Raiford Trask Jr. same South State Bank 2060 $ 200.00 ' GP #72744D SS rot. 7814D