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Home My WebLink About72801D - Watson/CAMA / DREDGE & FILL `�Nl MovIF1i� NO. %28OI A B C ��OANERAL, PERMIT 3/5 2011 Previous permit # New 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 07 H • 1200 ❑ Rules attached. Applicant Name Address its r I -7--- 1 r-rl%u cvx-e: T... �', — City ApJA/dcc State /✓C ZIP �27000i Phone #(S)Q71-& (pS7 E-MailJ^14e&cis+0MAcl.r,rt Authorized Agent N S C o Ns-r►cvcr %o.A/ Project Location: County �Lt/V- WICK Street Address/ State Road/ Lot #(s) 5 C 0 Al CORD or R EV.T Subdivision Al /A City OCEEAA Z' , r> BE.,IcN zip ;?-74-6 9 Affected ❑ Cw W PTA [I ES ❑ PTS 'AGr,tr Phone # ( q10 ) g70 �- 4:5 f ! River Basin J AEC(s): El HHF IH ❑ UBA ❑ N/A Adj. Wtr. Body nat a unkn ❑ PWS: Agent or Applicant Printed Name Signature Please read compliance statement on back of permit ** $ 2oo 4t-2.23 S Application Fee(s) Check # 1 YLEQ M C C�1 (.l1KF Permit Officer's Printed Name Signature 2 A4 ;Z 9 �t4 2019 Issuing Date % Expiration Date Mo�IFtED 0oil AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: _ � A% — &/) l -6 OW Mailing Address: ZCI�--A9MRI1o0W IAC106P 07 agpj() 04CW /) C- ;1-7 6 D,C Phone Number: Email Address: I certify that I have authorized _ f� (_ CM7126IC4 d A-) ill D " 56 (�6 'fig Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: in e e 1 (7" a. l I I In ShZIL at my property located at 5 inunty. l furthermore certify that I 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. Pra Owner Inf i Signature Print or Type Name Title Date This certification is valid through / / 2 te�""'�' t `.�K�.`7f�. 7hf• t iCi�£��'TjM;'�r".� .s-�o�lgg„? .,�. ?t�j,.� s� n> .� ._.._ ...._. -r �kAddvoas�- � R ..at 11, LEo7%-ti4►7"i ION Ai?-3MDftAWl�YG OF FIRVPOe31. D MV6LOPMEASi ildeffOldval Fr<*osing development r m-M fdii an below or a#taco a site dratai ,9i vg if �n•.w�FtFc��! Cs�gt T• ,. -: a . e,� to a E X . t , i 'relarslanz t m a PAT i:r.:£. mctvnS �L , bmiGkAzwe,,, w .� �'a,•, �^p�22y 4ff:� 4' : •Sftfr,4 :.i.2e�i ,." eC �+ i r Ya':F ::ii .'��:_ � .% , � `3ri h.42s !� r. a•;+�* -h� ' S ��vap.� s�tgt��r•-. rj s?s Ty �� »• fin .' �r•c NE VWX s r'il•.w.�� •`-+3 �1J7:'-idC� � gh'�4�r Ji1:7•N:.4 "- -. S¢�`j),`:ifA: Sa:•��1YYi'+:1[3i5r� �i�irir: �:.-, ADJACENT RIPAR PRQPFRTY 99NER LTATEMENT I hereby certify drat I own property adjacent to Dave Watson is Property located at 5 Concord ! (Name o9 Property Owner) anal (Address, Litt, Slo Ra d, etc.) on in Ocean isle %each . N.C. (Waterbody) (City/Town and/or County) "'t The applicant has described to me, as shown below, the development proposed at the above location. ___711L_ I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND�OR DRAWING OF PROPOSED DEVELOPME14T �fhd 1'afual pi±a�#os zrg� ttrg prase must ill -4 deiMr 6 ivia *14wV or 't e�ah" a aTr Installation of boat lift and pilings E,dning tloattng dock ax1C i t Li I � 3 c iVE fiD I h UlC44f i�t-S Yet {7e�t3�,S - 5CONCORD Gr_T►l'4 VV/-dIVER 2=%_ 30P1 1 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 to waive the setback, yqt g94WM' l t i6pia, propriate blank below.) I do wish to waive the 18' setback requirement. __> I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adja t Property Owner Information) Signature re* Dave Watson 11�1 U . -A ilea Pant or Type Name Print or 7 a NB s 195 Pembroke Ridge Ct, t-5a-T Mailing Address Malling ddress BerMuda Run, NC 27006 } �{L?aoao. a C 217 W s ,99!9TVp� CtVS1tstef7lp 6- 5-6968 0 ( (-53 -g 3& ) L. "aJtt e°' Telephone Number / email address Telephone Nu er / email address lti✓ `- 24� 09 Dare Date's (Revised Aug. 2094} Valid for one calendar year after signature'' Date Received Date Deposited Check From Name Name of Permit Holder Vendor Check I...aCheckmount Permit Number/Comments Receipt or Refund/Reallocated Columnt Colu-2 Column3 Col. Columns Col-6 Column? Co/urn" Column9 1 19 H Cons C/Matl Hon Irt heck from n 200 avitl Wa o check ham 2/07/1 - 8T ck p2238 2f711 P M 01 TM— . 7737 .......................... ti= 2' ................. 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