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Home My WebLink About72399D - ZuckerMpAMA / XDREDGE & FILL No 72399 A B C GENERAL PERMIT Previous permit# VNew Modification ❑Complete Reissue El Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality O// ��/' and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC t 1-560 ❑ Rules attached. Applicant Name Project Location: County /U� Address 3 �rJ w Street Address/ State Road/ Lot #(s) City Stated ZIP 2 4n5 _ YY\t Phone # () 9 9— / _ Subdivision E-Mail Authorized Agent / r4 �Q" kS-City ZIP Affected ❑ CW J(EW PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: ((ye / no PNA yes / Type of Project/ Activity Pier i Fixec Float Finge Groii Build Basir Boat Boatl Beac Othe Shor SAV Mor, Phot Waiv Phone # ( ) River Basin CF Adj. Wtr. Bod(na m�unkn) Closest Maj. Wtr. Body �SL� L'i (Scale: (t _ 30` ) ■■■■■■■I■■■11■iC�i��,■■■!1■■■I■■■■■■■ ■■f'�!a1�111�■■■■ii�ii■■i�iiiiil`i,�1■■�l■■■I■■■■■■f1■ ng Platform(s) ■■l'il�l��i�vl ■■■11■1 ■a\■►\■■■■■ice\■■■■■■■ I■■■■■[iJ■ 9: Nam, :■■ i length ■■■■ OEM ■I■■■N■I L MEMO SIM■: ■■■■■■■■I ■■■■■I ■l�■■� ■�■��■►\■■■■■■■ I■■■■■■■■ number ■■■■■■■■I■■■w■�■a■■■■■ic■■■■■■■w■■■I■■■■■�■gym avg distance offshore ■■■■■■■■I■■■Y■I■■\■■■■Ili■■'■[�: i��I�i�Y_IMI!!�■ max distance .channel . ■■■■■■■■I ■■■■■inn■►�■\\ ■I 1■\\�1■■■11■■■ I■■■Lii�t�■■i� ■■■■■■■■I ■■■■■", ■■\■i ■1■i■■■■■11■■■ I■■■e■I■i�rr cubic yards ■■■■■■■■I ■■■Y�I ■\\■\\■►\ ■Ill■►\■►\■■■11■■■ I■■Ifil.�ilri■■ ram ■■■■ ■■■I ■■■■� ■1\\■■ ■I \■\�■■■ii■■■ I■■�i■■■■■ ■■■■■■■■I■■■w■t■��\■�\■■i■��■►�■■■■■■■■I■■■■■■■■ louse/ Boatlift Bul Idozing ■■■■■■■■I■■■11■■■■■■�■I■��■■■■11■■■I■■■■■■■■ -line Length notsure . ■■■■■■■■I�r�l�■�■■■■��A11 ��iR�i!'��■1i11<�I■■■■■■■■I ■■■■■■■■j■■■w■■■■■■■i�■c�■■�■■■■■■�■■■■■■■■ yes nr z ■■■■■■I■■■11■L'1`1S:L!■�1�■■■■■■■11■■■I■\r■r■■■I \__-1 I A building permit may be required by: C i N O � I w ( rvALLI � ( Note Local Planning jurisdiction) Notes/ Special Conditions �1�I1GS Agent or Applicant Printed N174 Signature Please read compliance statement on back of permit ** 8 a y8 Application Fee(s) Check # ❑ See note on back regarding )I River Basin rules. Permit fficer's Print ame Signature I 11shl Issuin Date Expiration Date AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: e- ((�VY1 i L.t ll �biailing Address: -3r _` 15 r'5ti fyi mCf- VV S iCCI • _ t Iv'%' t'J'i��' •�C 2,W5 Phone Number q l -9 ~ 6 ` (0 Email Address: Q QMt a C'OW Ij 1 certify that t have authorized l�� T i YtK6�0Yr / T'L('t Qom_ Ag t i Contractor Ij to act on my behalf, for the purpose of applying for and ppob��tainingi all CAMA permits t necessary for the following proposed development: Ivi Qi " at my property located at —a ,S tic m ff to r ip,r� AP t tY►!`( b in gg tInDj r County. i 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. Property Owner Information: 1S Signature 4 flu, Print or Type Name Title Date This certification is valid through 1 !, CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM Name of Property Owner. Address of Property: (Lot or Street #, Street or Road, City & 56 Agent's Name #: i e0f't��nk JDn I Me- Mailing Address: 4101 W('ighisVi de- ke. Desi9n5 Agent's phone *110.342 6/qb9 �lcla� �u,i {,c 2,01 Ili Irnirtgt�n , N� 28 03 I hereby certify that I own property adjacent to the above r( applying for this permit has described to me as shown on the they are proposing. A description or drawing, with dimensions a Ir I have no objections to this proposal. I ha, If you have objections to what is being proposed, you must notify the C m writing within f0 days of receipt of this notice. Correspondence shoe o Wilmington, NC, 28405-3845. DCM representatives can also be cont o considered the same as no objection if you have been notified by Cer o WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, be back a minimum distance of 15' from my area of riparian acce wish to waive the setback, you roust initial the appropriate bi: I do wish to waive the 15' setback requiremen O r=1 Certified Mail Fee $— Fxtra Services & Fees (check box, add lee $ppi t�) - ❑ Return Recelpt (hardcopY) $ r 1 � . _( -1 El Return Reoelpt (electronic) $ '# I� _ ': I% I Poshnedt ❑ Certified Mail Restricted Delivery $ - f�BfB ❑ Adult Signature Required $ ❑ Adult Signature Restrcted Delivery $ Postage Total Postage and Fees r` Sent r� C3 S«ee city, I do not wish to waive the 15' setback requirement. (Pro erty Owner Inform tion) Signatur Gm ?n4ma n Print or Type Name I Mailing Address " W i In i llatm , MC 21k1103 City/State)fip quo - M -141 Telephone Number 8' 8' 18 Date (adjacent Property Owner Information) Signature W n de u� 9"-5a- V\6i8 Print or Type Alame 3(1 mmef Mailing Address City/StatelZip Telephone Number Date Revised 611812012 ---------------------- ---------- f7 CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM Name of Property Owner. Address of Property: (Lot or Street #, Street or Road, City & Agent's Name* ne0(0&?iAV r' PrLC Mailing Address: �10_1 W69ttil'fSV1 tie- ke. Agent s phone #:Q1O.342 !1b9 D4*9n3 _$1 �_, 2a1 I hereby certify that I own property adjacent to the above r applying for this permit has described to me as shown on the o they are proposing. A description or drawing with dimensions rr-9 _ E, I have no objections to this proposal. I ha M If you have objections to what is being proposed, you must notify the C o writing within f0 days of receipt of this notice. Correspondence shot o Wilmington, NC, 28405-3845. DCM representatives can also be conk o considered the same as no objection if you have been notified by Cer 0 r` WAWER SECTION [D I understand that a pier, dock, mooring pilings, breakwater, be back a minimum distance of 15' from my area of riparian acce a wish to waive the setback, you roust initial the appropriate bl< rr2- I do wish to waive the 15' setback requiremena I do not wish to waive the 15' setback requirement. T er I mation) , �7e0tCtC. C'rk5fa1 lAnot Print or Type Name awn Mailing A16dress ✓ ' - W i lnni rtat m , Mc 2 9JI03 City/State7fip �l�0'342•1g69 Telephone Number Date _)�f tuln------------------------------ IrL2.7 (Adjacent Property Owner Information) Signature Print or Type Warne Mailing Address ,l CitylStatozip Telephone Number Date Revised 611812012 z NIA Dats Data Received De INd Check From (Name) Name of Permit Holder Vendor Check Number Check amoum Permit Number/Comments t or Re/und/Reallocated __[Recei Colunml Column2 Column) column4 _ Columns Co_lu_mn8 Cohm/ 7 Column8 Column9 1/20/2019 Pink Associates/George Pinkston Benjamin Zucker Wachovia 8748 _ $ 400.00 GP #72399D BS rct. 7812D 1/20/2019 Pink Associates/George Pinkston Benjamin Zucker Wells Faro Bank 8763 $ 200.00 GP #72398D BS rct. 7335D