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Home My WebLink About74809D - Buckley-jCAMA / DREDGE &FILL No. 74809 A .B C D GENERAL PERMIT Previous permit# LXNe%A( Modification ❑Complete Reissue CPartial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality �� e and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC �i-� -� r , `❑ Rules attached. Applicant Name I� l�[ f t {fI{ t 'f Project Location: County �,r�iy p�;�'6'1 r Address ; A! i-4t �d 1—r , r; Street Address/ State Road/ Lot #(s) City State , � ZIP, Phone # ( ' 9:; F-Mail ' ' ' ` _? f Subdivision Authorized Agent : (Ji s f j /1,C, I rVjLJf `'�' °' City ZIP r Affected El Cw ❑EW PTA ❑ ES ElPITS Phone # ( -.__. River Basin ? " ❑ OEA HHF ❑ IH ❑ UBA ❑ WA e r ■ ...- :.. �/■��■■�I■�■11■■■®�I�■��■ ��■■■■■■■■■■ ■rO\■■10 ■■■ ■■■■\�'i i7�'I�®■!�Yl�t1�L. ■■■MUMMriMEir■riMEN ■■■■■■■■■YJ■■■■■■!!I Irk il��!!�■■�i�liYilil■■■■■■■■■ ■Ali■■!"�li■■Ifil7■■`!''lli�!�ri■ii1� �■■■■■■■■■■■■■■■ ■ �wrWiNUMMUM, i NIMISOw! �W MOMMEM■■■■MEMO • - ■�■■■■rr�■.�■■N�r�■■■■■ram■■■■■■■■■�.■■■■■ !I[�i�■■�■■■■�■ii/!ice■■■!! � "�7■■fl■■■■■■[�3l�Y!%■ ■l■■ 11LIS"Ail■11I1110 ,i:71?�iiiS■iCs r or Signature ** Please read cormpliance statement on back of permit Application Fee(s) Check # x Permit Officer's Printed Name IT e3i Signature Issuing Date Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: 1 L1Q Mailing Address: �L�� dZ \ L,5tvai/V Phone Number: _ (o (p �3 �-77 9 Email Address: 0 tia cr - "ICk < < Cd I certify that I have authorized Southern NC Marine LL , Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: Hurricane Dorian Repair and possible additions. at my property located atL� Z in 4ILCounty. / 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: Signature M Z rint or Type Name bwA.;e(Z Title 3 / (� / 2-0 Date This certification is valid through /�_/ 2j ADJACENT RIPARIAN PROPERTY OWNER STATEMENT i hereby certify that I own property adjacent to �_ 's t (tj , �jName+of ropert caner property located at �� _ f;Address`Looad, c.) (Waterbody) (City/T n and/or County) Thecant has described to me, as shown below, the development proposed at me abue location. I have no objection to this proposal, 1 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 1 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.) {bi I do wish to waive the 15' setback requirement. do not wish to waive the 15' setback requirement. (P rmation) c;lYXIre ;p / -7-7 �_ Telephone Number ,pure on) P2 Cor 1 ype_ICA G 4 malling Q dress 409 -, c;tv oa�e2?.3 �214 Telephone Number 3-(.- ?co Dale (Revised 6/18/2012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to �� u�,kl� --- s ,.�_.r_ s o..,.,b.+u owner► _ , property located at on WS (Wa WIM 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 fill 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 requir iment. I do not wish to waive the 15' setback requirement. (Property Owner Informatio) (Adja 4VrlrD y Owner information) iKnarur Az nulu t >t Lc, h ,r, [-ram Pft cr T eZI m�� rl ��+ - Pr+nf or Ty}�pe Narne C� 2411 L121L g Add r s mpilinp Address r? G bv� r t yni,� AlG l Ct lStafe ip Telephone Number Telephone Number Date J)ate (Revised 611612012) • o� v .r h �1� N 3 , xs3 � Gazebo will not be , built Addition of 4' Length to allow for bench I2'* W;�e� c.c,. *v-1 �XGtca. 3� � I ems% C:ra•SS Addition of T wide x 16' long fixed platform along creek bank edge in line with current NOT TO SCALE Daft Recdved Date Depodted Cheek Fmw fA4,PW Name o/ Pe—tr Holder Vender Chock Number Chock amount P—if NumbenCommenft R a RdbndRtedkxfd C.k~l Column2 COk~ Cnlumnl Cakermd Cok-7 Columnd Calumn9 3/13/2020 Luigi Montesano same Wells Fargo 2287 $ 200.00 GP #76244D GP #74809D BB rct. 11470 PA rot. 9739 3/13/2020 Southern NC Marine LLC Jonathan Burkley First Bank 1272 8 200.00