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HomeMy WebLinkAbout76235D - Cox�KCAMA / ❑ DREDGE & FILL No. 76235 A B C (V ENERAL PERMIT Previous permit # New' ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued As au loorized 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 U--f- H , 1 2-U0 I t ❑ Rules attached. Applicant Name W k `� � C- Cb yC Project Location: County , .. Address II (�/2 City Y� S ((� (� State_ tq C ZIP -2 \JKD Phone # E-Mail ti A Authorized Agent & c_ c� , L) ( � C_.e ❑ CW WW WTA ❑ ES ❑ PTS Affected AEC(s): ❑ OEA ElHHF ❑ IH ❑ UBA ElN/A ❑ PWS ORW: yes /'n�' PNA (�P/ no Street Address/ State Road/ Lot #(s) 1 �• / Subdivision City ZIP z,64—To Phone # ( ) River Basin L . - ipt Adj. Wtr. Body r- �,�� L (2 - v I .(naL4man /unkn) Closest Maj. Wtr. Body m W W WWI ■■■ ■no \����■■■ <BRENN■■ �• ■■■■■■■■■■■■■■�■■■ MEN ■■■■ ■■■0��..it!!I■■! MEM■■■■NO/■M ■■■■■■ ME■�■■■■■ ■ r��ll�!!!OG■�.�■■MH __ ■■■■■M■® . • . :. ■■■■■■■Mi,■■■M�iEO■EOM■■■IRS■���■ ■■■ ■■■■OMEN■MEN ■■[IC�I��y i�i■i■�■■■�■■■■111■■■■■■ ■■M■�MMM■■■NEE■� �■�►1■■■■■■■laIi■■■MEN MEN MENNOME■EEM■MI■MONE■■■EMOMM■■OMM■M ■■■ I NEIMM� ■1111111111WIN III==IMI MOON MEN ME ■■■�NEN■MN■N■N�■ NI iris■■■E■■NM■■ MEMO M■_■E�MEMEM■M■ ■I ■_ ■■M■®M■M■MM■ ■■MMO!hrtiO����M■M■MEOEM■M■■■MEMO �c+ on � IDN"Am""■■ MEN ■■■■�■■■OM■■■� _■■■_�_ffip"�N M���I�r�TA■■■M EMS19M ME MEMO ' ".Q��'.'l.�'Fl Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit* o c) - 1353 Applica n Fee(s) Check # Permit CIi d Name Signature 3-I-- -Zow 74-16-2—o2c) Issuing Date Expiration Date AMA / DREDGE A FILL No. 76235 L. ENERAL PERMIT Previous permit # A B C Wew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As aut6rized by the State of North Carolina, Department of Environmental Quality l and the Coasts! Resources Commission in an area of environmental concern pursuant to I SA NCAC T-1'C I ?oC) C Rules attached. Applicant Name e—r\ 6b — Project Location: County \ `r���� Address � ,24 �l v e_.u.� / E h/ ,� Street Address/ State Road/ Lot #(s} I Say City__- � k � � o � State_N c zl P2 � 10 %4-1A A- ^,� \�i r S Phone # (qua) t( cA L F7516 E-Mail __ Subdivision Authorized Agent L^ 1 e ,. c L V r -, C�t,,City \%\gal. zip 2, 0-0 Affected cw 4" )CPTA J ES D PTS Phone # ( ) River Basin �✓...�jw, ,/ __ AEC(s): ❑ OEA � HHF IH UI&A D N/A Adj. Wtr. Body Q, ��r5ZEjQman Lnkn ❑ PW5• ORW yes ZD- PNA � no Closest Maj. Wtr. Body >At ,#J 4 Type of Project/ Activity 1A�SA y< <s21 Pier f Fixed Road Finge Groir Bulkh Basin Boat Boat! Bead Othe Shon SAv Mor; Phot W" A building permit may be required by - (Note Local Planning Jurisdicti jj _ UU Notes/ Special Conditions ��+. S �CiNy`Y A./�KO✓ �20 a Agent or "ce tom% W@dl 2 �' PO on ra-d�compIiance statement of permit*' Zoo o Appi onree(s) Check# (Scale: 14 T S ) . ■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■Y■ �:1■i■■C■■■■gffil I".I"ar�TAFa::� ■■■■■ �■■■■■■■■mooMM ■■■ ■ ■■■�■■.t1��(1■■i■illilf�irwM■ IMIF so ■■■■■■■ ■■ IC %SO L'!■■■■■■ ■■Irr■■■■■■■ ■■■■■� ■��iN� -amain ■■■■■■■■■■■ cubic yards_ ■■■■■ ■ 1■ ■1■■■i110Wim "! 1ffirr"IR9■■■■ ■■■■■■Ousw ■■■■■YI��LQ�I■■■■■■■!a■ii■■■■■■ BMW ■■■■■■■N■■■■■■■1■■�■■■■■■■■■■■■■■■■■■■■ or■■■■■q■■■/■■■gyp■■■■■■■■■■■■■■■■■ ■��■�No MOONS !!f'!a■mos ■■■mm■ommmon e��:=c-�.■ i■■■��■■■■■■■■■■■■■■■■■■■■■■�I>•i■��1A■■■ � ..�� ■ r ■.-=====Imo:::-===-� not sure Y. Ly�"�!1�1;!�ti �7�1 ��'� �■ ■u■■■■i■■■■■Kri+��ww�rr■�:■■■■■■■■■z�i ■ ■ ■11!!tl�L�""�t/�i'f■■■■■■■■■iilii■■ ■■ ■■■■■■■■■■■■Yi�i�ii�lrirti�■il■■■■■■■IG:.' ❑ See note on back regarding River Basin rules. 2 Permit NNaanm Signature 3-1- 10LQ 73 -1 b-Zo2) r) Issuing Date Expiration Date v o oo:V i hi N3 X96 Zli 714 _a I-- A- NCDENR North Carolina Department of Environment and Division of Coastal Management Pat McCrory Braxton C. Davis Governor Director Natural Resources John E. Skvarla, III Secretary AGENT AUTHORIZATION FORM AGENT AUTHORIZATION FUKM Date: . ' I L(-I Name of Property Owner Applying for Permit: Owner's Mailing Address: jj�V Phone Number (31,2 y /shy Name of Authorized Agent for this project: Gckcp eocv5li %-- JI41r) Agent's Mailing Address: 2`b`lL� Phone Number A h 919 bq5 I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct the following (activity): For my property located at 1'� i b t' r b(j) i I , ,r%��7 f<= ,: ���- ,�. �,7 This certification is valid thru (date) ��C�`p � '�'� QIC ,-) Property Qfivner Signature Date 127 Cardinal Drive Ext., Wilmington, NC 28405 Phone: 910-796-72151 FAX: 910-395-3964 Internet: www.nccoastaimanagement.net An Equal Opportunity 1 Affirmative Action Emooyer CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: �ldl L Lox" Address of Property: O , L Lot or Street #, Street or Road, City & County) Agent's Name #: Agent's phone #: Mailing Address: iL 1,rej {yd )1 34--- LLLAzzo 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. C1440I 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. C9P I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature f zL2rt a Print or Type Name i L'l 1, vet ben") ,i2r � 4/ Mailing Address �tty/State/Zip Telephone Number (Adjacent Prog�rty Owner Information) �Signature, C'� J 4, 1q,11 Print or Type Name Mailing Address �f j ,j�(l S&l ,Je !y cr �/ T7U City/State/Zip �''/0-4e0-gi71-7 Telephone Number Date Revised 611812012 RLCUPT FMQVL3LTLO 01VISKIM OF COASTAL IAAMAGEMfMT ADJACENT RWASKAN PROM" OVPA' NOtOCATKWMAIVER FORM o* Sheet 0 SUW of ROWfey A Comady) Ila . flltuj't� 1 fJ4- v" wwa has ftso*wo 'a "' IA on ew wwow cotom+g We dmvftQQLAkv'bL=mW — 1"'l *pw box �' 1", - I bov . " N yft he" *61#900" to what is b" PnMPOSSA you must ni*Wl Um Di*MK- at C04114) MenooWivent OC* in WrMnq *Rhin fO days of ret OW SLOWS nobc* CorftspWdencla should be -**-d ro 1:7 C&I&nas Wive Lit. WMPrington. MC M405,M43 DCM ropfPSOMM"S can also be a:orqxcfvd At J910) ?W771$ No responlo is considwod the &am* as no citipcDon it you haw boon roosms.d by Cft%j-4 Mod, WAIVER SfCTX* fay�,Js4a>tttl VW a OW, dock, tttgprrfp PWV Coma- *Wot tKWN-,*P. 1,11 "groan rn,;V to W, tW:i, 4 ~we" ddWite of IV ftm " WM*Gf %Won wrmA a i*" *apsed by x* $*Miack tau MMt the oppmomm bw* 06600 0 J., to *&" the 15' berback I*qwtofnwd I do Alm W"Jll ID Wallo the M we** rmwoffwlt 1p ovnw WOMMOOM) Pw or rAv Now jjjq AAPAVAO*oa f Y. 'v 2 fia m T'64pftm Ako 01 Aft" A*ftu Rev~ 12 Data Ret.h d Dm itd Check Fmm Nam. Name of Permif Hold., Vendor Chalk Number Chat amount Pwm/f Number/Commenfs Rate!.( ., Rdund/Reall«atd Chh.mnf C0/umn2 Co1umn3 Cuh.MN CO/unm5 Col—S Cohmm7 "—n✓I Column9 3/19/2020 Willie Clarence Richardson/Richardson Cc Gnce Construction_ of Brunswick County in Backwater Marine of NC LLC 1 Dale C Funderburk Jr. Reynolds & Mary Lisle BBBT _ 7663 13539 1004 $ 200.00 $ 200.00 a 600.00 GP #762820, GP f76235D GP f76277D BB rcL 10920 _ BB rcL 10918 BB rct. 10909 3/19/2020 William Cox _ BB&T 3/19/2020 Jamie Sischo OUT 3119/20201 same South State Bank 1 16021$ 200.00 GP l76265D I JD rot 10393