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Home My WebLink About74842D - TanglewoodCAMA / ,❑ DREDGE & FILL No. 74842 A B C(J)' GENERAL PERMIT Previous permit# ANew ❑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 J 5A NCAC 10 77 H . 1 24D 0 J.L . + J /� ❑Rules attached. Applicant Name �n�n C Project Location: County U��nSw ► C- 1G.- Address Po 31j�,3=' t1 Street Address/ State Road/ Lot #(s) '3/8S City ��C-'k164-e State�� ZIP a� 4 S9 WC eey � Phone# t0 )-IK II 13 E-Mail -POA@afMc.h+ Subdivision_ Authorized Agent H-O . c/a, M0.Y H0 Affected ❑ CW W EW N PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ N/A ❑ PWS: ORW: yes /6pj PNA yes /_0 City Q S4 ZIP Phone # ( ) River Basin L�.Mber Adj. Wtr. Body A\ vi \JU /man /unkn) Closest Maj. Wtr. Body �k�UJ ■■■■■■■��niw�� ■■ � ■! �■■tea■■■■■■■■■■■■■■! ■■■■■■■��■�� ■■■ �!■ ■■■■►ram ��r��■■■■■ i!i■�iiiili■i!liilii�■i■liii!lli�iiii■�ii� i!i■�iliili■i�eiiiii�iiiiiiiiiiiiiiiiiii M. !!!!!!!!!N!!��l�l�!!!!!!�!!!!!!l��■■! illy • WN Agent or Applicant Printed Name Signature *e Please read compliance statement on back of permit .. 'ocy �- Application Fee(s) Check # 13 ffe-kC oc Permit cer's Printed Name /�., �� ✓ P"�—ram'" Signatu�te z0 Issuing Expiralion bate AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: 17 Mailing Address: _ ; ti. �i'x 3 Phone Number: `i I6 — it a 3 Email Address: + tfi L cl I certify that 1 have authorized H5 Construction J Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: at my property located at 3 j s-.:�- d� %�° , r F', 5 i_-' , in - KiCounty. 1 furthermore certify that 1 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: ell ,, 4(z, - '1 , XL,"-; Sigrfature YL-':i r`► Y.i_ SIC: �n�'"� ��"r`:�iG� -- Print or Type Name C4 "ct C,-t Di 4r L5 Title Date This certification is valid through I ! TY M A I hereby certify tttat i ow edj t t.r pro art iodated ai 3 a `, (Woo of Property r) (Addre6m, Lot, Black, flood, etc.) OP In N (41ia"ady) �, KC.'1� 1Krt aluilOf CQLf31fj►} The applicant has deacr)badd to ine, as stum n WOW, the devetopM&M proposed at the above location. I have no ob)ectfon to this proposal, i leave @bJertions to wa propo$14 r posing +[�N proposing p +gNDfO#t. DRAWftif6 QP PRDP0$9D f EVL,-- .t�PAMNT ~ development Muot MI In ctesedpMn below or etfech a site draw ft) T�(�. . 1 Ph Drk k f u+�l Ate�d. that a pier, dock, MWrin9 Akin a„>X ictA►a iitot+Re, fit, or groin must be Set back a minimum dista"W of 15'.%vm my area of dpat'teh access wfess waived by me. (if y wi$h to waive Me tietback, YOU must tnit#a! the appropriatte Wnk befovv.) l do wih to waive the 116 s*Wrk requirement. f &.nott+eish in waive tPsa5' setback regzlker�� (property 0" Infam:st cnji P#tt or Type Mart AfaWg Address C*Y' eta2101 felsptw»e Number ra- la;—�7 owner tntornoition) X PT TP* Nears Adet7fl�q ddirss �-j r/: I elepho Wntber Date (RevfSOIJ 5/1W012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Teo h 's (Name of Property Owner) property located at 31 3 ,5 �J)q Ic IL i,' _ (Address, Lot, Bloc�ks. Road, etc.) on %� C i�L' in JCc 0N.C. (Waterbody) (Ci n and/or County) The applicant has described to me, as shown below, the development proposed at the above location. A{ 4 -( 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) E45+ �1't '' FD 1^loaii hj WAIVER SECTION 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 rie. (If you wish to waive the setback, you must initial the appropriate blank below.) X/ I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) Signatte / Print or Type Name Mailing Address City/State%Zip Telephone Number/ mailaddress / L !JOG, /I�'1 _�/�r1/�< �J /CarT ![i 1.1 / (� V Date a tiro Signazu c* Print or T e Name Z3 C Y O ceg G r'+c S'� C •� • S w Mailigg Address �,3a (, 4 N ( )-�s�! G y City/Sta e ipT— Ot t 1 - SSA' 4' • 03 or Anurr�S.tc Telephone Number/email address Dule * (Revised Aug. 2014) Valid for one calendar year after signature" (-Yl-o::[: rz 0J Ex is; o's �, WOO> .D. c:Y,, ( ,L -r vn -e ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to 1" U/'1" 's t� I umproperty located at �� UC �rd/- 1/tev'� > s ,(o Property Owner) l (Address, Lot, Block, etc.) on , in uL4 N.C. (Waterbody) (Cityfrown andlo County) The -�ppfi ant has described to me, as shown below, the development proposed at the above to I have no objection to this proposal. 1 have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DZr Zi-W— ;— findivifMal nrnnncing-rhvelnnnteant mulct fill In descrlQrlon below or attach a site drawing) WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin myq back a minimum distance of 15' from my area of riparian access unless waived by lfwilsdo h to waive the setback, you must initial the appropriate blank below.) wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature yj �L [! , - Ale - Mailing Addless T91ephone Number/email address Dare "Valid fv: i7ilnt g(Type *m Mailing Add ss / Telephone ber/email address tie Dare* (Revised Aug. 2014) Date Received Daft Check From /Name) Nama ./P�I(Hokfer Vendw ChOO Number Chock cunt Pe It Number/Cw ft Recai t w Relund/Reall—ted C.1-1 cat-2 Column3 cdumM C.1um.5 M Columa7 CdumnS Column9 1/92020 Lighthouse Manne Construction Inc. H5 Construction LLC Brian ScheP rley Tab lewood POA Coastal Bank and Trust B88T 3002 $ 200.00 GP #74853D JD tci 10931 BB rct. 9470 1/9/2020 2426 200.00 GP #74842D