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Home My WebLink About76263D - Grisel�cAMA / Q DREDGE & FILL NO. 76263 A B c GENERAL PERMIT Previous permit # :504ew El Modification 'Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality O7 I ydQ and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC ❑ Rul attached. Applicant Name /4 � S� L Address D � 5 � p City ✓✓ State /✓G, ZIP7O 1 ` Phone # ( )V Z 9 1/ TE-Mail Authorized Agent //bi� . Affected ElCW $OW PTA AES ElPTS AEC(s): ElOEA ❑ HHF ❑ IH ElUBA /Z N/A ElPWS: ORW: yes / r!� PNA yes Project Location: County C! f 4U W Street Address/ State Roa51/ Lot #(s) Subdivision , City a ZIP Phone '# ( �— River Basin ' Adj. Wtr. Body!litit4 lS ' nat unkn Closest Maj. Wtr. Body • EWORN NE■NEE■E■■■■■■■■■■�■■■■■■■■■■■■■CVO - - ■■■■■■■■Ir''fir■■�■■■■■/f■■■■■■EI■■■■■■■■■■■■■ ■■■■■■■■■17■■■■■■■■■■■of■�1■I ■■■■■■■■■MEMO ■NEE■■M■■� I �■■■■OEM■■■■E■ �:-� I ■■■■■■■■■EOM ■■■ ■■■■■I■��■■ ■■■■■■■�■■■■�■■■■■■■■■■■■ r . ■■■■■NO:NIMMUM0 ■�■■1■■■■■I■■■■ME■■i■■■■ • - EE■EEO■■■■oEE■■��oM■EI■o■■■■■■■■■■■ EMOEM■EEEMM■E■��n�H■M■■SEE■■A■■■■■■■ Elm■■■■■■■■■■N■EEEi■E■■■■■■■NEE :E■■NONE ��■■■Rlisfhi■�EC�fll■EliiiiL'eli . . , �E�%Nisi%E■■E■M■■■■■■o■ ■ ■■ ■■■■ Boom ■■■M■■■■■M 6M,4� 1, i9��-- Agent or Applicant Printed t4ame ignat re Please read compliance statement on back of permit Application Fee(s) Check # Pe it f icer's Printed Name t-- Signa re .Zq-.7,tj -7.24.� Issuing Date Expiration Date - _ yl. ! f � 41 i i .., j f . 14' I 1 ! i Rip 7 i r CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: i U Q n m( 5e I Address of Property: o r �� ( (Lot or Street #, Street or Road, City & Cou ) Agent's Name # Ej1j►� e M4r! e ns Mailing Address: AU E4 dt L4fie 7 Agent's phone #: I 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 descriution or drawing with dimensions must be provided with this letter. l I have no objections to this proposal. _ I have objections to this proposal. L K 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. Contact information for DCM offices is available athttp /,�rvww.nccoasta/management -rreVweb/cm/staff-li- sting orby calling 1-888-4RCOAST. No response Is considered the same as no oblection if you have been notified by Certified Mall WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must be set back a minimum distance of 15' from my area of riparian access unlesswAived by me. (if YOU wislyto waive the setback, you must initial the appropriate blank bel I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Pr arty Owner Inf rmation Signa e �rq6jj &1 d Print or 7ppe Name 6 I &A 5-�-e -- Mfu►g Address j QW/Sta*Zp C Telephone Nu/mber/Email Address Date J (Riparian Property Owner information) Si to —` �r Lov )Piet Print or T e Name. o -Donni Pd Mailing Address 17 City&,***� q / q - !F�-7,)-- -=� ct Telephone Number / Email Address 6 a off,0 Date (Revised Aug. 2014) CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: yC Address of Property: �, r (Lot or Street #, Street or Road, City & County) 4 Agent's Name # inn �qj'1 n C ailing Address: Agent's phone #: q 10 - ��j- �t� ry5 r C a14 6 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 orovided with this letter. 1 I 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. Contact information for DCM offices is available at http:!lwww.nccoastalmanagement net/web/cm/staff-listing or by calling 1-888-4RCOAST. 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, boat ramp, breakwaterboathouse. or lift must be set back a minimum distance of 15from my area of riparian access unless waived by me. (if you wish to waive the setback, you must initial the appropriate blank below.) '�tQ` �• I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) J Signature - rua h C l 'e,e 1 Print or type Name 1 rc� ce-+ Mailing Address Ct , NC a1� City/State/Zip �L.9 Ag- 994 5 Telephone Number/Email Address Date (Riparian Property Owner Information) Signature Print o Type Name �Icl uc Mailing Address �%-!� tl -,ch, N C, z 75-(2y City/State/Zip IIIg- Telephone Number/ Email Address 3 -/ 8- dQ Date (Revised Aug. 2014) AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION Name of Property Owner Requesting Permit. Mailing Address: 0 Phone Number: gig- LLA1719 4-r Email Address: I certify that I have authorizedI Agent ! Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: 5ed l I DC C k 6111 at my property located at in ) County. I 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: Z-A I, 0-n-ze-41, /Signature UI Print or Type Name D oijer Title I 4- Date This certification is valid through / ! NC Division of Coastal Management 9 Cashier's Official Receipt 6rV Received From: 6-, `— Permit No.: 3 - n Applicant's Name: F "' Project dress: Address: 10399 AB Date: 3/ 2 20 , Apo Check No.: D7/ County: Q (f Please retain receipt for your records as proof of payment for permit issued. Signature of Agent or Applican Signature of Field Representati Date: Def. Recelvetl Date De etl Cl—k From Name Neme of Pwmk Nok/w I . Numbw Cneck I Permlf Numbw/Comments--j Recal f or RWun&Ra llocatctl Column Column2 Culumn3 umn Cole Co/umn5 Column# Column? I column# Column# 3/24/2020 Wry Ennett do Ennett Marine Constructic Bryan Griser Coastal Bank & Trust 2802 600.00 GP p76263D JD rd. 10399