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Home My WebLink About74874D - Tarttl 6� CAMA / - I DREDGE & FILL NO. 74874 A B C 0-NewF,NERAL PERIMIT Previous permit # ❑Modification ❑Complete Reissue El 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 I SA NCAC ! ❑ RYles'attached. Applicant Name ' _TG Project Location: County Address G Z Street Address/ State Road/ Lqt #(s) Cityv� Statef- L ZIP Z�� 7 � d Phone #'T-00 943 E-Mail Authorized Agent 66 in 17� Affected ❑ CAN EW YPTA 9ES ❑ PITS AEC(s): � OEA HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes / no. PNA yes no Type of Project/ Activity Pier Fixes Flow Fingr Groi Basir Boat Boat Beac Oth( Shor SAV Mon Phot WaiN Subdivision city L�7 ✓ ZIP 7' Phone # (� }-�"�� River Basin V Adj. Wtr. Body a 1,04 0 G unkn Closest Maj. Wtr. Body (Scale: (.— 21), ) ��if/■■■■■■■■■■■■■■■■■■■■■■■■■■■ Y ■■■■■ Platform(s) i length ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■wlt■w�■■�■■■■■■■�■■■■■■■■■ number ■■■■■■■■i�iii'■iiii■iiiii■■■■■■IS■■■■i■max distance offshore ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ cubic yards ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ramp ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■1 �� 1■■■� ��■■■■■■■■■■■■■■■■ ■■■■■1��1■■■1�■■■■�1J■Fsl'9S�N��11�■■■ ■■■■'iFSRNnotsure fline Length ■■■�I�LW �!i��■�N��AGI��II�LI■III®■■FI■■■■ yes i■■�■W■rA■I I■■■■■■■■■■■■w■■■■I 11■■■■EM■■�i,■■ �i■IS�l[Lu�L■L'?■■■■■■■■■■(/7G�(�'i■■■■■■�fT.t":i!i.�i�J■■ . ■■w■■■■■try■■■■■■■■■■■�I�w■nl�r,��■■■■■�■■■� •_��!■��u■■■■■■■■■■■�i■■■■■■■■■ A building permit may be required by:d/ / /w ( Note Local Planning jurisdiction) Notes/ Special Conditions // G"A4 1 I Agent gr'Applicant Printed Nam4 PerfnitOfficei S' nature Please read compliance statement on back of permit **r Signat r Application Fee(s) Check # Issuing Date ❑ See note on back regarding River Basin rules. Name 27.ZO S • ,2Z, Zo Expiration Date AI'td s� I i�m"f AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: 3 Da 1 a rd 6 (L' Phone Number: q (q- gab - 4,26 Email Address: I certify that I have authorized En!)et. ri n e 6 Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits f necessary for the following proposed development: eA L&1 11, h e cd l%GAG IS at my property located at in 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: 4��l <j—ez:� Signature l Print or Type Name 4merujLer Title Date This certification Is valid through I i ADJACENT RIPARIAN PROPERTY OWNER STATEM NT I hereby certify that I own property adjacent to 1Ill-v a r "t s Property located at Yd-�C�-,- ("Me of Property Owner) on--c(Address,nLot_ k, Ropd, etc.) �.�, N.C. (Waterbody) (Cl and/or County) The applicant has described to me, as shown below, the development proposed at the above lOcdQr- ?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) pleall: see crf{ac heck 4p-,:kx . i n J WANE SECTION I 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 me. (If you wish to waive the setback, you must initial the appropriate blank below.) ,�nva` I do wish to waive the 15' setback requirement. 0A& -, I do not wish to waive the 15' setback requirement. (Prop O r Info' rm`tlo�n) (Adjacent Property Owner information) St aF a Signature" , r- 5 i9n Prf tor T Na Pant or Type Name ja•�p hip q� r -3 A - sr e o G1�r-f d Mailing Address 1A Cf rs aterz; Tatephorre Number / emafl address 4 Telephone Number l erred address Date - ` Dote • 'Valid for one calendar year after signature' (Revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to ! V Q 1' 's property located at �� rd 5 -�t-C a+ ( ame of Property Owner) (Address, Lot, BIo k, Road, etc,) on in (Waterbody) N.C. (CityrT n andlor County) The applicant hM described to me, as shown below, the development proposed at the above 10 10 ` 4 have no objection to this proposal. 01;�1' nrt ____„____ I have objections to this proposal. DESCRIPTION! AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill to description below or attach a site drawing) P(eaic see crffnchcd WAIVER SECTIONi I 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 me. (If you wish to waive the setback, you must Initial the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. I(Pr,orty ner Infonmatio (Adjacent Property Owner Information) SigAae Signature* Pri t or T pe 1 e Print or Type N me j�•�p Ma-'ng d M iling ddrass 1" �City State rp lT" —� 7 t2 (q- D - �G8 Crty/Srere! y4r Telephone Number/ email address - Telephone .Number / em address 4? Dare Date • Ll, 9,n/d rrr e YA46o N 'Valid sor one calendar year after signature` (Revised Aug. 2011) Date R-4-d Date Devosltod Check From Name of Pemdf Wdar Knd- Check Number Chock mount Pemdt Number/Comments R t a Ralund/RWloeeted C.1-1 Column2 CWumnJ W-9 Cof-5 CalumnQ Cdumn7 CdumnL Cokrmn9 1222020 Allied Marine Contractors LLC JeffreyRiecken First Citizens Bank Coastal Bank and Trust BB&T 8615 $ 200.00 GP i74875D _ GP •74874D GP #74804D JD rcL 10940 1222020 Je Enrtett do Ennett Marine Construe BillyTart 2688 $ 600.00 JD mt. 10939 1222020 I H5 Construction LLC Austin Healy 2457 400.00 BB rct 6606