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Home My WebLink About72701D - AngellCAMA / '❑ DREDGE & FILL NO. 72701 � 649r;NERAL PERMIT%tAA+1� v `4�1 Previous permit# �New ❑Modification El 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 15A NCAC r ++ El Rules attached �xy\w) Applicant Name Y h 4 Project Location: County Add r ss Street Address/ State Road/ Lot #(s) City i' State_ ZIP Phone ��) _ ail Subdivision Authorized Agent .%�V��V1 City � � � ZIP Affected �W '4� L� A ❑ ES ❑ PTS Phone # ( River in AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body W_3 r nat unkn ❑ PWS. ~ Closest Maj. Wtr. Body ORW: yes / no) PNA yes no Type of Project/ Activity 0 b Vv +rid Pier ( X Fixec Float Finge Groir Bulkt Basin Boat Boatl Beacl Othe ll Shon SAV: Mora Phot, Waiv Abu ( Note Local Planning Jurisdiction) Notes/ Special ■■■■■■■■■■■■■■■■■■■■■1!■■■■�\I■/1■■■■■■■■■■ i length ■■■■■■■■■■■■■■■■■17■1l111■�■■■=�■■®■■■■■■■ ■■■■■■■■■■■■■■■■■1■�1►�J�//■!l Via/■■1■rl®■■■■■■ ■■■■■■■■■■■■■■■■■■■■■`J■■■■Illi/■■■/_�/G■■ . ■■■hannel ■■■■■■■■■■■■■■■■■�■■■i:■:�r■■��■■�■■■ ■■■■■■■■■■■■■■■■►L �>I■� 1 I\■■II ■�/■■■fit �! ■ii■■■ ■■■■■■■■■■■■■■■Fi■ 11■■ I I\�I■I ■■■■■!��ir■■■■■■ ■■■■■■■■■■■■■■LU7■ 11■■ 1 I■►.911111 ■■W1019 1WRE■.■■.\■ rnp to ■■■■■■■■■■■■■■■WSM i11■■ 1 II ■\\I ■1■1/ZL1%■�'SI�I��`►7 ■■ ■■■■■■■ ■ Ems■ 11:�:.^■■■ I■I ■■►\ y1�1■!!■■'/_■■ ..■�■■■■■■■■■■■■ I■s ONAVIRM11■I ■.. ►�►L�I!ti►; :'■■■. � �i( r■■■��=C��■■A��lilinl�i�iil�i�i%�il�i ice: ■��■■■ ■■■�■■■■■■■■■►/■■■ r■Nli■■ M1■■0 M■■■■■■■ - � ■■■■■■■■■■!!�'S '�s6r-�1 Jafr . ■■■■■■■■■■i■■M'■■■■■■ll1rH :_H�O■R■9■•n-MIl■■■■ �a I & v A M e (4) 77VIA/A I I V qgp or Applicant Printed Nam Permit Officer's Print Name Signature ** Please read compliance statement on back of permit* Si natur L' Application Fee(s) Check # Issuin Date Exl AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: DW`. AV, c Cam LI lcm4z Mailing Address: ?j8001 SW Av-41I �,� 20� j ✓ham NC 21101 Phone Number: �'l 1 I - Z LI1-{ - 3;,-\D Email Address: 1ir� ZO hCc.✓✓. t 1 certify that I have authorized M9� V t6✓�av'-2 MAVil le, , Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: N4FW 'Dock Cuv\s�c -%ovn at my property located at I � b T.:�V+V-0— in 1 /A4Y\5.W%'LIL County. 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)nformation: Signature oi- ` Print or Type Name Title Date This certification is valid through 1 1 �r CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner CA-'k { J \/ Address ofProgerty: ►�u� SW�j� ►i/� �C1k IS'cK6 r ays, ISV�JtGi` (Lot or Street i#, Street or Road, City & County) Agent's Name #: vcss& Agent's phone #: _ 110 H q 3 31 I ,Dl Mailing Address: L D l N •QyL-�lG I hereby certify that I own property adjacent to the above referenced property. The individual appfying for this permit has described to file as shown un the attached drawing the development they are proposing. A description or drawing with dimensions must be provided with this letter. I have no objections to this proposal. _ -- (hay e ohiectiems to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in :vriting within 10 days of receipt of this notice. Correspondence should be mailed to f27 Cardinal Drive Ex,t.. Wilmington, NC, 28405-3845. DCM representatives can also be contacted at (910) 796-7215. No response is considered the same as no obiection if you have been noiified by Certified Nail. 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 rne. (if y1-u wish to waive lie 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. (Property Owner Ir rmation) .4ir,�trrrftrti Print or Type Name 3 > Mailing Address -L7-7 % Citylstatelzip telephone Number �q i>nrcr (Adjacent Properbl Owner information) .S'igturt td•c Print or Type Narne /6 0 7 Z17i 0--'0-- A,,1ai/ing Address Citylstate2ip --�-- 2 g �-b J,-- Telephone Number 910: ,� 7g-31 3 7 !)rrle .Revised 611812012 Ibos" SQAV�Dql.. p?rNv,� P . w }-ioW l iniS o , i ---� M« ,e f ■ Complete items 1, 2, and 3. A. S nature gQIL I, N� ■ Print your name and address on the reverse so that we can return the card to you. Add ■ Attach this card to the back of the mailpiece, ..Received by N e) , C. Date df C or on the front if space permits. jrz;%' , . JJ /a / A) 1. Article Addressed to: D. Is delivery add diffimWIllrom item 1? U Yes If YES, enter ddlivery address below: ❑ No � � � ^7 S1N � �v� ✓�-- vsPs na L- I sly A& 3. Service Type ❑ Priority Mail Express® �' IIII IIII III I II I I I I II I I I II I I I I I II'll ❑ Adult Signature O Registered MaiIT"' ❑ Adult Signature Restricted Delivery 0 Registered Mail Restricted ❑ Certified Mail® Delivery 9590 9402 3542 7305 6333 08 ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise 2. Article Number (Transfer from service label) ❑ Collect on Delivery Restricted Delivery 0 Signature ConfirmationTT° El Signature on 7 018 2290 0001 7669 7083 urn Mal ry ured Mail Restricted Delivery DeliConfvery Restricted Delivery I er $500) Ps Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt ■ Complete items 1, 2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space Dermitc I. Article Addressed to: g `J CVV VlG� CG�cCvA tti C a8�as IIIIIIIIIIIIIIIIIIIIIIIII III11111 IIIIIIIII III1 9590 9402 3542 7305 6333 15 �. ie rvumher !Transfer from — a faservicbe/) 018rvuc2290 0OQ1 7669 7076 PS Form 3811, July 2015 PSN 7830-02-000.9053 A. X ❑ Agent ❑ A— ddressee Date of Delivery I D. 1s delivery address different from item 1? ❑ Y If YES, enter delivery address below: ? A6 3. Service Type ❑ Adult Signature 11 Priority Mail Expresse ❑ Adult Signature Restricted Delivery ❑ Certified Mail® 0 Registered Mail- Registered Mail Restrictedf ❑ Certified Mail Restricted DeliveryDelivery ❑ Collect on Delivery O Return Receipt for ❑ Collect on Delivery Restricted Delivery ❑ Insured Mail Me handise ❑ Sigrc nature Confirmation T'^ I ❑ Insured Mail Restricted Delivery (over $500) ❑ Signature Confirmation i Restricted Delivery Domestic Return Receipt .� �„ __ � � _---- � � � _. i � -��- ....,�..�.-�----r-- � .. , _ _ .,�..�.. Date Rece/ved Dats Depositod Chock Fom Name Name of Permit Holder Vendor Check Number I Check amounf Pemrit Number/Comments Receipt or Refun&Reallocatad Columnl Coumn2 Column3 Column) Column5 Colu—s Column? Columns Coh mne 12/14/2018 1 McPherson Marine Services LLC Jim and Cathy Angell First Citizens Bank 1601 200.00 GP ii72701 D Tmac rct. 7432