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Home My WebLink About67998D - Azar�CAMA / DREDGE & FILL *14 S. I I, GENERAL PERMIT ram 4f ,1799 Previous permit #_ A B C (!) .New - Modification ❑Complete Reissue El Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Resources and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC Q� Applicant Name (---)f-0Yn Q y/� Ck Y- Address i "� i � (., O1,AA 1I ( t V tv City (, 't x�Y\1�� State /J( ZIP Z.-7 2 '1Z Phone # (-�Jj Ll Z (� SCE -Mail Authorized Agent G r ce.. C o yv�� c h a YA Affected ❑ CW ; 4W >(PTA ❑ ES ❑ PTS AEC(s): ❑ OEA HHF ❑ IH ❑ USA ❑ N/A ❑ PWS: ORW: yes / no PNA yes / no) ❑ Rules attached. Project Location: County 9 C Street Address/ State Road/ Lot #(s) ;? 'VtA;K;kA6A SI Subdivision City_ �4 zip �f �� hone v ( 91 Q ) 1 !— 1 5 River Basin LO-A �,ay— Adj. Wtr. Body ca V1 Ai (nat / /unkn) Closest Maj. Wtr. Body Alw W - - - MINOR ■■■■■■■■■1■wla.d ■■■■■ III■�■I ��1n,r■■■■■■■■■ ■■■■ ■■■■■■■■■■li!■ 1■■■■■ 11 ■■■■I ■■r■■■■■■■■■■■■■■■ ■■■■■■■G:S;1'■ • --■■■■■■illl■�■Nrw�lN��■■N■I■■I�.11■r■irrirl!■■ ■■■■■■■■■1■■■■■■■■■■■■ ■■��w,��a■■■■■■■■■■■■■■■■■■■■��nwi: ■■_■■■■■MNEN ■■■■■ ■:■■■■■/1r7�il■il�■ irili■11�■■ ■■■■■ ■I■■■■■■■ zd■■■■■■ A''■■■■■■■■■■■■01112 ■i ■ ■ Nent or Applicant Printed •Name Signature * Please read compliance statement on back of permit* 100.Cu 2Q�"Z I 0i-�5 Application Fee(s) Check # Fa V--C Y w Permit -� - L471-i-o)-7 Issuing Date I E iration Da6e NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: l 7,aPermit #: G7 Date: d21oY/2-(% Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement found in your Habitat code sheet. TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet (Applied, for. (Anticipated final (Applied for. (Anticipated final DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. Habitat Name Choose One includes any Excludes any total includes Excludes any anticipated restoration any anticipated restoration and/or restoration or and/or temp . restoration or temp impact - famn imnarfel it n.4 amnnnfl I famn imnaefel mmmnnfl (� Dredge ❑ Fill ❑ Both ❑ Other rV Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other 0 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑: Both ❑ Other ❑ Dredge E7 Fill ❑ Both ❑ Other ❑ . Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both 0 Other ❑ Dredge ❑ Fill ❑ Both 171 Other ❑ Date Date Check From Name of Permit Vendor Check Check Permit Receipt or Received Deposited (Name) Holder Number amount Number/ Refund/Reallocated Comments GP Grice 67998D 2/15/2017 Construction George Azar BB&T 10975 $400.00 @$200 SF rct. 3552D `• NWDE�IR North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis Governor Director AGENT AUTHORIZATION FORM Pate: John E. Skvada, III Secretary me of Property Owner Applying for Permit: N me of Authorized -Agent f r this project: - a ry�1CS�r�tQ r� Owner's Mailing Address. R \ - 272SA2 - Phone Number(. ) Agent's Mailing Address, CYL r Zg Phone Number ( tG��V� S I c4rtify that I have authorized the agent listed above to act on my behaN, for the purpose of applying For my property located at D,n is vali hru (date) C O M I" O ner Signature Date 127 Cardinal Drive Ext., Wilmington, NC 28405 Phone: 910-796-72151 FAX: 910-395-3964 Internet: www rtccoastalmarFagement.net An Equal Opportunity-Wirmnlive Action Employer m to ra fti m 0 0 0 0 �o 0 O r- ■ 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 permits. 1. Article Addressed to: II I IIIIII IIII III I I I I I I I I III II I II II II IIII II I III 9590 9403 0603 5183 4334 90 A. Sig trlre El Agent A* . /k , I -4kA ' J� ❑ Addressee B. 4oWivqby-(Printed Name) C. Date of Delivery D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Priority Mail Express& ❑ Adult Signature ❑ Registered Mail- ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted Certified Mail@ Delivery Certified Mail Restricted Delivery ,lNIRReturn Receipt for ❑ Collect on Delivery Merchandise ❑ Si nature Confirmation- 2. Article Number (transfer from service label) ) ❑ Collect on Delivery Restricted Delivery 9 ❑ Signature Confirmation 7015 0640 0006 3682 1836 tricted Delivery Restricted Delivery PS Form 3811, April 2015 PSN 7530-02-000-9053 Domestic Return Receipt CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: �LC� {�� 1 ZQ r Address of Property: U 1 v.� �Yl1 n n J� �CQ 0 (Lot or Street , Street or R ad, City & County) Agent's Name # CIC� C;J� S�YI��( �l�jl1 Mailing Address: WS l&Qd j D— Agent's phone #: C 779 U 1 � u r 1_! 5� �1C � 1 � �(C A? I hereby certify that I own property adjacent to the above referenced property. The individual applying for C this permit has described to me as shown on the attached drawing the development they are proposing. d A description or drawing with dimensiol' mist s�.'pKovided with this lefts!'. J 1 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. Correspoh6hince should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representatives can also be C contacted at (910) 796-7215. No response is considered the same as no objection If you hl�_ re been ✓ notified by Certified Mail. WAIVER SECTION r� 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. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adja=Ry Owner Information) 1 e� nature Signature wS , Z_Ck r Print or Typ ame Mailing Address LQ�\OQ� N, CitylStatelZigj (, ,L-ID,5-Ht�V Telephone Number l� � 1 Date Print or Type Name /b8 7o%7,s Mailing Address Are --el ,: l le- Ale- 2 Ll 7 City/State/Zip I F 4/- 4(1,g -g's 0 Telephone Number Date Revised 611812012 Postal CERTIFIEDo RECEIPT Domestic ca Certified Mail Fee $ 3�1 $ 0470 m ExtraservicesBFeaarcnerxboc.uv ) ❑ Return Receipt (hanixwP» $ Clg � � _ ❑Return Receipt (electronic) $ Sall _ Ili l ❑Certified Meil Restricted Delivery $ Postmark H� ❑ Adult Signetxye Required $ ❑ Adult Signature Restrbted Delivery $— Postage f0.47 12/21 i/2tI j 6 Total Postage and F r 47 $ u1 o se t T `-�! oa b XNu --- ---------------- -- ■ 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 permits. 1. Article Addressed to: 6' tM ,a rn \Zvice 9590 9403 0603 5183 4335 06 A. Sigr)dt X ❑ Agent ❑ Addressee Wdelivery]dress ivName) C. Date of Deli/erent from item 11 ❑Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Priority Mail Express® ❑ Adult Signature ❑ Registered Mail- ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted %Certifi Mail® Delivery ❑ Certified Mail Restricted Delivery "793etum Receipt for ❑ Collect on Delivery Merchandise 2. Article Number (Transfer-fmm service label) ❑ Collect on Delivery Restricted Delivery El Signature ConfinnatlonT. ❑ Signature Confirmation 7 015 0640 0006 3682 1614 Restricted Delivery PS Form 3811, April 2015 PSN 7530-02-000-9053 Domestic Return Receipt CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: �t6 �� (' �l ZQ r Address of Property: (Lot or Stre , Street or R ad, City & County) Agent's Name #6&1(6n � --IJOC� Mailing Address: WS 0QCLc h � U Agent's phone #: ` � � J� 1 " � U � C � o j \� b � 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 drawin tg_ he development they are proposing. I have no objections to this proposal. I have objections to this proposal If yqu shave objections to what is being proposed, you must notify the Divl n of Coastal Man ment (DCM) in writing within 10 days of receipt of this notice. Correspe should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represent can also be contacted at (910) 796-7215. No response is considered the same as no objection lfydW been notified by Certffled Mall. 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.) . 1 do wish to waive the 16' setback requirement. I do not wish to waive the 15' setback requirement. (Propelty Owner Infonnation) n (U nature �e h zap Print or Typ ame ri O Mailing Address n NC 2--72.92 eity/state i -l) ln-L.D5 ` H C 60 Telephone Number UM-4 Date Revised 611812012 -Z, - (G,(�� -- \6f� mJ��,Sv,\�k �L 2.3 �- }— �O'v � s Cu VL�C\-\�p \JA 'A lit 11w loulp, I P A ,.A "ii 1_4tr,ujLh Owito.41POOffimij I" -wily' j"_jjjV..-m.ljL Ow le-1 I -,I I- -1 1, "Ilk 0~ W I lily, 1. e,•I ry i,r1 .1 46,1 1 - fl, A nj _wtv .v-_ AUV*: wwwnmlw it" --al, �161, - i ...I IF jjk*4W W ... MR so droll imr r- 9 aft!.l vL.• ellv orml�; Ifk*d &Lmm, lob md T Wit f I Jlr 0 M4M WwW&ftyosW,M ",0"- d"A 4 --ol— pq to* MA "MAP 'r k otw,sil If, Off "'A alto ft, oftn"w ,004 rr It v,I 0.14-4• jib.-#: kv.. IkL" awl *l4JJ,%AwrA*mp4%, �'• i r;� -r 1. .i 1• ;,, . , ,, i T I't or; of,