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Home My WebLink About69277D - Bostic0 _ 4 LAMA / `;1,,DREDGE & FILL GENERAL PERMIT Previous permit # A B C New __:Modification Complete Reissue Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Resources m and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC Rules attached. Applicant Name DoK-IS 1 /OST (C,- Address _ C) f�Dk A 15 City T'x_V LPcV 1 W-JeF State ZIP ` Phone # `(� 0E-Mail Authorized Agent DU Y,e ` j r h Affected ❑ CW )�ZEW ):�PTA s ❑ PTS AEC(s): ❑ OeA ❑ HHF ❑ IH ❑ USA ❑ N/A ❑ PWs: ORW: yes /(foD PNA yes /(!E:) Project Location: County QV\_0 VJ Street Address/ State Road/ Lot #(s) --� (34 c) `1 c. `;4.- Subdivision City-->-. CM ZIP d►�� Phone # ( "-j---" ,0 River Basin CPA— Adj. Wtr. Body "A,4A)S 0'I( � ' (na man /unkn) Closest Maj. Wtr. BodyyN' =- M. ■■■■1ii■■■®■■■a■■■ mom OMEN MENNSIMMEM■■� ■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■�■�■w■�;■wail■■ No Nor■ ■■■ ■■■ /%l'J■tl■■■■■■■f SOMM■■ ■�■■■■ - ■■■■■■■■■■■■■■■ 2=27■■■■■■■■■■■■■■■■■ 11wwMNMM NONE mom1.■....fit�l�..�....... ■■■■■■M■■■ so ■■■ ■■■■■■■■■■■■■M■■■■■■■ .auIN ■■ ■■ MM■■ ■■■■■■■■■■■■■■ ■■■M■■■ ■■■■■■■■■■■■■■■■�■■■■■■■ , WtI l '&�Je t or Applicant Printed N S1 L ghAure * Please read compliance ste nt on back of permit* Application Fee(s) Check # tA,-IL- PEi:mit0 cer's Printed Name Signatur Issuing Date ^ Expiration Date aQ ANY.pA_RIAN-iKp I Eby cerUfV that I own property 34lau;nt t,, Oroperty located at lr:a-r�k �� %••��> ., .�.. an - (Waterbody( in_.."". The appl,can; s described to mr. as ?,howrn bel-)rr tl ,�r•:�rr•�sr ;, �:, r, _ :,. a,t - iOcatigri f _ " I have no objection to ails proprjsal I have objections to this prrposel CESCRIPTION AND/OR DRAWI14G Or PPrjGrji�t-- (Individual proposing development must fill in descripfv�,n-bv;:J.r tr, V ,,e . t WAIVER SEC if:oN I understand that a p,crdock, mooring pd,n95 :,-;a' :)-� ,r;�i_• _ _ - -_ must be set back a mmimLm distance of 15' f•r,-n --1 the (if you wi to waive the setback you must initial ilia ✓ I do wish to waive the 15' setbar* requirement I do not wish *,o vraive the 15' safback requtrer-te-r (Proper Owner Information) IJ�rI5 Lan f rC— Prrit Type Name !nle 44MI15 "F, NC, '2 �5 10 C•f.'Y 5tc3 Zip o*phcw a Ncrrnm r/email address "mod for one calendar year after signature' (Adjac-ent ?mope -, Prim sc Type ' �J • ��'P I hereby certify that I r,wn property a jl:, .ard to property located at (Name of Property Cior-mrp (Address, Lot, Block, P.-,ad. etc.) on In , Materbody) (Citiffo+m andoor Ccuntyj e The 9pplicant har, �Ir. ,�.nbr:d 's, rnr, . �,t.own I haves rtc tc thi5 prr,tr, ,al _ I haves oblectrons to this DESCRIPTION AND/OR DRAWING or PROP03ED DEVELCF"TENT (Individual proposing development must fill in description below or attach a site drawmg) q,c a tiL _% WAIVER SECTION I understand that a pier, clock, mooring pl,ings ttoat rarn;, must be se: back a minimum distance of 15' from my area-,' • ..Stc-S ass :.a .e! by MG (if you'NIsh to waive the setbackr you must initial the 8;,p-s:,' ,- Vzi do wish to waive the 15' setback reaulre7vant I do not wsh to waive the 15' setback recu4re7er.t (Property Owner Infonns ) (Adjacent Property Owner Information) .i r, rru!trrs� �-, .SiXn�ure Prilt l W /yp11 1lRiQ , / / ly j '.'a-re%r f� f (/' n {. . Madigg �A r�ra; I 1yc o� 5 Mai ..�..- fit , iftz .. ph r/Ilmslt address Teep 9 Nair ! ervd !lire • ro .+.ra. A-- ",gin./e M, &QfMAQT-HQR.11AYI0N 1-011 CAMA P1.14it I ",t E'I IC'tATI(IN Name of Property owritn Ituquostinq I't+rnmit: ,w,,,a(L, t r c=�� - Mallinrg Address-, Phone Number: Email Aderess: q j o- a �� -I, g q______g lg bq& --7340 SCM D$'f)6 G ma; 1, Gym I certify that I have authorized------- Aaont t+' to act on my behalf, for the Pui posy. of applyfiq for and ohtaininq all C;AMA pemlits necessary for tho follcwing proposed development at my property located at in 4_ji %� % County. 1 furthermore certify that 1 am autliotizecl to grant. and uo in fact gr;,rnt pemnission to Division of Coastal Managemmont staff, the Local Permit Otter and Mei►- agents to enter on the aforementioned lands in connection vita c.vatuatitrg inknuation relsted 6,C t.hs permit application. Pmprrty Owner Information: Siqnaturvp _i-- e t' C. _ Mint or Typo Namo Is v l through /- 1 _---,. NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: �� y #' 46,7Z 7 7 Date: 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 temp impacts).impact amoun temp impacts amount) Dredge ❑ Fill Both ❑ Other ❑ iJ Dredge ❑ Fill ❑ Both ❑ Other / Q Dredge ❑ Fill ❑ Both ❑ Other Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill 0 Both 0 Other 0 WIRO Date Recelvetl Date Deposited Check From Name Name or Permit Holder Vendor Check Number Check amount Permit Numbed Comments Receipt or Retund/Realloceted 8/30/2017 Lighthouse Marine Construction/Darrell Er Doris Bostic Coastal Bank & Trust 1627 $600.00 GP 69277D JD rct. 4735D 8/30/2017 Will Richardson Construction Bill Perez BB&T 6808 $200.00 GP 69330D BS rct. 4905D