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Home My WebLink About69146D - Bennett� CAMA / . D13EDGB & FILL A B C D GENERAL PERMIT Previous permit# JSNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Resources l �/ and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC iJ I �- loo �rw ❑Rules attached. Applicant Name 0 &, - h e �+ Project Location: County �� E]Rul`��,� Address �Q� �t �l / " , Street Address/ State Road/ Lot #(s) Ciry TS(AN State ZIP Z%i(a S ! Z`� � W 15 St - Phone # (q(0) i �8- )T34 E-Mail Subdivision Authorized Agent ma r City N14 i V _ ZIP Za yG S Affected ❑ CW PQ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin CCU' Z AEC(s): ❑ OEA ElHHF ElIH ElUBA El N/A Adj. Wtr. Body 6iti" t S C Ay\K nat /man /unkn) ❑ Pws: �p�.�i 6 ORW: yes /, no PNA yes / no Closest Maj. Wtr. Body I L1 l Type of Project/ Activity t I'x4ji 7 01^ M i (Scale: ` = 2' ) Pier (dock)den th LDL Fixe, Floa Fing Groi Bulk Basil Boat Boat Beac Oth< Shor SAV Mor, Phot WaiN ■■■%■■■■�■I��+��r�r_rnnl ■■■ cam■■■■ ■■■�n�ii■■■ 'ng Platform(s) ■■■■■■!1■■■■li■fir■■■r■■■■®■■■ ■®■�I■�■■ i length number■■■■■■■■!1■■■■Il■■G�fi��■�7■■i.1�!!�7■■ MENEM ME MEN NONE! ■■■■■■■■ ■■■■■■■ !1■■ ■■11I. ®.��yCr��■■■■■■■ MEN ■!1■■avg ■■■■■1!I■ ■■Cl�l4?�itlNit�Sti�■■...■■■. distance offshore max distance offshore channel M ■■■■■■■■l 1■■■■■■Pm N■I 1■ I®fit■■■ ■■■■■■■■ ■■■�■■■� ■■■■�■■1■� �� i■■■ri■■■ JJJMEM=MM O cubic yards ramp ME, ■��■n■�I�I�■� 1■■ ■!�■■■� 1! I®■■I��■■■ ■lam■■■■■■■ ■■ %l��ilr■�1■■■■w■Jli■1R11�17I■�■■� Flown,", ■ Jine Length not sure yes i'* �r Attached: Yes . irr�`�-- I�■■■■■■■! 1■■C.`��■■■� 1�.1 I■ ■■■■■■ ■■■�■■■■�1�■■�■■■■,1ril■■ ■■■Nriir "�■� ��I�1•N��I� ■ r• tT ■■■■■■ 71•�/�� ■■emu■�■■i �:��■■■■■r�■■■r��■■■ 01191LI�M■■■ ■■w1■t� ■■� 1■■■■■■ttiil�l�■■■■■■ ■11i1!■!■■ ■■ L� A building permit may be required by: 1 0 �,+ n 6 ii ZS� alY� o ❑ See note on back regarding River Basin rules. ( Note Local Planning Jurisdiction ( 7W f 'Fc Notes/ Special Conditions t � A T_S } Q'N tut rV ( Ck A p . (Agent or Applicant Printed Name Si nature* Please read compliance statement on back of permit* W 200 - S W to Application Fee(s) Check # Name SignatureU a 211410 21 Issuing bate I Exp ration Date WIRO Date Received I Date Deposited Check From Nerve Name of Permit Holder _ Vendor Check Number Check amount I Permit NumbeNComments Receipt or Refundlftalloclted 6/22/2017 Pippin Marine Construction LLC 6/22/20171 Pippin Marine Construction LLC Michael Prevatte We Fargo Bank 4328I Charlotte Patterson Wells Faro Bank 4329 $200.00 $250.00 GP 69279D major, 1320 Mallard B Dr., Haml JD rct. 4038D JD rct. 4039D 6/22/2017 6/22/2017 WC or JK Bennett BOKF MoneyOrder/Peter Mueller Carl Bennett NewBridge Bank Jon & Amelia Raiford BOKF, NA Mone ra 5616 $200.00 GP 69146D BS rct. 4631 D JD rct. 4213D R206571282 $200.00 GP 69280D l�C. NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant:44 Date: G l Z- i 1 1 .4-- 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 amount) temp impacts) amount \ Other Dredge ❑ Fill ElBoth ❑ � I l 2 19 2- Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other 0 Bj'A NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis John E. Skvarla, III Governor Director Secretary AGENT AUTHORIZATION FORM Date: —'? Name of Property Owner Applying for Permit: Name of Authorized Agent for this project: Dar L & n t7 P- ? --J�Z — rk IQ(S61+ c� Owner's Mailing Address: 'Ryes Phone Number (5jO Agent's Mailing Address: '90bay 50Q- Phone Number (9/b) I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct the following (activity): For my property located at This certification is valid thru (date) Property Owner Signature Date 127 Cardinal Drive Ext., Wilmington, NC 28405 Phone: 910-796-72151 FAX: 910-395-3964 Internet: www.nccoastalmanagement.net one NorthCarolina Nuturallil An Equal Opportunity 1 Affirmative Action Employer DIVISION OF COASTAL MANA E-NENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATiON/WAIVERFORI�1 Name of Individual Applying For Permit: ca rL n Address of Property: (Lot or Street #, Street or Road) C) �J-c (City and County) 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, should be provided with this letter. j I have no obections to this . � proposal. . If you have objections to what is being proposed, please write the Division of Coastal Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900 within 10 days of receipt of this notice. No response is considered the same as no objection U you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set bck 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. Sign Name Ad Print Name Telephone Number with Area Code S:lcamalshellslriparianproperty.frm Da N C DENR [MVMOM"ew N/01/�y Name of Individual Applying For Permit: _ Ca(-L Jj0 n Y7,041 Address of Property:. Loa y ' CS�J Ls I (Lot or Street #, Street or Road) (City and County) I hereby certify that I own property adjacent to the above -referenced -property. The individual app lying for this permit has described to me as shown on the attached drawing the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Coastal Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900 within 10 days of receipt of this notice. No response is considered the same as no objection it you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set bck 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. n - ' � "�) �' Zo( Sign Name Date Print Name Telephone Number with Area Code S:lcamalshellslriparianproperty.frm NCDENR CH"M0"Off AMO %Wt/1ti lqu . cq