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Home My WebLink About69216D - BockP � -t LAMA / DREDGE & FILL , Z ' GENERAL PERMIT Previous permit# A B C lew Modification ❑Complete Reissue []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 —7 �� / ❑ Rules attached. Applicant Name m t rq m V (� Project Location: County /VYE u 6 L Address_ � r„ ( Jmy1 . �� f CityG0 Vr, V11�? StateAIL ZIP Phone # E-Mail Authorized Agent (,-)� `Cr �1 IVA Affected ❑ CW �C' A ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes / (o _,) PNA yes / Type of Project/ Activity Pier (dock) length Fixed Platform(s) 1 ` Floating Platform(s) Finger pier(s) Groin length number Bulkhead/ Riprap length avg distance offshore max distance offshore Basin, channel cubic yards Boat ramp Boathouse/ Boay Beach Bulldozing Other L Shoreline Length SAV: not sure yes Moratorium: n/a yes Photos: yes Waiver Attached: re no A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Speci�C�ti r ICJQ �' "Aci `Mentor Applicant Printed Ngmk ,C - Signature Please read compliance statement on back of 7rmit Application Fee(s) Check # Street Address/ State Road/ Lot #(s) (d S Subdivision (rCity(earl ,16-kLc(l ZIP klMl Pnone t 109 - River Basin Wvt. Adj. Wtr. Body k vi Gi` (nat /l ►i"a��) Closest Maj. Wtr. Body 'Al f_.yw (Scale: 1 � � ; ? D ) ❑ See note on back regarding River Basin rules. !�pth (-� l� Permit Officer's Pri Na Signature s- fiG ol- 6 h17 Issuing Da e E iration ate WIRO Date Received j Date Deposited Check From (Name) Nome of Permit Holder Vendor Check Number I Check amount Permit Number/Comments Receipt or Rdund/Reallocaled 5/26/2017 Gnce Construction John Parker BBBT 11247 $200.00 GP 69214D SF rct. 4250D 5/26/2017 Gnce Construction _ _ William Buck _ _ _ BB&T -- 11248 $200.00 GP 69216D SF rct. 42510 512612017 Gnce Construction 'James Carros BB&T _ 11249 $200.00 GP 69215D SF rct. 4252D _ 5/28/2017 Donald or Carol Ewing same NCSECU 6848 $400.00 GP 89213D SF rat. 4253D Ad AWN 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 AGENT AUTHORIZATION FUKM Date: 5 — " 1 % Name of Property Owner Applying for Permit: N e of Authorized Agent for this project: Owner's Mailing Address: YX 1 �J ,hclso, `Dr. t�l-01,Vkl(e. NC a166 PhoneNumber(W) 05-0'15fb Agent's Mailing Address: l & C r 21164 Phone Number - 96g5 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 28 bzn or7{ ',:3}. Octls\¢ NL This certification is valid thru (da ) Property Owner Signature Date 127 Cardinal Drive Ext., Wilmington, NC 28405 Phone: 910-796-72151 FAX: 910-395-3964 Internet: www.nocoastalmanagement.net An Equal Opportunity 1 Affirmative Action Employer ft'1 Domestic Mail Only For delivery information, visit our website p Certified Mail Fee f 3.35 ru $ co Extra Services & Fees (check box, add fee Is�tp: ppgere) [I Return Receipt (hardcopy) $ED 77 VV V V ED ❑ Return Receipt (eiectrenic) $ !n — 1] ❑ certified Mail Restricted Delivery $ i W Il(1 C3 ❑ Adult Signature Required $ ❑ Adult Signature Restricted Delivery $ O Postage f lr 49 C3 $ � Total Postage and Feed : 59 `D Sen ■ 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: .-r-1 0472 04 Postmark Here 04/25/2017 A. Sint X ! ❑ Agent ❑ Addressee B. c ' d by (Printed Name) C D to 7of livery ( i/ D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No llI'III'I I'll I'II) Ili I lI III I'III III I I IIIII I III 3. Service Type ❑ Priority Mail Expresso ❑ Adult Signature ❑Registered Mail- 9590 9403 0603 5183 4333 08 I] Adult Signature Restricted Delivery ❑ Registered Mail Restricted ified Mail@ Delivery ❑ Certified Mail Restricted Delivery L31!§42aturn Receipt for ❑ Collect on Delivery Merchandise 2. Article Number (Transfer from service label) ❑ Collect on Delivery Restricted Delivery ❑ Signature Confirmation- 7 016 0600 0000 8200 4853 til ❑ Signature Confirmation til Restricted 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: W� 1\�a^rl Ct ►�C�C� `1 _3A Address of Property:�� V 'miry ` 1�5� ?kct v (Lot or Street #, Street or Road, City & County) �, C Agent's Name #U�ti l4 � � ��—��fl rMailing Address: �,% Agent's phone #: �� S��c u�r �c a vv�Syz 1621-LL� NL Zvi `i(o 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. I 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. Correspondence should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representatives can also be contacted at (910) 796-7215. No response is considered the same as no objection if you have been notified by Certified Mail. 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.) do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Property Owner Information) 1 tom"`- ct ri� Signature Print or Type Name Mailing Address City/Sta e/Zip `bZb- Telephone Number t\ _ ;��_ �-7 Date ja nt operty Owner Information) ign t ke Print or Type Name 1as LA?�j Lprwg(. CkLpIr�. MaiI4 Address Rostie_lL, G Ar 3COU. City/State/Zip L(r) y - 915 -6 552 Telephone Number Date Revised 6/18/2012 Er m Domestic C C3UI w O Certified Mail Fee $3.35 ru $ fydra Semices & Fees (check box, edd fee ppp fe) 0 ElRetum Receipt (herdoopy) $ V . Ulr C3[1ReturnReceipt (electronic) $ S0.0r0� O ❑ Certified Mail Restricted Delivery $ 4j C3 ❑ Adult Signature Required $ $0.00 ❑ Adult Signature Restricted Delivery $ C3 Postage $0.49 —0 $ C3Total Postage and Fees $ $6.59 -0 S o C3 tr t. t I ■ 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: V-"A"L\ O'A A. Signatur ❑ gent X [ Addressee B. Received by (Printed Name) C. D to of D livery Lj D. Is delivery address different from item 1? LJ Yes If YES, enter delivery address below: ❑ No 0472 04 Postmark Here 04/25/2017 Service Type O Priority Mail Express II I �III'I I' ICI I I I I I i I III I' I II II IIII' II I I III3. ❑ Adult Signature L1 El Registered MaiIT"' ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted 9590 9403 0603 5183 4332 92 ❑ Certified Mailer ❑ Certified Mail Restricted Delivery Delivery ❑ Return Receipt for ❑ Collect on Delivery on Delivery Restricted Delivery Merchandise El Signature Confirmation- 2. Article Number (Transfer from service label) 2Collect ❑ Signature Confirmation 7016 0600 0000 8200 4839 aestricted Delivery Restricted Delivery PS Form 3811, April 2015 PSN 7530-02-000-9053 Domestic Return Receipt CERTIFIED MAIL - RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: (( ((,Lot or Street #, Street or R ad, City & County) Agents Name #: � \yvYlS 1� lL�tJll Mailing Address: Agent's phone #: a � )- 5-79 - q 6c�Q�4 t1 —,P e ZCh 1? 1H y I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described tom as shown on the attached drawin the development they are proposing. AAR .� I have no objections to this proposal. I have objections to this proposal. c! If you have objections to what is being proposed, you must notify the =Pe o�C-oastal Management (OCM) in writing within 10 days of receipt of this notice. Co, should be L mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represen can also be r contacted at (910) 796-7215. No response is considered the some as no objection #*W been �7 notified by Certified Mall. �Y WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 1 ' m my area of riparian access unless waived by me. (If you wish to waive the set 7x=waive e appropriate blankbelow.) the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Own r nformation) ignatur\e Print or Type Name L161 10\ r�_ r Mailing Address City/Sta /Zip ?2- - 310- 6337 Telephone Numbere 1-2�1-7 Date (Ad' t operty Owner Information) Signature Print or Type Name 3� e0-JC044 ST Mailing Address City/State/Zip 05,�, 341 11 ZA d Telephone Number 4 - mate Revised 6/18/2012 1 i SL.LL C,6\3 Avro 11 su pu)o -�-"o -)rQ� Lk -Sf,-\-� c�1ljD9 QA -�q�l