HomeMy WebLinkAbout69138D - Brantleyx
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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
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
❑ Rules attached.
Applicant Name h' Slingr in 4f t4 Project Location: County?Ytwn SL—.ACL
Address S0 j,, /(,J; yY,y� S�� � J _ Street Address/ State Road/ Lot #(s)
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City 1?64, ot(& Stated zip Z$12o 14106 E.�o�(�� ►ar•
Phone # ( ) 2I q U;O� E-Mail Subdivision
Authorized Agent City % K ZIP Z
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Affected
AEC(s):
❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW:
yes ro�
PNA yes no
Type of Project/ Activity
Pier (dock) len¢th
Fixe
Floa
Fing
Groi
Bulk
Basii
Boat
Boat
Beat
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SAV
Mor,
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A building permit may be required by: j Ua �n o1s l .Yi.lS
( Note Local Planning �
Jurisdiction),, i I
Notes/ Special Conditions ILirI'dQ �>7. /1Q�) q ,� n _mil A`f G ////
�Plr
❑ See note on back regarding River Basin rules.
Agent gr/Applicantname ♦ Pe tOfficer's Pr*nted Name
S'gnature Please read compliance staten4ent on back of permitignature
Application Fee(s) Check # j� Issuing Date Expiration Date
Date
Date
Check From
Name of Permit
Vendor
Check
Check
Permit Number/
Receipt #
Received
Deposited
Name
Holder
Number
amount
Comments
5/15/2017
Backwater Marine
Daniel Brantley
BB&T
2861
$400.00
GP 69138D
BS rct. 3773D
Construction Inc.
NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant:
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 amount)
temp impacts)
amount
44G
Z 40 0
7 Llo V
Dredge ElFill [IBoth ElOther
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
1 hereby certify that I own property adjacent to — 1p : ,, ; -,
property Located at _ '-i �: (Name of Prol
on (Address, Lot, Block, Road, 8tc.
(Waterbody) (CirylTown a
The applicant has described to me, as shown below, the developmer
location
r I have no objection to this proposal
I have objections to this proposal,
DESCRIPTION AND/OR DRAWING OF PROPOSED DEV
(Individual proposing development must rill In description below a
WAIVER SECTION
M
.
f- s
rty Owner)
N.0
I/or County)
proposed at the above
r attach a site drawing)
I understand that a pier, dock, mooring pilings, boat ramp, 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
I do notwish to waive the 15' setback requirement.
Ci
��� 1 V
Telaab re Noriber/email address —
l �urc• /
'Valid for one calendar year after signature'
(Adjacent Propet
Owner Information)
�._ '6
Print or Typq Name j�
r1'y%I`f &.fn 9 L, , .
Telephone Nymber f email address
1, 7
Datec
(Revised Aug. 2014)
A
I hereby certify that I own property adjacent to I "'a „U -t I X
(Name c
property located at
(Address, Lot, Block, Roa
on :7— in /I9 k -T,-. t r
(Waterbody) (City/T
The applicant has described to me, as shown below, the deve
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSE
(individual proposing development must fill in description b
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, bre;
must be set back a minimum distance of 15' from my area of ri
me. (If you wish to waive the setback, you must initial the apprn
I do wish to waive the 15' setback requirement.
_- I do not wish to waive the 15' setback requiremen
P'tc.)
IC
N.C.
wn and/or County)
pment proposed at the above
) DEVELOPMENT
,low or attach a site drawing)
kwater, boathouse, lift, or groin
)arian access unless waived by
oriate blank below.)
(Property Oyrne_Onformat j (Adjacent oroperty Owner Information)
d
/ email address
SigYla * j
C ✓ S.[_ r
Print r Ty p Name
Telephone
Date *
5
0-2o�-srvS't
/ email address
(Revised Aug. 2014)
'Valid for one calendar year after signature'
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Brunswick County GIS Data Viewer
May 10, 2017 1:799
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■ Addresses — US Hwy — Mlnor ® Parcel I. .. . I—, , I I —yI—.. I .—I
0 0.01 0.02 0.04 km
Roads — NC Hwy Parcels
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