HomeMy WebLinkAbout67983D - Barnes_.'.LAMA / DREDGE &FILL
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PERMIT Previous permit # ��i
WIENJERAL
❑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 15A NCAC �, �"t • ��/
Rules attached.
Applicant Name `TL i�� YIJ Project Location: County Vl—
Address U21 .1 4- 1
1 PdStreet Address/ State Road/ Lot #(s)
City�State
Phone # ) ' VD E-Mail Subdivision
Authorized Agent City ZIP/
Affected ❑ CW CAW �A S ❑ PTS Phone # ( ) River Basin l
AEC(s): ❑ OEA HHF ❑ IH ❑ UBA El N/A Adj. Wtr. Body Gil f� 1 an n
❑ PWS:
ORW: yes (no PNA yesCno) Closest Maj. Wtr. Body
I / / ''
Pier (dock) length
■■■■■■■■■■■r��■■■�i■�rir�■Ei■■■r�r.�au,Floating Platform(s)UZAMEM
. Fixed Platform(s)
■■100
Finger pier(s) JIMEN
Groin length
number
■■■■■■■■■■■■■■■■■■■■■■■�■■■■IN OEM
■■■■n■■■■Bulkhead/ Riprap length
■■■■■■■■■■■■■■■■■■■■■r�z►��■r�■■■■■■■■■■
avg distance offshore
max distance offshore
■■■■■■■■■■■■■■■■■■�.:■■•.■�ii■■■■■■■iBasin, channel
cubic
Boat ramp
Boathouse/
Beach Bullclotng
Other
Shoreline Length
SAV: not sure yes
IS
Moratorium: n/a ye
PA
Photos: yes I
Waiver Attached: yes no
A building permit may be required by: ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) /..,� -lL �^ / !
Notes/ Special Conditions U. d / � • ! L
HC? � T /T1l toM ofA Ohl
Agent or.Applicant Printed Nark PermitOfPicgrs Printed Name
Signature; Please read compliance statement on back of permit ** Signature L
ApplicationFee(s) -7 -,P4J Check# Issuing Dhte Expii
NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant,: rPermit #:
Date: C" L
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. FeetFdisturbana
t
(Applied -for. (Anticipated final (Applied for..final _
Habitat Name DISTURB TYPE Disturbance total disturbance. DisturbanceChoose One includes any Exdudes,a total includesyanticipated restoeation any anticipatednd/or
restoration or and/or temp . restoration or temp impact
CWDredge
❑ Fill Both ❑ Other ❑
/
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge. ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both Other ❑
Dredge ❑ .Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑: Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑ .
Dredge [I Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both [I Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Payment Proccessing Confirmation
Date Received 1 2/2/2017
Check From (Name) Allied Marine Contractors Inc
Name of Permit Holder John Burns
Vendor First Citizen Bank
Check Number 5286
Check amount $1,400.00
Multiple Permits Yes
Major/Minor
Permit Number/Comments GP 67983D, Permit Fee $400
Receipt or Refund/Reallocated TM2805D
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date j- /2, f
Name of Property Owner Applying for Permit:
Soh n &L 11, <Z m ,Bur n_S
Mailing Address:
lelhyl
I certify that I have authorized (agent) `�°�-r ��� �� to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to /
install or construct (activity) J Ul le, h e"'e ,
at (my property located at) V-,---
This certification is valid thru (date) l z - 3 1- 1-7
Owner Signature
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: 252-808-28081 FAX: 252-247-33301 Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper
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9590 9402 1883 6104 3421 21
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Merchandise
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2. Article Number (transfer from service labell
7015 1730 0002 1608 8054
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PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
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1. Article Addressed to:
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❑ Registered MailTM
❑Adult Signature Restricted Delivery
XCertlfled Mail@
Mail Restricted
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Delivery
9590 9402 1883 6104 3421 45
❑ Certified Mail Restricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
Merchandise
2. — — - --- ------•-- •-�-..
n Collect on Delivery Restricted Delivery
❑ Signature ConflrmationTM
7 015 1730 ODD 2 1608
8085
❑ Signature Confirmation
testricted Delivery
Restricted Delivery
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PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
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