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Home My WebLink About69048D - Cameron,s6CAMA / ❑ DREDGE & FILL 9 �ENERAL PERMIT LiNNew --Modification ❑Complete Reissue ❑Partial Reissue . kI A Previous permit # Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Resources r �) //jj and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �� L LV p , c fi Rules attached. Applicant Name �1.( t Q iN�C i 6'► ` Project Location: County j 4J ci % Address u L. i w a di Ot , Street Address/ State Road/ Lot #(s) (I ) lG d . Ci-State_ ZIP 2 ""0 Phone # (Tiff );7,0-fO'K E-Mail Authorized Agent St efkl to G0h wuxq Affected ElI CW VEW PTA El ES [IPTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes / no PNA yes / no I Subdivision ` ( eru t d city �I_ 1w 2 z i P_ 2 L-,L1y3 ItAone # 10 �2 3 6gi 71 River Basin 01rt Y Adj. Wtr. Body Q h1 S n man unkn Closest Maj. Wtr. Body MMA 61C ` ■ ■■■■■■■■■; i■■■ E■■■■IMM��W��■�■N■■■■�■■■ rrZ011 r A mnl■®■■■■■■■® ■■■■■■/iME■MM E Ma on MOMM■■■■■■■■■ 00■■1I■■■1H■■■�■■■■��li■■■■■ ■■■ ■�■■Ri■�1■■ ■1®■■■�■■■■■lid■Et'�'�■■■■■■■■■ TM ■■■■■■■■■ IVEm=111110110MOM■■■MMMwT' Jlif"IIA1■■■1■■■■■■■■■ ■■■■■■■■■■■■■■ M. ■�■'.i+��'��1 ■1 ■®Enm � 11■1 ■■■■■■■■■■®■■■■■■■■■■■■■ ■■■■ ■■■ ME IM■■■O■ ON IMEMEMOMME■■� ■®■■■■■Lloo E1 Is ME ■■■�■■■�■■■■■■� m ■■■M■■■■S' . .. ..RIM■ ki lKk dm ■■�1�■■LJiit�■ .. t -� , U, w� Agent,grApplicant Printed Name Signature Please read compliance statement on back of permit 2W p jr2go Application Fee(s) Check # Date Date Check From Name of Vendor Check Check Permit Receipt # Received Deposited (Name) Permit Holder Number amount Number/ Comments 3/23/2017 Southeastern South Coastal State Construction Cc Bruce Cameron Bank 10240 $200.00 GP 69048D CS rct. 3618D NC Division of Coastal Mgt, Habitat impact cc.-Aputer ShOP-t Applicant. (�(u,l�-'!-�1 Permit #: Date: Describe. below the HABITAT disturbances for the application. All values should match the name, and units of measurement foundin your Habitat code sheet.___ --- Habitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any. anticipated restoration or temp impacts) FIN (AnO die' ENC re al imps, W Dredge ❑ Fill ❑ Both ❑ Other i Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both 171 Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other [] Dredge ❑ Fili.❑ Both ❑ Other ❑ Dredge ❑ Dredge ❑ Dredge ❑ Dredge ❑ Dredge ❑ Fill F1 Fill ❑ Fill ❑ Fill ❑ Fill F1 Both ❑ Both ❑ Both ❑ Both ❑ Both ❑ Other ❑ Other ❑ Other ❑ Other ❑ Other 0 .L. Sq. Ft. TOTAL Feet for. NNAL rc— (Anticipated final pated final jrbance. (Applied Disturbance disturbance, Was any total includes Excludes any and/or bration _ any anticipated restoration temp impact ycrtemp restoration or CFW RMENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Bevedy Eaves Perdue James H. C-mgson Dee Freeman Governor Direcior Secretary AGENT AUTHORIZATION FORM Date: 3 x-3 1 1 3' Name ofPropertyOwner Applying for Permit: Name of Authorized Ag nt for this project: sts' cis(, Owner's Mailing Address: Agent's Mailing Address ► 2 0, 61-enell Phone Number (111i Phone Number I certify that I have authorized the agent listed above to act on my behalf, for the rpose of applying for and obtaining all CAMAA Permits necessary to install or construct the following activity): (my property located) at zo,,v This certification is valid thru (date) Property Owner Signature Date 127 Cu" Drive EA. Wir i4m, NC 2M Phone' 910-796.7215 t FAX 910.39 3964 komet: www.nCW3st*=agefr"net An Equal OPPkw*A Nkma .e Aeft Efmftw ?lgb3 NonrthCarolina Naturally RECEIVED DCM WILMINGTON, NC MAR 2 3 2017 ADJACENT RIPARIAN PROPFRTY O;T- ;�RATATUMVNT (FOR A PIEk1A100JnG PILLVGSIBOAOAMOUSE) I hereby certify that I own property adjacent to 1W Ca,r-s o M Property located at -79 on . 4m .. J 9,.i tr (Waterbody) A (Name of (Lot, Block, Road, etc.) perty Owner) (Town and/or County) He has described to me, as shown below, the development he is propos no objections to his proposal. I understand that a pier/mooring pilings / back a minimum distance of fifteen feet (15') from my area of riparian (If you wish to waive the setback, you must initial the annrc i� I do not wish to waive I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROP (To be felled in by individual proposing _. -T-- ..a.r uoiecnons to what is being proposed, you must notify the Division of within 10 days of receipt of this notice. Correspondence should be mailed to 127 DCM representatives can also be contacted at (910) 796-7215. No response is considered lhr samr ac ., ,I4C. (Yafolrmatioa for Property Owner/Applicant Applying for permit) —� L 0 ( C, Mailing Address 28 Itol CitYY9titC-/4qW Ep Telephone Number S• re ztllx (Riparian Prol n x & q,f 127 Cardinal Drive Ent ,Wilmington, North Carolina Phone: 910-796-72151 FAX: 910-395-39641 Intemet: www.r= An Equal OPPodwity 1 A1Bn1lalive Action Employer - 50% Recycled 110% 's N.C. at that location, and, I have ,tlift / boathouse must be set ss unless waived by me. ate blank below.) VELOPMENT: I Management (DC.'VI) in writing al Drive Ert. Wilmington, NC rty Owner Information) i5Wso/f x Signature �. �LccAU, Print or Type Name Telephone Number Date ement.net Paper RECEIVED DCM WILMINGTON, NC MAR 2 3 2017 ADJACENT RI.PARIA:N PROPERTY OWNER ATE)L IEN T (FOR A PIER,21100JUXG PILLNGS180ATLIFT/ O,fT' IOUSE) I hereby certify that I Own property adjacent to $f K&& Cs,.-i i a.% Property located at �%9 ge"I I<t o�(Na me of t operty Owner) on Y �jgfM,i (Lot, Block, Road, etc.) �� ii�r {W7aterbody) {Town aj d/or County} He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / bo itlift / boathouse roust be set back a minimum distance of fifteen feet (t 5) from my area of riparian ace ss unless waived by me. (If you wish to waive the setback, you must initial the appropt late blank below.) _ X _ I do not wish to waive I do wish to waive that setback requirement. - ---------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT ao be filled in by individual proposing devel "rent) 'if you have objections to what is being proposed, yort must notify the Division of Co tal lvfana ement Cc within to days of receipt of this notice. Correspondence should be mailed to 127 g in writing ACM representatives can also be contacted at (910) 796-''215_ Ca inal Drive Ext. Wilmington, NC fliu rrs»oha, c considertd the »Le as n ,'(Information for Property Owner/Applicant Applying for permit) Mailing Address 6tjrlState,`ZitUTZ Telephone Number ate (Riparian F x A-4.1 4,� Robert E. L, 127Card iral Dnve Ext., Wilmington. North Carolina Phone.- 910-796-72151 FAX.- 910-395-3964 ; Internet www.rrcc An ERUal OPPOd ity 1 Affirmative k-bon Employer - 50*4 Recycled 11o% rn rt7 Owner Information) Signature Jr. Print or'I'ype Name 336-217-4150 Telephone Number 3/22/17 Date Paper RECEIVED DCM WILMINGTON, NC MAR 2 3 2017 ,► � j f E i i O I