HomeMy WebLinkAbout74813D - Fountain,L:E-LCAX-D e4-c (olUoU ';�q'f r X.L)
AMA / DREDGE & FILL NO. 74813 A B CO
' GENERAL P jRMIT Previous permit #.-741G
❑New Modification Complete Reissue CPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality II L
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC R C�
❑ Rules attached.
Applicant Name A Ilk Project Location: County " S \ ti \
Address Street Address/ State Road/ Lot #(s)
City V State ZIF�
Phone
-Mail Sub tsion
Authorized Agent City ZIP lU�
Affected �W � J$*TA ❑ ES ❑ PTS Phone # ( ) River B in
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ WA Adj. Wtr. Body an unkn
PWS:
ORW: yes / no PNA yes / no Closest Maj. Wtr. Body
Type of Project/ Activity l ° .myc<wl -. - my\3 v : V
Pier (dock) lengt4V X L
Fixed Platform(s)
Floating Platform(s)as c
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin. channel
cubic yards
Boat ramp
Boathouse/ Boatl
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes %rfo
Moratorium: n/a yes `./
Photos: s o
Waiver Attached: (�no
A building permit may be required by:
( Note Local Planning Jurisdic
Notes/ Special Conditions Y\Y .
Agent or
Signature , **Please read compliance statement on back of permit"
%� �LQ
Application Fee(s) Check #
OAVIS CREEK MARSH
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1 i'1• ❑ See note on back regarding River Basin rules.
Name
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Issuing
I hereby certify that (00k party edjae it to
property located at
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9 . N.C.
(CKylTawnr Dior County)
The appl nt has described to me, as shown below, ftd Nir posed at the above location.
C het no objection to this propoeai.
I have objections to this proposal.
DESCRIPTION AND/OR DRAW034F p pp09SD DEVELOPMENT
(individual proposing development must dIfAt' aF*Wr4W0d bekrtr or b a site dratafng)
14
WAIVER SiCTION
I ur4erstand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
m mkam distance of 16 from my area of riparian access unless waived by me. (If you wish to waive
the .you must,InMal•the approprlate blank below.)
�� ' requirement.'
I do wish to waive the 1 � setback
I do not wish to waive the 16 setback requirement.
(Property Owner tnfor`matlon) (Adjac6ntPrbpertybwner Inionnation)
31gjatr�re r-�
ti! a h nl t• t'txu i4r!
All or TWeGr.
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Telephone Number
Dale
6 4/140-4-
print orDpe MvW/ T
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Abili g Amass
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Telephone Number
7- /-1/
Dale
(Revised &MOIJIVED
JUL f 7 2,09
DOM wtLmINGTON, UC
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Date of Delivery
1? ❑ Yes
❑ No
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Domestic Return Receipt
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[�'P' 16rity Mail Express(D
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❑ Collect on Delivery Merchandise
2. Article Number (Transfer from Service label) ❑ Collect on Delivery Restricted Delivery 0 Signature Confirmation-
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7 018 2290 0001 3023 4002 all Restricted Delivery Restricted Delivery -
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(HAMLET, NC 28345)
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D. Is delivery bd&sW�r
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late of Delivery
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9590 9402 1663 6053 3088 32
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❑ Return Receipt for
❑ Collect on Delivery
Merchandise
2. Article Number (Transfer from service label)
❑ Collect on Delivery Restricted Delivery
❑ Signature Confirmation'"
❑ Signature Confirmation
7 016 0340 0000 4332
3352 Restricted Delivery
Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
Data Received
Date ked
Cheek Fool eme
Nafm oM—ft Nolder
Vendor
Check Number
Check
mount
Permit Number/Comments
Recel f w Refund/Reallocated
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Co1umn9
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$ 200.00
GP #74794D
GP #74813D
GP 074628D
IGP#74295D
JD rct. 9445
Tmac rct. 9094
JD rct. 8546
IPA rct. 8521
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