HomeMy WebLinkAbout72244D - Crissey4-t�7—,-n Y lVu A
CAMA / r7 DREDGE & FILL NO 72244
-. GENERAL PERMIT Previous permit # '� 1''1 1 g D C Q
New —Modification XComplete Reissue El Partial Reissue Date previous permit issued 1 1& /2019
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 07H. 12 O O
❑ Rules attached.
Applicant Name MAgk & L SA CR1 sS,gy
Address 23 c ugl3r-(ZL-AND .STRcEr
City OCCA,v SSLE &AC114 State AIC ZIP 2 84& 9
Phone # (M 274 — 5373 E-Mail L ML 2102 ®9n►ni�. cop
Authorized Agent CNA;tLX-C 770X
❑ CW
)`EW
XPTA ❑ ES ❑ PTS
Affected
❑ OEA
❑ HHF
O IH ❑ UBA ❑ N/A
AEC(s):
❑ PWS:
ORW:
yes / no)
PNA
yes / no
Project Location: County 13A Ads W i cK
Street Address/ State Road/ Lot #(s) 20
//
o0 Rr- STREET
Subdivision W A
City OCCA4 .1-SUL StAC-N ZIP
Phone # (910) 5JJ - 0 9 0 8 River Basin Lkµ CIER
Adj. Wtr. Body CANAL (nat man�/unkn)
Closest Maj. Wtr. Body A I W W
Type of Project/ Activity COIN S-rR N cT A /V E W DC, e%.146 FA C I L.iTY
(Scale: 1ii : 20 ")
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A building permit maybe required by: OG•p
EA N ZS L.r F>CAC N ❑ See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions 07N. 1200 AND A W, OTNER 4 0CAL . STATE ADD
FsprxA L REC, LALA7100I AP PLY
ti
Agent or Applicant ted V
Signature ** Ple` 4eread.compliancestatementon back of permit"
400 * 25535
Application Fee(s) Check #
1 y Ez MC-6K1RE.
Permit Officer's Pri Name
G
Signature
&/r7-/19 tojr'7�19
Issuing Date Expiration Date
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Applying for Permit: L # '5a- L ed 9 rG - Cr 55 Cy
Mailing address: 013 C u_n-m ber I an d S 4--
(Ocec.n 151e 13ea.ch Nc_ 08,1Co9
Phone Number: `7 5 -7 - a -7 y - 5 3 `1
I certify that I have authorized Charles Fox Homes
Agent / Contractor
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of
at my property located at
in Brunswick
residential home, boat lift and boat dock
20 Moore Street,
County.
This certification is valid throw 12-31-19
Date
(Property Owner informatloni .' ..•.
/ Signature
Print or Type Name
Trite
Date
`75,7-,Q17--53-73
Phone Number
Emati Address �J
Ocean Isle Beach, NC
E
-1ef1L%t>Y 'ref* th8l,l CAW) PMP" aC4WMn1 to . WAF* WV Lao Cmft�
—(ft—WW of Prop" Owner)
property locaW at 20-11ACKAt 37le. Lot it, C-fW 3. ;*rhos A 4 1,4
(Address, Lot, Stock, RoW, etc.)
or. in We G"CA, wksn- ". 0onry
Wate ti
(tba<ty) (City/Towii an—dJor County)_.__
The applicant mas descrd)ed to nie, as shown bek)w, the davejNrsterjt PrOPO-seU at 'he above
have no obtecUwj to tW proposai
1 have 04eCtons to this proposal.
xwycga-ngN
I understwW OW a Pier, dock, rnoonng piTnxp, boat ramp, tweakwater, boetWuse, lift, or gram
Mikat b* SW hea a nw*Twum disimce of 15'#M MY area of rttiWian access unless waived try
0*- (ff You *16h to waive "'a $006clK. You n"At if*W the aPPrOPOOD bier* below )
irl" —
- — . I do wish to waive the 16 seWack requirefrieW
I do not wish to waive U* IS' seftack requrenwnt,
W"O" Owner Wormahm) (Adjaii:!M Pm' er Owner lnfomali6n)
P** or Type Name POW LV Type mam
'VV-1- C r-j n- QW091011111111M.St -
agov AO"" I Us &V A d* wil A m
',1 71 J'k1700W ho sew*,. NC 7,640
4VSW&ft CC4VV"f4
e a 7 / ��V% "W-W44313e
raw*oag maber / HMO address Number i &ma# addrow
(Rewwd Aug. 20 14)
Wabid tor one rAmandaf yew after signoxim,
t nereby mw I own pK p" acI)SM/1kIM fta w L. cry
S
P(00" f�aw l t W Mft o set04: LOt 43. Carat S. a�sdko A & mot],# Property C�fv rl�) 4
in .."�"c r"` We
sa n' anaemic icxmry _ N.0
C erbodo (City/To n and/or Countj�'—
The applicam has deserted to ma, as shown below, the daveiopFi� pry , ,,� e
• �, > I hom np ot�ctio n to this pmpusai-
I have f 400AOM is q ppm*s-81-
WAIVER $9Qil
1 uroderstand brat a per, dock. mo oriN pings. boat ramp. breakwater, boaVwuse, li€t, or gr*ln
aMuaf be set tiao a r ununum distance of iS froitq my ame of €qptratn amens uedesS wtawed by
(if Yat,-vresb to waive the sobadr, you racist Wonj Vie apprvp a bkn* below 3
'f t dc-wishto verve ftw 15 seMaCk redu rernent
iA&t`W wish to waive Ow W saftoc k requwemom.
(A4b*wtt Propelty tt'
or 1` 1 how PmW or Type t16e M
2SL �'ss INI1v�A/??3?t t.rzx oo�,
Tabvftrtt adc"tS dma% pt�aroe tlhlra / erbafl ads
TAW lk�sc=
(Rewsev Aug. 2014)
IVAW kw Otte c406cltSar Yom aftr 5gneOare-
ON 'NOiJNIWIIM WOO
6lOZ 91 M
CANAL
CANAL
Date Received
Date Deposited Check From (Name)
Name o1 Pa It Holder
Vendor
Check Number
Check
amount
Permit Number/Comments
Receipt or RelundlReallocated
Co7-1
Column2
Column3
Column!
Columns
Column6
Co7umn7
Columns
Column9
142019
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