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Home My WebLink About67127D - LamyAdj. Wtr. Body f'S �� r (nati w"CAMA / ElDREDGE & FILL v j " "j''' 6a� 31V L PERMIT l ✓ Previous permit # A B �lew odification ❑Complete Reissue ❑Partial Reissue LIC �o 1� Date previous permit issued )rized b the State of North Carolina Department of Environment and Natural Resou�es 1 Y � P j� Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC (/' i' �ul les uhed. it Name L Project Location: County_ �ek,��''�� See -* 17 Street Address/ State Road/ Lot #(s) f"S 1//-r tateAOK ZIP e'/ i_S -* i-y V Mail ,SNS-4H 6+ ��m�/�°�00/ Cqubdivision zed Agent :5��!0,h V �� CityI'tze11-1 t.JY%1k /S ZIP ❑ Cw Ifw OTA ❑ ES ❑ PTS Phone # (') 231—S5/-V River Basin ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ NIA ❑ PWS: ,f Project/ Activity v lof Jingpermit may be required by: See note on back regarding River Basin Local Planning lurisdiction) _ _ _ 2 14C Division of Coastal Mgt, Habitat Impact Computer Sheet Applicant: (,( �/'( Permit #: Date: Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen found in your Habitat code sheet Habitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied. for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp . impact amount) TOTAL Feet . FINAL Feet (Applied for.. (Anticipated fins Disturbance disturbance. total includes Excludes any any anticipated restoration and/i restoration or temp impact temp impacts) amount) 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 El 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 ❑ fi NCDENR North Carolina Department of Environment and Natural Resources Pat McCrory Donald R. van d Govemor Secreta AGENT AUTHORIZATION FORM ame of Property Owner Applying for Permit: Name of Authorized Agent for this project: wner's Mailing Address: Agent's Mailing Address: mall: SQ V�1 j Q M Q �q j �� q J l��lr l Email: i�ti.�t,/�1/c�c��`./� �w 5— rc�/. lone �GJ'i�l ��)�(n G 2 �%I �% /1 ✓ Phone Lct/D -ertify that I have authorized the agent listed above to act on my behalf, for the purpose of applying ir, and obtaining all CAMA Permits necessary to install or construct the following (activity): ''roject Site Address: Property Owner Signature Date* *This narfifinnfinn is vnlirl 9 vaar fmm rinfa cinnarl by nrnnarfv nwnar ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Su Sa L a I (Name of Profmirty Owner) property located at q (� ter. cam, a �r . _ (Address, Lot, Block, .) R d, etc on - SrfvsP�� , in k 0 �(Q N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location 1 have no objection to this proposal. mplete items 1, 2, and 3. A. Signature nt your name and address on the reverse ❑ that we can return the card to you. d ach this card to the back of the mailpiece, B. Received by (Printed Name) C. D e of on the front if space permits. IIsGVt �St .+ ��rl i 1 . icle Addressed to: f IN- c (3 P ct D. Is`deeliivery �e�refrom item 1? If U(.IVI il� rL a,bN"' "�E? 21 2016 or attach a site drawing) RECEIVED DCM WILMINGTON, 1` 3. Service Type ❑ Priority Mail Express@ J' 1 C J r�1O�C III II III II I II II I I IIIIIII II III III I I III ❑ Adult Signature ❑ Registered Mail ❑ Adult Signature Restricted Delivery ❑Registered Mail Restricted ❑ Certified Mail® Delivery 9590 9402 1670 6053 8859 20 ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Irlp Nnrnher (transfer from service label) ❑ Collect on Delivery Restricted Delivery ❑ Signature Confirmation'*' n 1— '-A ti+ail ❑ Signature Confirmation 7 015 0 6 4 0 0004 1075 0 0 0 0 tit Restricted Delivery Restricted Delivery >rm 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt varu a uz I wvvt I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waiv the setback, you most initial the appropriate blank below.) / Vvt� Y �L I do wish to waive the 15' setback requirement. 1 do not wish to waive the 15' setback requirementS t (P Information) Print or Type Nam (Adjacent Property Owner Information) ,Tature n Print or Type ame Sx/G ' act AAmiliniv Arlrinocc Ma► no AddrP-s.R ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to C . LA�Q y1 La my - 's Name of Property Owner) grope located t 4 ' t'V _ Q 0 (Address, Lott B . ck, Roal,, etc.) on 66 , in V i l " C N.C. (Wa ody) (Ci /Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. i -45A I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must rill in description below or attach a site drawing) RECEIVE[ DCM WILMINGTON JUL 15 2416 WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back 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 do not wish to waive the 15' setback requirement. (Pr perty Owner Inf ation) (Adjacent Property Owner Information) �fj 1 afore , Signature Cc &,krz-Y 13, G�r� P or pe Name Print or Type Name ADJACENT RIPARiAH 1P R®PER Y WHER STA T [-PuuENT I hereby certify that I own property adjacent to a --> s (Name of Prope Owner) property located at � � P,^ i� u �4 I ,- . _ ,(Address, Lot, Mock, Road, aft - (Waterlbody) (Ityrrown and/or County) The applicant has described to me, as shown below, the development proposed at the above location. _ I have no objection to this proposal. 1 have objections to this proposal. -DESCRIPTnN AMID/OR DRAWOK90 OF PROPOSED IDEVEL OP7,9EHAT (h,wdffvid a?1 prepasing development mus-9 Off in descripffon below or aVach a site draiving) ( .5 e- 01VAC-L ec�l J WAIVER SECTION I understand that a pier, dock, mooring pilings, 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 do not wish to waive the 15' setback requirement. (Props Ownerr Information (Adjacent Pro s-iij owner Q�iFo�¢wa�aocd� S= a Si e Pnnt or Type Name Print or Name /_pia / ) s.��''� ,c�% 6�� 1 0n 0 f ,l. I ; '1'- b , FY THAT THIS PROPERTY WA5 SURVEYED AND MAP DRAWN UNDER MY SUPERVISION+ 'HE FACE OF THIS PLAT; RATIO OF PREC1510N A5 CALCULATED BY COMPUTER 17 NDARIES NOT SURVEYED ARE SHOWN BY BROKEN LINES PLOTTED FROM 3 SITE 2 IAT THIS PLAT WAS PREPARED IN ACCORDANCE WITH 'THE STANDARDS OF 0 0 IG IN NORTH CAROLINA' (21 NCAC 56, 1604); WITNE55 MY ORIGINAL SIGNATURE, 74 . THIS 22ND DAY OF 5EPTEMBER A.D. 2015. FOCAL POINT A5 PER M5 37, PG 36 I J W E -- FLOOD EBB 5UN5ET LAGOON LOCATION MAP NOT TO SCALE / I 5URVEY REFERENCE / I / I l MAP BOOK 5 PAGE 127 NHW LINE TABLE LINE LENGTH BEARING L 1 39.13 580°2 I '00"W L2 5.90 58000714"W L3 14.98 1 578°35'50"W co 1 MAP BOOK 37 PAGE 361 tt DEED BOOK 5897 PAGE 279G h / I NOTE: THI5 LOT 15 LOCATED / IN ZONE AE (EL. 14) A5 PER �� MAP # 372031 G700 J (, COMMUNITY ID # 37536 I DATED: APKIL 3, 2000 CORRIDOR LINES PER _ / FLOATING DOCK RIGHT RECORDED MAP / I AT PIERHEAD LINE _ if -AD LINE ---------- FLOATING',"----- `/ �' / ' NC / � i � � PRE5UMED CORRIDOR LINE5 5 2016 //RAMP 15, (NOT 5HOWN ON RECORDED MAP) RAm THI5 MAP AND FIELD 5URVEY WERE MADE �/�I�- FOR 7HE IXCWSIVE USE OF THE PERSON, m PER5ON5, OR ENTITY NAMED IN THE 15.0IILri DOESFNOT IEXTENOR TRANSFER TO ON HEREON. 5AID INYION /GAZEBO O WITHUTANEEXPORE55ED RE-CERI IrICATON )RMAL HIGH WATER 15 I BY THE SURVEYOR NAMING 5AID PERSON, -ACE OFBULKHEAD PIER I PERSON5, OR ENTITY. _ /J (l ' Uac�IL o 5 P p.E' ��oc� Ut�S 1 JiFC 41�CF"�ia � oDCk 4� 7'x au c�O�N