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Home My WebLink About67964D - Black�CAMA / � DREDGE & FILL J/4// � �9s� A B 3ENERAL PERMIT I Previous permit# New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued_ rized by the State of North Carolina, Department of Environment and Natural Resources t' -oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC N 12 o 0 ``// ❑RI ttand t Name �.1n R1 CA (, F 1 `1 b Y AA (AA-6 v� (x q t-C `j ,✓ State NC ZIPZ7�I� 351E-Mail ed Agent j A/ 1 I � K'.[ k (A- ✓A So V1 ❑ Cw /*W *A [IES ❑ PTS ElOEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PwS: yes / ,(Q PNA yes / Project/ Activity uesa c e Project Location: County zam u, i 1� Street Address/ State Road/ Lot #(s) Z ceat", UO, Subdivision City 16 �AA Sir Q ( ZIP A =T LUI�) Phone # (�j b) �7' 0335 River Basin Adj. Wtr. Body 0_4 , )(nat /i Closest Maj. Wtr. Body 4 wW 1 G1 ue t" yk sk\ nfli,, � 1. a (&. r, J C, ( K U uN A if -ram t --L U rio VIA (Scale: I" ; ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■1 !gym ONE ■■■■■■■■■■■■■ mom ■■■■■■■■■■■■R Platform(s) 14 EMOMENEEN■■■■■■■■■■■■■■■■■■■■■■■■■iI mom igth.■■�■■■■■■■■■■■�■�! ■■■ ' ' NI�■■■�■NE ■■ ■ ■■■ =MI EON nber ■■■■■■■■■■,■■■■■/.J`I■■■■■■■■■■■I MOM ■■■■■■■OEM■■■■■■`■t,ll■■■■■■■■■■■■I Mom ■■■■■■■E=■■ M►IV FAME■■■■■■■■■■n distance offshore ■■■■■■■■■■■■■■■■`�11@OEM MEMEMEMEEN ■m■■■■■■■■N■■■■ mom ►Iimmoo■■■■■■■■■■n ■■11l■■■■ii■■■■■■■■■■C,7■■■■■■■■■■M■■O ■�i��■■■■OON■i 9�: C■II , 1 , 0,■n1 ic yards ■■■■■■■■■■ui■■�I■■II■■■■ NGTtiLITI ARI ■ai owwwE MEEK■■mmmf;;room■N■ ■■�' ■■■■■■■■■�■■\'MEk tt1■■i�'■■■■■■ O�I�r1■NONE■■ ■■►■■ \R �' INIV71V 3■■1■■ ■■Nil�.l�E■■■■■ ■N■■►`\MII ■M,; MikO1i ��O■ ■/ ■■MEta-GENE■■NO�rE ON% .4 tea■ I I!1►14■ C\■■NF/ ■�UIV MEMO Mw i`J■\If ■m■ ::!sLan-m ■s■■■a ■■■E■N�I9`�e:.\■■■I Now N \FIOM/I■1■OO■ L!11011 in OMEN= ■■■■9\ ■O■■■■N■NM 14"FA ..- .� �! �[�►iri■■I � EO■ ■!�w!"M • ■ENE■■■ ■N:+�►` ■■O ■ i■1►i►� cz.ea■NONEI■E■■= 1■EI�O�!''-'=::.� WOMEN ■�N■■mom NONE ,■Eri ....ZOIN160 NJ . ■NONE■■EN■■N■ OMEN ■E■INS O■E"It�L'�J��:/NON■ .ocal Planning jurisdiction) A NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: I4VI 9 ( aC 14 Date: y 4 /Z o ((� Permit #: G -7% ij. Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurer 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 (Applied for. Disturbance total includes any anticipated restoration or temp im acts) FINAL fe (Anticipates disturbance Excludes ai restoration temp impac amount) Dredge ❑ Fill ❑ Both ❑ Other s 15 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 ❑ DredgeECOIFill ❑ Both ❑ Other ❑ Dredge ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both 0 Other ❑ Dredge 0 Fill ❑ Both 0 Other ❑ 'ayment Proccessing Confirmation )ate Received 12/14/2016 ;heck From (Name) Willie Clarence Richardson DBA Richardson Construction flame of Permit Holder Ken Black ✓endor BB&T heck Number 6576 heck amount $400.00 Multiple Permits Yes Major/Minor 'ermit Number/Comments GP 67964D ($200) Receipt or Refund/Reallocated SF/3479D ALT AUDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management . Beverly Eaves Perdue James H. Gregson Dee Freeman Governor Director Secretary AGENT AUTHORIZATION FORM Date: November 29th, 2016 Name of Property Owner Applying for Permit: Name of Authorized Agent for this project: Ken Black Will Richardson Owner's Mailing Address: 1908 Marion Place Raleigh NC 27615 Agent's Mailing Address: 3235 Seacrest Ave SW Supply NC 28462 Phone Number &9 280-5381 Phone Number ( 910 ) 367-0335 I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct the following (activity): Floating Dock and Ramp replacememnt (my property located) at 882 OBW Holden Beach NC 28462 This certification is valid thru (date) 1-17 Property Owner Signature Date Rowland Farms Inc 9104223494 p.1 ec.02.2016 12:15 PM Richardson Cons-. & Marine 91CS425597 PAGE. 1/ A33�A CiKNT R iPARIA PIMPERTY OWMM STATMENT r Ye. "y that own PmPnt9 stwe= to Ke.n &act, is ,(Name of Prop" awaer) Prop" located at O csieun E31vd �J .(LA Block, Road, etc.) tws��') a" smd/or Con W.C. nt�r) Ap~a phom Mxiiiag Addy+ l4 o S M Gk^ J an 1-io has dcscnbed to me, as shown below, the dcvewprm=g br is proposing actthat Ioeatinr, and I have no objoctkm to his pr%ma1_ I tmdersbmd dult a piedmvormg piling / boadi$t I bow oust most be set back a min um d4uucc of fdt= feet (151 from my area of writ woo =I= waived by mc. (If You Y&h to waive the setback, you roust iaitial the eippropria►te "k bclaw.) I de n wish to waive I & wish to waive that sutwA DESCRIPTION AND/OR3:1A&WI c7 OF PR(ROSED DEY 0FrdEN'T: (To be filled ix by h"&viAr proposing dtveLgpmcn0 t11 (IX&rMation for Property owner foryerni t) ��A 2c,YPS t"tVOL Matting AOUM Lek �C ag � cityis �cum9 u cck-� crn os Araw i fq . (Ttipar "]Prop" 0"erInforial)d")re- - S' Dena & P6z Print or Type Name I r- ADJACENT RIPARIA-N PROP"TV OWNER STATMINT (FOR AmiAtooRm PnjNG"o4zLnrr1AoA rffotisE) twreby certify thd I own prop" adpcem bD - kin----- :s OUM 4irrmpav OWAW) propaty tocamd at fAgan- � "I Vti a'K Mmk Read, Ste.) on in 'A (Wa*r") (Tom and/or Canty) He has degaribed to tric, as 3bDwr-, below, the jvvck4wnca he is pr(Tosing - hAvc nO (AnOctiom to his propusa�- I underruind out a pierlynoonnt at tw k)cattwL ancL I pINW, be xft / boam(Aise amA be 9d back a Hwumm distance of frhm fee (I fl from my � of r4ar 'm wem unkm v &6a by me, (Hvou Wiab to W&M th* sebeck you awt la*w the AppraprMt* b,hak bqavw.) i 49-Ass wish to waive t -4g WL* to wove thu 116 m* req%mramow DESCRrMON AN -NOR DRAWL14G OF rROPOSLP DFVLWPMN-r, (Tv be fdied in by �fpqWskg dtwjo�w�,o AI — 'lrm. for Prop mly 0W*W tocoAcrn a5 AV a W% A I - 4 1 ' A Ye rN bict Mwarim Prow-ty Strr C.A D pfist T 336 6qI-Ow7 Scope of Nork: 1: Permit package and Permits from DEO/CAMA and Town of H 2: Removal and disposal of existing ramp and floating dock 3: Purchase of materials and labor to build new floating dock as 4: New aluminum ramp modified to fit existing opening 5: Glean up and debris disposal Owner: Ken Black b82 OBW Holden Beach NG 28462 q 1 q-2M-53b 1 Contractor: Richardson Construction 3235 5eacrest Ave. 51N Supply NG 26462 q 10-361-0335