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Home My WebLink About67170D - BormannICAMA / []DREDGE &FILL 4�' ��A B GENERAL PERMITPrevious permit# New ❑Modification ❑Complete Reissue []Partial Reissue Date previous permit issued ,ized by the State of North Carolina, Department of.Environment and Natural Resources -� n., (6 :oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 4+'I+, • j L D �� M A Y) 0 � ❑ Rules attached. t Name I��/� �(,� -( ^�_ Project Location: County ,��<,�sc � 14 k— s twO� Dr. Street Address/ State Road/ Lot #(s) ` :y! j /i !4AOR Jvt T'4114i�Qr State /JY ZIP11414-3 _ (;10 315 ' 351 E-Mail Subdivision � ad Agent (-ramtp (.�o.+s+rvt:�Oe'k City Ia��c� �GC� ZIPv"�o Q��/ � ❑ CW J *W XTA ❑ ES ❑ PTS Phone # ( ) River Basin /4l� ❑ OEA ❑ HHF ❑ IH ElUBA ❑ N/A }_ El Pws. Adj. Wtr. Body ; ilk v'12i4 CQ ►1Li ( (nat /r yes Co) PNA yes no Closest Maj. Wtr. Body �� C Project/ Activity. :k) length y X 1 g itform(s) Platform(s) 6'Y_ igth nber I/ Riprap length_ distance offshore- ( distance offshore annel is yards16;fte p 43'x 1C �-.'9 Pe/ Boatlift ► 3' X 1 3% illdozing Length 1 L�• 61 not sure yes Ino im: n/a yes yes ttached: yes �pp xjCyct� L�'-orvvr i�.o.!'tixL FJX(� iQa✓i O , (Scale: 1 r = 4 r7 ig permit may be required by: (v,nS�,,�(� CQ_ ❑ See note on back regarding River Basin r .ocal Planning jurisdiction) NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: 111`pS cvV�A vI Y� Date: 6Q 113 f 16 Permit##: P Z06 - L Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement 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 I TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount) O Dredge ❑ Fill [I Both ❑ Other 3 �-lJ 320 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ . Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management 'at McCrory Braxton C. Davis Governor Director AGENT AUTHORIZATION FORM Dote: ame of Prope Owner Applying 'for lPermit: �W wner's Mailing Address: lone Number %�� j / ' 7 John E. Skvarla, III Secretary N e of Authorized -Agent for this project: �$r Agent's Mailing Address: Z%%4 Phone Number ;ertify that I have authorized the agent listed above to act on my behalf, for the purpose of applying r and obtaining all CAMA Permits necessary to install or construct the following (activity): )r my property located at / r �i - '= its certification is ate) \fib CA,_' m put- 'LQ tl Property Owner Signature Date CERTIFIED MAIL. • RETURN RECEIPT REQUESTED DIVISION OF COASTAL_ MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: Address of Property: _.. .� (l.ot or Street il, Street or Road, C�Co1un1Zyj-- ` Agent's Name ll: Mailing Address: ll.VV% Agent's phone 11:. _C\(k lV c 2-06,-1('69 I hereby certify that I own property adjacent to the above referenced property. The individual appyring for this permit has described to me as shown on the attached .dra)0n tl?e development they are proposing. Mlt� ►Cf'ifl 7 ,,ksiN��i ii3'1 1 have no obJections to this proposal. I have ot�jcetiow to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (I)CM) in writing within 10 days of receipt of this notice. Corresygnffence•should be malled to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3846. DCM represeht4oves can also be contacted at (910) 796-7215. No response Is considered the same as no objection !f you h" bleep - notified b 5� ertlfled Mail. — 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.) 69,5L 1 do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) \ Signature ^ _ PrintorType `N��amc� Meili g Address City/State/I_1p�1 �- 511�- telephone Number -- (Adjacent Property Owner Information) Print or Type Name Moiling Address Citylstate/Zip Telephone Number CERTIFIED MAIL RETt1RjV RECEIPT REQUESTED -- DWISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: �"AA t, +� - AddressofProperty: -Poo (hot or Street #, Street or Road, Cfty & Counly� Agent's Name#: �� , lam_ i�+1 ailing Addre`s�s':' (_� Agent's phone #: M� - �'� ailing Address: l/ 2 I hereby certify that I own property adjacent to the above referenced property. The individual appfyfr►g for this permit has described to me as shown on the attached-irawinMthe development they are proposing. � >~'lpitllal.1?S�TNOIb rl%`as �uffikdlfbf i� •,..ail �zf� "S' ��It�t��ri. _ .-1 have no objcctions to this proposal. I have obiectiow to this proposal. if you have objections to what. is being proposed, you must -notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Corresagnplence. should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represetntolVes can also be contacted at (910) 796-7215. No response Is considered the sane as no objection !f you h" been notified by Certified Mail. 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. do not wish to waive the 15' setback requirement. (Property Own r nformation) (Adjacent Property Owner Infon tion) Signature �Signalt+re Print or Type Name Print or Type Name AD t4v a(ao 5ef\ pko-y Mailing Address Mailing Address G wok-3 Sc City/Stato---^— City/State/Zip To/Thone Number Telephone Number USPS.com® - USPS Tracking® Page 1 of English Customer Service USPS Mobile VOUSPS.COM USPS Tracking® Tracking Number. 70150640000636822420 Product & Tracking Information Postal Product Features: First -Class Mail® Certified Mail- Return Receipt See tracking for related item: 9590940306035183433537 DATE & TIME STATUS OF ITEM LOCATION Au List 10, 2016, 10:'10 am Arrived at USPS Destination GREENVILLE, SC 29607 Facility Your item arrived at our GREENVILLE, SC 29607 destination facility on August 10, 2016 at 10:10 am The item is currently in transit to the destination. August 8, 2016, Unclaimed/Max LITTLE 7:52 am Hold Time Expired RIVER, SC 29566 July 21, 2016 , 1:02 No N Left L(o Notice e Authorized LITTLE pm Recipient Available) RIVER, SC 29566 July 21, 2016 , 9:09 am fD put or Delivery rY LITTLE RIVER, SC 29566 July 21, 2016 , 8:59 l Sorting Complete LITTLE RIVER, SC 29566 July 21, 2016, 6:01 am Arrived at Unit i LITTLE RIVER, SC 29566 July 20, 2016 , 3:40 pm Departed USPS Destination Facility COLUMBIA, SC 29201 July 20, 2016 , 11:02 am Arrived at USPS Destination Facility COLUMBIA, SC 29201 Register / Sign In E2Customer Service > Have questions? We're here to help. J Get Easy Tracking Updates > Sign up for My USPS. Available Actions Text Updates Email Updates u�� Shy _ S�►�sQ.� ' 4-- 2g5t�.C� cxr.,rx� D ►%4 0 2' Ctz�,vsr-eA Z-h and 12 5 • (o � ��-- — ? r