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Home My WebLink About67228D - Buie] CAMA / ❑ DREDGE & FILL V �O I&ENERAL PERM, Oew ❑Modification ❑Complete Reissue ❑Partial Reissue 672,28 A B Previous permit # Date previous permit issued -ized by the State of North Carolina, Department of Environment and Natural Resources -7 :oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC n / �' 1 IN 0c) `- ❑Rules attached. t Name � (/� Project Location: County �'�J� �►Z,� G Street Address/ State Road/ Lot #(s) State A&C ZIP' a( E-Mail Subdivision ed Agent (Wce c�s -of �t� City [ Q�.t("C � ZIP ❑CW �(IEW *A El ES ❑PTS 1111kone # (` 10) . -79! 0 River Basin �l/►�V6� ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ N/A Adj. Wtr. Body �1�. i nat ElPWS: yes / no ' PNA yes /;' oy Closest Maj. Wtr. Body Project/ Activity Q �^� r (Scale: 5 ;k) lengt itform(s) - — i Platform(s) t - .__ __ i igth nber I/ Riprap length_ distance offshore K distance offshon annel I ,ic yards ip ;e/ Boat] Length �b not sure yes no um: n/a yes V yes R ttached: yes ig permit may be required by: .ocal Planning jurisdiction) 064P1 �3� k V% ❑ note on back regarding River Basin ru iSee NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: �j1j� Permit #: Date: O q A Gt/C Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement found in your Habitat code sheet. TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet (Applied. for. (Anticipated final (Applied for. (Anticipated final Habitat Name DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. Choose One includes any Excludes any total includes Excludes any anticipated restoration any anticipated restoration and/or restoration or and/or temp restoration or temp impact temp impacts) impact amount) emp impacts) amount) j (/V Dredge ❑ Fill ❑ Both ❑ OtherW,C �Q V 16 Dredge ❑ Fill ❑ Both ❑ Other 0 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 ❑ ..^ AMA NCDETIR North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis Governor Director John E. Skvarla, III Secretary AGENT AUTHORIZATION FORM Date: Jame of Property Owner Applying for Permit: me of Authorized Agent for this project: owner's Mailing Address: C�—AQ\- r Agent's M if Address: (�,61S �.ecCV\ �c>� 'hone Number Sc L ZE — Phone Number POS S_ - - ROR certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying x and obtaining all CAMA Permits necessary to install or construct the following (activity): or my property located at 2_1%�� 'his ce ification is valid thru (date) 9j Z / (:�, Property Owner Signature Date HAND UtLIYtK ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to �rf�lti� 's (Name of Property Owner) property located at (Lot, Block, Road, etc.) on cqr-, . , in lug to cz� rl, N.C. (Waterbody) (Town and/or Coun )11, J 4b 51 °t aR'149 Mailing Applicant's phone #: g Address: Cm n k � r�c Z T it9 Ile has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (I Y) 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 not wish to waive I do wish to waive that setback requirement. ---------------------------- ----------- -------- ---------------------------- -- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) (Information for Property Owner Applying for Permit) p.(). ?J149 1 Mailing Address (`itv/St5kte/7 in (Riparian Property Owner Information) wwb —V Signature i ;, �JO�jr Wt+trs -1 T Print or Tvoe Name SAND DELIVER ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFTIBOAfHOUSE) I hereby certify that I own property adjacent to Fea►n , QuIQ Is (Name of Property Owner) property located at (Water„body) (Lot, Block, koad, etc.) in mANw L tdL , Gwn �4 , N.C. (Town and/or County) Applicant's phone #: �1q' VqS Mailing Address: 16`i kuc�t �)(— 6w Ocaw►-76(e U061 (11L He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a mininnum distance of fifteen feet (IY) 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 not wish to waive I do wish to waive that setback requirement. -------------------------------------- ------ ----------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) (Information for Property Owner Applying for Permit) P. o. aN x Mailing Address �C"rt R,�th� r-y . 2 V353 (Riparian Property Owner Information) al5 1"1c't �Jcqx uw i IBC zin3 I J P O, 3Nx �•a►v.�.-.b�,� 1� � Z �353