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Home My WebLink About67247D - CloaningerCis AMA / i❑ DREDGE &FILL \LL, 31�-VE•NERAL PERMIT ` of l�' Previou s permit # Hew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued -ized by the State of North Carolina, Department of Environment and Natural Resources :oastal Resources Commission in an area of environmental concern pursuant to I SA NCACQQ t �i�•'2 ❑ R les attached. t Name w I t)akA ir�)_f y Project Location: County j9 30 �� ( Mf0 Street Address/ State Road/ Lot #(s) 'mot 1,N� State ZlP E-Mail _ Subdivision �~ ed Agent ----_— - City �:>Vti1 ZIP Z ❑ CW EW�TA ❑ ES ❑ PTS Phone # (70q)(�ZZ ' j �o S a River Basin L� ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body Cal,yt ❑ PWS: yes / no . PNA yes Closest Maj. Wtr. Body— A' V�t1/� � ' Project/ Activity UT i A 4— a� �` � � i �,y1 � n i `C: V «1M !1 . : t Vt A 4—t G ol, o V"!�_ ck) length atform(s) 00 Platform(s) � ngth mber d/ Riprap length distance offshc uc distance offs cannel Sic yards np - FT_ ise/ atlift l e Length .50 not sure yes no' -- ! •ium: n/a yes o ( i q i ' Yes (9 I Attached: &) no T ng permit maybe required by: (Q�/�/i� �j� �vvx Local Planning Jurisdiction) 7 (Scale: ' ❑ See note on back regarding River Basin r NC Division of Coastal Mgt. Habitat Impact Comb Applicant: C 2 b(�(� ""*- Date: �� Zol 1 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 FIN (Applied for. (Anticipated final (Applied for. (Ani DISTURB TYPE Disturbance total disturbance. Disturbance dist Habitat Name Choose One includes any Excludes any total includes Exc anticipated restoration any anticipated rest restoration or and/or temp restoration or tern tem impacts impact amount temp impacts) amc (� o V V Dredge ❑ Fill ❑ Both ❑ Othe 22-0 22 p Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ 1-6 10:08a Aztech Security Systems 7047535703 p.3 ADJACENT RIPARIAN PROPERTY )OWNER STATEMENT I hereby certify that I own property adjacent to VV) Li�Jc"q "/V �E'_ r 's (Nam f Property perry Owner) ` property located at _ �� ,� C� )� j (Address, Lot, Block, Roa , etc. on (� , in �J 1 S � Nr- tLk N.C. (Waterbody) (CitylTown and/or County) W�— Thhe appplicant has described to me, as shown below, the development proposed at the above locatioi X I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) 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 wai, the setback, you must initial the appropriate blank below.) Pvt_ I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) Sr at t e 7— S � Si nature —Ii�ItOi^1 +4L10.. A. f�er►y�l Print or Type Name Pr' or Type Name 06 ,Mailing Address Mailinn Arfrinace ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to bl'a �fr (Nai property located at% S' of Property Owner) r 's (Address, Lot, Block, Road, et,,c. on /~�1;..`��- in=�U111`=� �" tEC=rtC k , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. je f}F:�- I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) 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 `he 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. (Property Owner lnfomattiiOn) i` Signal e MLArn CrICALJ'Nf= &i, Print or Type Name Mailing Address n e / i (Adjacent Property Owner Information) Al �� -, Al _ SJ nature Print or Type Name 13133 Do ve j 4t- J�2 Mailing Address $6 10:08a Aztech Security Systems 7047535703 frofo5ll � re.ixu; 4e- /0 C OAJ, Wqjkjjj a oj i I lo e- sAorkr So %hc.4 4e- dock � m C OU 8en, ojL-k(-L c $6 10:08a Aztech Security Systems 7047535703 p.2 i )k— AV, IhotnaS