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HomeMy WebLinkAbout67266D - CollinsI CAMA / ❑ DREDGE & FILL �1 �� 1 V A B PENERAL PERMIT l 1 Previous permit# lNew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued •ized by the State of North Carolina, Department of Environment and Natural Resources 't / :oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ++_- — M Rules_ attached. t Name �� 'j Y`� �`� o (k'�n S Project Location: County F�� c 1 ! 2 \ + L, Street Address/ State Road/ Lot #(s) GrrpS�State G4jfrZlP (1-1-0) 206- 5539 E-Mail Subdivision ed Agent D�kv; 8 �GtY\ City -440 WI f6'(-a ZIP�y�1. ElCW )4EW )(PTA❑ ES ❑ PTS Phone # ( ) River B� jfasin // ElOEA ElHHF ElIH ElUBA El WA Adj. Wtr. Body Nq; �f �aUY A ((ng r/r �❑ PWS: des/ no PNA yes (no Closest Maj. Wtr. Body ' Project/ Activity ck) length ;p Xvs, itform(s) 16 1X lip Platform(s) ngth nber i/ Riprap length ;distance offshore x distance offshore cannel - Ac yards loc; MENEM se/ Boatlift HE MEMO ulldozing e Length- j IS' ;4yP notsure yes 1 no �^ ium: n/a yes nc yes no kttached: yes no i t 1N (Scale: ng permit may be required by: t NJ13ET? See note on back regarding River Basin n Local Planning jurisdiction) .., k NC Division of Coastal Mgt. Habitat Impact Comp Applicant: F (oev I � d C t'-C-41 Coa m Date: 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. (Ant DISTURB TYPE Disturbance total disturbance. Disturbance disti Habitat Name Choose One includes any anticipated Excludes any restoration total includes any anticipated Exd rests restoration or and/or temp restoration or teml temp impacts) impact amount) temp impacts) amc L Dredge ❑ Fill ❑ Both ❑ Other ODredge ❑ Fill ❑ Both ❑ Other Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both 0 Other 0 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: � - CL51 —vj � Mailing Address:�-�- 1 Phone Number: Email Address: C-CA-A N t'j 5 5 � � �L�S oil-k4 ' �"� I certify that I have authorized l-)yl�l� r-t- I- I � '� ��'�= Agent l Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: `' ��t�fhtL 1`7ac ��ti tiles 1 k--- 1'0-A at my property located at (L 11AA1FS�- S� in County. 1 furthermore certify that 1 am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information: Sig tore t�Y Print or Type Name Title CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Robert W. Collins Address of Property: 150 Great Oak Drive Hampstead, NC 28443 (Lot or Street #, Street or Road, City & County) Agent's Name #: David Logan Agent's phone #: 910-367-1348 Mailing Address: 3975 B Market Street Wilmington, NC 28403 I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing_the development they are proposing.A description or drawing, with dimensions, must be provided with this letter. I have no objections to this proposal. I have objections to this proposal. Initial 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. Contact information for DCM offices is available at http://www.nccoastalmanagement.net/web/cm/staff-listing or by calling 1-888-4RCOAST. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.) do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Initial (Property Owner Information) (Riparian Prop e Owner Information) Signature ignatitre David Logan Print or Type Name 3975 B Market Street Print or Type Name ADJACER O.jYXE$1IATEMEN_L i hereby certify Robert Coll,ns that I own property adjacent to (None of Property Owner) propeRy located at 1So Great Oak Drive _ .__. o (Address, Lot Blork. Road. etc.) On ,Topsail Sound {a r..ki -_ ut Hampstead --- _ _ N O (Waterbody) (Cityflown andlor County) The p t has descrZed to me as sr awn be!vw the deve+opment prapused at lie aWve k rr,r.,a1s I have no obrecbon to this proposal DESCRIPTION ANDIOR DRAWING Of PROPOSED DEVELOPMENT ***DRAWING ATTACHED*** WAVER, EiCTION I undwrstand that a pier. dock. mooring pilings. oat ramp. breakwater boatntwse, lift, or groin im,st be s.-t back a mirumum d:stancp of 15' from my area of nparan access unless waivud by r►Kr ,If / n to water the settlack. you must initial *lie apprcrpr,ate bank below.) ve #Vo- 100 %OT w'sh to K'J;ve the 15'setback regwrtment (Oroptrty Owner Information) Cd.o tagst,.: i e'izedd N,•v11 w Ty�tr Ndrrrs Ari...r.T �i�l=roe To,vprvorw Number i rmad addre*s it- (Adoctnt P party Ou or(JJ�ffoimat,onl L ,err a f� r.a 4s yea_ a3) �`