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�
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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
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ium: n/a yes nc
yes no
kttached: yes no
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(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
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To,vprvorw Number i rmad addre*s
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