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Home My WebLink About67159D - Collins?CAMA /❑ DREDGE & FILL r� 6 6 1� 7 A B '"'NERAL PERMIT Previous permit # ew ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued -ized by the State of North Carolina, Department of Environment and Natural Resources �a� �� :oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC n Q r ❑ Rules atta ed. t Name t wt Q �'%�/ t Q In Project Location: County i LA1 kkn;l Street Address/ State Road/ Lot #(s) State .50yw__11 1"1i (1(0) `A(J-&b A0 E-Mail Subdivision ed Agent SC, 0 �4 VVY Y 1 A NBC, CiZIP Aic ❑ CW YJEW XPTA ❑ ES ❑ PTS Phone # (W(V) River Basin 1" ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body hivyw Inar ❑ PWS: yes / (ho, PNA yes / Closest Maj. Wtr. Body ' Project/ Activity :k) length itform(s) Platform(s) igth nber i/ Riprap length distance offshc x distance offsh annel iic ip W I Length ^' S ! ..+-- not sure yes In. I. um: n/a yes yes attached: yes ig permit may be required by: C n�nsv� t CU�vI -ocal Planning jurisdiction) WE 1,*, = J ❑ See note on back regarding River Basin rL NC,Divlsion of Coastal Mgt. Habitat Impact Computer Sheet Applicant: 7I-YvIQ-�h y Cpj l m S Date: d r �a b Permit #: O(S q- j\ 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 TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Feet (Anticipated fina disturbance. Excludes any restoration and/c temp impact amount) (A 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ WNW North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis John E. % Governor Director Secn AGENT AUTHORIZATION FORM Date: Name of Property Owner Applying for Permit: Name of Authorized Agent for this project: l i'M �� h,x L G L,—j /Z/VS Owner's XaMft Address: y 3 PAL ✓IA N(L- 7-gy.2 Phone Number o I C) FI `i l,- 6 l y C. 11 _T6�'S079 1 certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying for 9)?d obtaining all CAMA Permits necessary to install or construct the following (activity): For my property iocabed at This certification is valid thru (date) Property Owner Signature Deb WV I t:L 600CAZ/> DIVISION OF COASTAI. MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTMCATION/WANER FORM Name of Individual Applying For Permit: Address of Property: 't G: i L e e K w oo L ro Ih, 1W 1 (Lot or Street #, Street or Road) 9 n l - rA;L n s XLlLlrl- (City and County) I hereby ccrtify 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 drawir the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. I have no objections to this proposal. If you have objections to what is being proposed, please call Debbie Wilson with th Division of Coastal Management,127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215 within 10 days of the receipt of this notim No response considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, moorings pilings, breakwater, boat house or boat U must be set back a mini distance of 15' from my area of riparian access- unle 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. V C , C I do not wish to waive the 15' setback requirement. NY 10:L 600Z./OZ/V DIVISION QF C:OASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNLR NOTIFICATION/WANER FORIv Name of Individual Applying For Permit: �; th '4 L , Co // ; /VS Address of Property: J63 L a w dl 3 (Lot or Street #, Street or oad) fia 11 `,r ; A R r�Ns ui; c.K (City and County) 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 drawl the development they are proposing. A description or drawing, with dimensions, shoul be provided with this letter. i< I have no objections to this proposal. if you have objections to what is being proposed, please call Debbie Wilson with t Division of Coastal Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215 within 10 days of the receipt of this notice. No respons considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION 1 understand that a pier, dock, moorings pilings, breakwater, boat house or boat must be set back a minimum distance of 15' from my area of riparian access- uni waived by me- (If you wish to waive the setback, you must initial the appropriate blank bellow.) I do wish to waive the 15' setback requirement. _ ^ 2� I do not wish to waive the 15' setback requirement. I1 ;�/. _i- G , I . i i e x �o ► m I CrM 3 o 7Mkl CCo cs—N.s 4OCeW OOJ LLy 12D IX 03 �r aoCXv�,AJ.c. s ssrvno-D �✓s_L i aYua s 1 f 77 ?)'�-51j- sT S