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Home My WebLink About66578D - HonCAMA / ❑ DREDGE & FILL �I f '� I�V A B EN ERAL PERMIT «l 6 Previous permit # New' ❑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 NCAC� ` "'`�� Rules attached. Name i? ' \ \\-D VA Project Location: County ►N� LLk Z �- G U. Street Address// State Road/ Lot #(s) cA VVjA State zfp "X7 t.f 1 _Mail Subdivision / ad Agent ❑ CW QEW PTA DOEA ❑ HHF ❑ IH ❑ PWS: yes / no PNA yes I Project/ Activity 1, ck) length atform(s) use/ Boatlift�' Bulldozing ine Length r` 0 not sure yes o ❑ ES ❑ PTS ❑ UBA ❑ N/A City `;�T ZIP i Phone # ( �"j�—� �J River Basin Adj. Wtr. Body n t Ir Closest Maj. Wtr. Body orium: n/a yes o s: yes r Attached: no ding permit maybe required by: n I nrni Plannino lurisdictloni r'I . + (Scale: t = 1. ❑ See note on back regarding River Basin -i .tom 1. , I -iz NC Division of Coastal Mgt. Habitat Impact Coml Applicant:' �Aaf' I�Zo Date: oG (0 1 ('�.a( 4 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 Fly (Applied for. (Anticipated final (Applied for. (An DISTURB TYPE Disturbance total disturbance. Disturbance disc Habitat Name Choose One includes any Excludes any total includes Exc anticipated restoration any anticipated res restoration or and/or temp restoration or terr temp impacts) impact amount) temp impacts) am �w Dredge ❑ Fill ❑ Both ❑ Other Q5 S t OS -3 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other 0 rcd North Carolina Department of Environment and Natural Resources Division of Coastal Management Eaves Perdue Braxton C. Davis )r Director AGENT AUTHORIZATION FORM Date: 5 q Property Owner Applying for Permit: Mailing Address: Dee Freeman Name of Authorized Agent for this project: Agent's Mailing Address: lumber j ) Phone Number t hat I have authorized the agent listed above to act on my behalf, for the purpose of applying )btaining all CAMA Permits necessary to install or construct the following (activity): Lr�1 property located at li 'cation is valid ru (date) I� Property O r Signature D to LAND DELIVER ADJACENTRIPARIAN PROPERTY OWNER STATEMENT (F-OR A PIE,R/MOORING ,PILINGSIBOA I LIF".TBOAT,N'OUSE) I hereby certify that I own property adjacent to 1,V �,i .0 el `s (Name of Property Owner) property located at u _ �F ` (Lot, Block, Road, etc.) on Jn' R' , N.C. (Waterbody) (Town and/or County) Applicant's phone H: If, 0 � .� s ° Mailing .A.ddress: �� J`e �� 5 He has described to tne, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/inooring pilings / boatlift / boathouse must be set back a minitnutn distance of fifteen feet (15') frotn my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) Z 11411—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) Mailing Address J) a tti d �, "A City/State/"Lin. (Riparian Property Owner Information) Print4 'Type Nan, ►N0 DELIVER ADJACENTRIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/M00RING PILUVGSIBOAILIFTBOATHOUSE) I hereby certify that I own property adjacent to ;rr, ;'�'" �.f 's (Name of Property Owner) property located at.r -- (Lot, Block, Road, ctc.) on in %�,� :r - N.C. (Waterbody)� (Town and/or County) Applicant's phone f1:L Mailing Addivss: He has described to lne, as shown below, the development he is proposing at that location, and, t have no objections to his proposal. I understand that a pier/mooring pilings 1 boatlift I boathouse must be set back a minimuin distance of fifteen feet (I Y) from my area of riparian ae=s unless waived by me.. (If you wisl) to wzlve the setback, you must initial the appropriate blank below.) i JR no wish to waive I do wish to "waive titat setback reyuirernent..._'.,.._...»..........................•---... DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT: (7b be fisted in by individual proposing development) y r ' (Information for Property Owner Applying for Permit) Mailing Addreso ..t..w� yr � � �. •y� � , (Riparian Properly Owner Information) ignature Prin�®r 'ypc arnc 't'elephonc Number; IW Y f�-fl VOT)4 2- 8 40 CAMEl / DREDGE & FILL �v � 1 L A B I"ENERAL PERMIT Previous permit# New ❑Modification ❑Complete Reissue El 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 NCAC �)� rl • , 0 C Name �Z 0� , f � ❑Rules attached. U(Jl ��U ��t�y" Project Location: County 9 (NOs ", . Street Address/ State Road/ Lot #(s) + 7C State L (� ) S(, 'A(,13 C 1 > /E-Mail Subdivision �d Agent (; Y\C,( t d 1/��1'V ( h CityUA C G� ZIP <0 ❑ CWIEW PTA ❑ ES ElPTS Phone # ,River Basin U) ElOEA ❑`HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body a � (nat 11 ❑ PWS: fes / lho) PNA yes / >o Closest Maj. Wtr. Body Project/ Activity Y r�Y1 0 k) length tform(s) 'latform(s) CJ igth fiber / Riprap ength distance offshore c distake offshore annel is rds Length not sure yes o um: n/a yes o yes (i stached: (5 -noo ig permit may be required by: _ocal Planning jurisdiction) L (Scale:' .. -)(t, Avg �-SK Y�C� h ❑ See note on back regarding River Basin rL NC Division of Coastal Mgt. Habitat Impact Com; Applicant: �01yG �lv h Gam/ Date: 0 �� ' I, `P 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. (An 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 terr temp impacts) —impact amount) ternimpacts) am Dredge ❑ Fill ❑ Both ❑ Other100 00 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ NCDETIR North Carb'tina Department of Environment and Natural Resources Wision of Coastal Management Pat McCrory Braxton C. Davis iGovemor Director AGENT AUTHORIZATION FORM Date: 7Ie of Property Ow er Applying for Permit: ot36-1? 1— 13 J-A/CC-1-i s,,�-A, ►wner'"ailing Address: 'hon6 Number (-4 John E. Skvarla, II Secretary Name of Authorized -Age fort project: C7r�� S�tti-t T1 6(-\ Agent's Mailing Address: Phone Number (ql0 )S-7T--q0q S certify" i have authorized the agent listed above to act on my behalf, for the purpose of applying )r and obte I044V. CAMA Perm* necessary to install -or construct the following (activity): T or my property located at e,ZA)c�2� S �G�!�ti �� L his certif ?Aail is val' thr� (dam) G �✓ON c/ (�Tn�� Property Owner Signature Date - CERTIFIED MAIL. RETURN REC91PT REQUESTED —DP SION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of property Owner: Address of property: �_ -----f------ (Lot or Street #, Street`or\ oad, City & CounTy� C G't \ V_\XO `'KAa�ling Address: Agent's Name !x: --- _ Agent's phone #: 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 drawin�q the development they are proposing. cebltltlrirt�ht�4�r'psutrlttr di `i11I►3 ►1a% �ttM1#t. S�ts I have uo objections to this proposal. _ I have objections to this proposal. if you have objections to what, is being proposed, you must-natify the Division -of Coastal Management (I)CM) in writing within 10 days of receipt of this notice. Corres,9gnder►. hauld be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3846. DCM representOVe$ can also be contacted at (910) 796-7215. No response Is considered the some as no objection If you i been notified by Certified Mail. - 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 the 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. Inf rmation) Print or Type Name djacent Pro arty Owner Information) Print or Type Name kzzs_>zs�-,tea Mailing Address Mailing Address Cityistateizip cityis ate/zip '10 -' 6 y - / ?23 -3►0- \ .-287 __ 1'elenhone Number Telephone Number Name of Pro Address of Agent's Name Agent's phone #:�C S LC `-1.U�-�,..__ CERTIFIED MAIL R.-TI RM R CC IPT REOESTEn —DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM party Owner:e_r ---- ---- Property: _�-c � �C, r C _ l��' . ..1L� - ►'T �[-I--U -�_ (t_ot or Street #, St4et or Road, City & Coun yy_— � u n5�11 t C.k acting Address:llt [ U � (tck COA n 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_drawiny, the development they are proposing. I hove no objections to this proposol. I have objections to this ln•oposzil. if yibu have objections to what. is being proposed, you must -notify the Division of Coastal Management (ACM) in writing within 10 days of receipt of this notice. Corresypnoence.should be mailed to 127 Cardinal Drive Cxt., Wilmington, NC, 28405-3846. DCM represetnt4# 009 can also be contacted at (910) 796-7215. No response is considered the same as no objection if YOU hIp'o been notified by Certified Mail. -- 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 riparlan access unless waived by me. (If you wish to waive the setback, you rnus Initial the appropriate blank below.) do wish to waive the 15 setback requirement. I do not wish to waive the 1 S' setback requirement. (Property Ow a Information) — d con Pr party caner Information) Sid r fill. Print or 1 ype Narnv Print or Type Name riling Address (� Mailing Address City%State/ZIt) �C� City/state/zip Telerhone Number Tefo�imber 1 1 1 ( ( / % / cv '1 .. • / NT I hereby certify that I own property adjacent to Ko 13c 2 1141-1 /3 R Cl>.5s2's (Name of Property Owner) property located at AIC,:l�9-b Si/�c�i'T a (Address, Lot, Block, Rid, etc.) on C� .11!/� �- , in dC- Al � - Sc-0 N.C. (Waterbody) (City/Town and/or County) The applica9t has described to me, as shown below, the development proposed at the above 1p ' ion. ' I have no objection to this proposal. 1 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) -fx mz- AJ -P 6� r �jU.s �L Lr WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, 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 the setback, you must initial the appropriate blank below.) wish to waive the 15' setback requirement. not wish to waive the 15' setback requirement. (Pr ner I formation) r Si e Pri t or Type Name :- 17 A n l d n 9 i) Information) Signature* 1,44PI, EW91AZ Print or Type ame ;Z 3o j,��--S' Tel V EQ �� b Oct nk�13 ,.i 1 0' Si IN lt�sc� ■ Complete items 1, 2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. a Addressed to: \��5 NC 2773 Ilillllll IIII IIIII III III III IIIII11111 IN II III 9590 9403 0603 5183 4336 74 2 Artinlp Number ffransfer from service label) 7015 0640 0006 3682 PS Form 3811, April 2015 PSN 7530-02-000-9053 A. Si at ❑ Agent �� ' ❑ Addressee B. R ceived y (Printed Nam C. Date of Delivery L4-1 3-_1 U7 D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No J. Service Type ❑ Priority Mail Express® ❑ Adult Signature ❑ Registered Mail- ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted ❑ Certified Mail® Delivery ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ollect on Delivery ❑ Collect on Delivery Restricted Delivery Merchandise Signature Confirmation— n�eail ❑ Signature Confirmation 2253 it Restricted Delivery Restricted Delivery Domestic Return Receipt U.S. TM Postal Service 'CERTIFIED MAIL° RECEIPT Domestic Mail Only .1 For delivery informatinn vicir ... ,..ems :. .......... _ $ rtified Mail Fee f3 . 30 �!i 045 Extra Services & Fees (check bar, add tee ❑ Return Receipt (trardoopy) $ a5 C3 C3 ❑ Return Receipt (electronic) $ Certfied Mail Restricted Delivery $ ElAPB 2016 O ❑Aduft Signature Required $ O ❑ Adult Signature Restricted Delivery $ Postage $0.47 O Total Postage and Fees f6.47 114 Ln $ Sent USPS r-1 Ct t Pd z o--------------------------------- �� r1� -- -------------- hJ ---------