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Home My WebLink About67116D - Kozark�CAMA / ❑ DREDGE & FILL A B 3EN L PERMIT 1 b \ "rev permit # tew odification ❑Complete Reissue ❑Partial Reissue � d�I1�I1 Date previous permit issued wized by the State of North Carolina, Department of Environment and Natural Resources - 1 Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC V ' i w V 0 ❑ Rules attac e . it Name Z �r d7i�(l Project Location: County AAA's T ` Street_`Add�rress/ State Road/ Lot #(s) V' State ZIP �5 60 ` S cD ( bIEMail \\ Subdivision zed Agent City m 0`C l-% ZIP ❑ CW 1�EW A ❑ ES ❑ PTS �k ne # � 0 ) U • 5 ti I l River Basin ❑ OEA ❑ HHF IH ❑ UBA ❑ N/A Adj. Wtr. Body \ nat ❑ PWS: e� i PKIA —. i41 Closest Maj. Wtr. Body Local Planning Jurisdiction) // 1 i1 • 1 T 1 1 L- i 11 i_ F WC Division of Coastal Mat. Habitat Impact Computer Sheet Applicant: 1Go2C-,,C F-- ��CLkc )�qv-\ Permit #: G-7( Date: 7 S/( Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremer 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. TOTAL Feet (Anticipated final (Applied for. disturbance. Disturbance Excludes any total includes restoration any anticipated and/or temp . restoration or impact amount temp impacts) I FINAL feet (Anticipated fin disturbance. Excludes any restoration and, temp impact amount) W Dredge ❑ Fill ❑ Both ❑ Other (o '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 [I Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: �Z r`MI o4oz C Permit #: Date: G-7 Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremei 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. TOTAL Feet (Anticipated final (Applied for. disturbance. Disturbance Excludes any total includes restoration any anticipated and/or temp . restoration or impactamount temp impacts FINAL feet (Anticipated fin disturbance. Excludes any restoration and temp impact amount) Owl V Dredge ❑ Fill ❑ Both ❑ Other 5 S Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ .. Dredge ❑ Fill ❑ Both ❑ Other ❑ 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 0 s / — ------------- - f =1Z^OMd dO NOill/001 SM44. PORMW 0"60400 01 OMPOOM Aq" q lions �IKNow !i 14 SWA wwwew S smn000v N1 pm -u3 p� et�ore�M =MAJ'A"K3 r:j Pam -woj j ZB=Tat im-co-sm i-03-2007 10:02 From. To:89298w-, Ct&IMM MAIL - R -W—R11 R�F+C�fiI ", RE,QUES t 1~ iD ! f f ii�: i u � • .0 �4� a >•. : ►� �. ' � ► a i i ' i tr f j� ► 4 i � ► a � f 1., � i i i u The purpose of this form is to provide prYhper notice to you as an ad'pmw riparian property owncr to the indivWUM or individuals 11=11 below: Tit LAMA Gems! Pennit gVlWation pmued rres raquim that applicants provide 11wDivil CAI Marapmcnt confmnation that a written stasnment has been obained signed by the adjacent ripwM property indicating that they have no objection to the proposed work 1 brat dt adjacent riparian Property owners hove be= a by certified trail of the proposed work Often these forms are wbrnitted to the adjacent riparian property owners by r canaactor or otter individuals acting as an authorized agent on bchaltof the applicant. This form w►as seat fps you by the totiowing iwdlvldual or company designated by the applicant as as autborbmd agent_ /1 Agent's Signature Name of Individual Applying For Permit: 2 i 0L0 L Ko ZgC,1C._ c3 c— Addm3s of Propetry_MV►n.a� � r- , ( Lot or Street il, Street or Road) (City and County) I hereby certify that l own property adjacent to the above -referenced property. The individual spplying for has descn'bed to me as shown on the anSched drawing the development they are proposing. A description c with dimensions, should be provided with this letter, X---—� t have no objections to this proposal. tT you have objections to what is Wag proposed, please write the D"lon of Cogsml Maaagl Cardinal Drive Extension, Wilmington. NC 28405 or tall 9ILO-796-7215 within 10 days of Mmmipt of No response is er-41dered the same as no objection if you have been woti0ed by Certified Mail_ WAIVER SECTION I underMad that a pier, dock. mooria` pilings. breakwater. boat kouse or bout lit must be minimum distance of 15' [rout my area of riparlan access • artless waived by me. setback, you most initial the appropriate blank below.) j� I do wish to waive the 1 S' setback requirement. rY \ t tin nn!-wich rn wniuft *i— 1 40 �aei�....4 ..�.....,,�...�..s (tf you wish i AA FG-0 3-2007 10: 02 From: To ; 8,129BO6 C;1?&1=D_MAIL - REC Da'RF- UF-STi:D Me 1106"MIMPTY30:1, OWL The purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual or individuals listed below_ The CAMA General Permit application pr..ccdum roquire that applicant provide ths-Divia Coastal Management confirmation that a written statement has been obtained signed by the adjacent riparian property indicating that they have no objection to the proposed wort of that the adjacent riparian property owr=3 have been n by certified mail of the proposed work. ORen these foams are submitted to the adjacent riparian property owners by r contractor or other individuals acting as an authorized agent on bahaitof the eppik=. This form was sent to you by the fallawing indivldural or company desknated by the applicant as as atttbptrized agent: [d�_ - U Agent's Signature IDate Name of individual Applying For Permit; ZI/— K tJ 2 ?� S r , Address of Property. / w ai .'/"D e - ; �..��.. (Lot or Street 4, Street or Road) (City and County) { hereby certify that 1 own property tadjXent to the above -referenced property. The individual appiying for i has described to me as shown on the attgched drawing the development they are proposing. A description a with dimensions, should be provided with this letter, " J I have no objections to this proposal, If 'you have obje dons to what Is being proposed, please write the Division of Coastal rlanage Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215 within 10 days of receipt of i No respow is considered the same as ao objection ityou have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock. mooring pilings, breakwater. bout house or bout tin must be minimum dis-tunce of 15' from my area or riparian access-.ualess waived home. (U You wish u setback, you most initial the appropriate blank below.) /,/// t do wish to waive the 1 S' setback requirement_ t fLn war —*..I% 1 V ..w&—t. IMPUNWA 0 "ao ONCRETE ONCRETE C4ML 20'-0"