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Home My WebLink About67225D - McCall1,QAMA / pOOREDGE & FILL 3ENERAL PERMIT (lew ❑Modification El Complete Reissue El Partial Reissue A B Previous permit # Date previous permit issued rized by the State of North Carolina, Department of Environment and Natural Resources :oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Rule. t Name ! ` 161.E �(al Project Location: County Street Address/ State Road/ Lot #(s) kV 1 Or-5v,`t�State ZIP a L VY'" +" ijV`(0I -r () E-Mail Subdivision ed Agent City �Vn �qt �Zlp ❑ Cw XEw �kA ES PTS Phone # ( ) River Basin t�1J1N� ElOEA ElHHF IH ❑ UBM ❑ N/A W Adj. I tr. Bod(nat fi ❑ PWS: � VP-, i � PNe �p� i Closest Maj. Wtr. Body Project/ Activity ngth / nber Riprap length 5 (J distance offshore I I f ig permit maybe required by: d62sN/1 1t geC .Pl ❑ See note on back regarding River Basin rt _ocal Planning Jurisdiction) j, r �---r i WC Division of Coastal Mgt, Habitat impact Computer Sheet Applicant: " �l� mG l Permit #, Date: D 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 . FINAL Feet (Applied for. (Anticipated final (Applied for.. (Anticipated final Habitat Name DISTURB TYPE. Disturbance total disturbance. Disturbance disturbance. Choose One includes any Excludes any total includes Excludes any anticipated resto[ation any anticipated restoration and/or restoration or andlor temp restoration or temp impact temp impacts) impact amount) temp impacts.) amount) Dredge ❑ Fill Both ❑ Other ❑ coo . Dredge ❑ Fill Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge. [I Fill ❑ Both C7 Other ❑ AGENT AUTH0MZATi0N FOR CAMA PERMIT" APPLICATION c Name of Property Owner Requesting Permit: /A _ Z Mailing Address: -2 Z Z KE Phone Number: Email Address: // ll I certify that I have authorized Agent 1 Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: �� -� -�« 1,)AII at my property located at iri/ K �y �✓� cL County. 1 furthermore certify that I 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: Signature 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: �� . /kti c C A L L Address of Property: J-1 (Lot or Street #. Street or Ro City & County) J Lhc Agent's Name #i 3i . ,,� S Mailing Address:. - Agent's phone #: ?L` �z— <3 —�'` �'� ` '� 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. v objections to this proposal. S I have no objections to this proposal. _ _ I have � p p � 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. Correspondence should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representatives can also be contacted at (910) 796-7215. 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, breakwater, boathouse, lift, or groin must be set back a minimum distance of 1 y yea of riparian access unless waived by me. (If you wish to waive the setback, y must initial`t# p appropriate blank below.) I do wish waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature Print or Type Name 140-y'OWUV brmation) Signature .print or ype Name -.4 . A -r�l / CERTIFIED MAIL -RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: AA A C A,� LCA L Address of Property: YJ (Lot or Street #, Street or Roa6. City & County) Agent's Name #� c_ �� s Mailing Address: Agent's phone #:613 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 draw►na with dimensions must be provided with this letter. .� I have no objections to this proposal. I have objections to this proposal. t 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. Correspondence should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representatives can also be contacted at (910) 796-7215. 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, breakwater, boathouse, lift, or groin must be set back a minimum distance of 1 y aria of riparian access unless waived by me. (If you wish to waive the setback, y must initiSa' appropriate blank below.) I do wish to waive the 15' setback requirement. efil I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Pro Owner Information) Signature AM Ct- Print or Type Name Sigh:,r I\� -PtYn't Tttylpe N/a�me Mailina Address Mail Address Certified Fee :3Return Receipt Fee _ :1 (Endorsement Required) U Restricted Delvery Fee :3 (Endorsement Required) i Total Postage & Fees :3 — Sent T s".•//� V s4deer a inio.,�� r � C I� �� l✓crx� 1 or PO BOX No. rl'+4 -------^ City State. Z -. l _iill 12NALTIF \I111111OM161al: Domestic Mail Only For delivery Information, visit our website at wwmosps.com®. ■ Certified Fee O ED Retum Receipt Fee p (Endorsement Required) M Restricted Delivery Fee E3 (Endorsement Required) J,. ru t ;. . IF' Total Postage & Fees C3 $ ;_ . !I +- Postmark tt Here Ln Sireei a : Av.. or PO Box No. ° `= - --- '-----_.. --- --- - City. S P+4 PS Form 3800, JLli� Nc o1 %W 2014 See Reverse for. Instructions or on the front if space permits. 1. Article Addressed to: YI/ D. Is delivery address different from item ? L If YES, enter delivery address below: C A� Service Type 0 Priority Mi II I II'I'I I'II III I I I I II I IIII II "I II II I'II I II'I�3. El Adult Signature D Adult SignatureRestricted Delivery V ❑ Re❑ 9590 9403 0235 5146 9871 17 Ma ❑ Certified Mail Restricted Delivery ry ❑ Return Re ❑ Collect on Delivery Marchand I 9. Article Number (Transfer from service labeq ❑ Collect on Delivery Restricted Delivery ❑ Signature ❑ Signature 015 0920 0000 7 61,1 8247 ❑ Insured Mai! Restricted Delivery 50 Restricted7 0��1 l PS Form 3811, April 2015 PSN 7530-02-000-9053 Domestic Re ■ 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. Article Addressed to: 00 �- f o 111111111111111111 IN 1111111 III Il it II I I I II III 9590 9403 0235 5146 9871 24 i Artinlw Ni imtvar rrrancfnr rrnm cnn.l�e i.,,,,,n 7015 0920 0000 7611 8261 PS Form 3811, April 2015 PSN 7530-02-000-9053 A. Signature f X '�': '/v1 B. Received y t Name) C. Dat D. Is delivery address different from item 1? If YES, enter delivery address below: L 3. Service Type ❑ Priority K ❑ Adult Signature ❑ Registeret ❑ Adult Signature Restricted Delivery ❑ Re4istere ❑ Certified Mail9 Dekvery ❑ Certified Mail Restricted Delivery ❑ ReturnFie ❑ Collect on Delivery oil 1-1 Collect on Delivery Restricted Delivery ❑ Signature sured Mail C Signature sured Mail Restricted Delivery Restrictec —ten — G4nni Domestic HE