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Home My WebLink About67130D -MaioranoICAMA / ❑ DREDGE & FILL 31ENERAL PERMIT �� -" A B Previous permit # lNew ❑Modification ❑Complete Reissue Partial Reissue 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 CJ ` /�- ❑ Rules attached. t Name Project Location: County i Street Address/ State Road/ Lot #((s) �J / State -ZIP L ^ , 1-3.7 _ ,G c C "� E-Mail Subdivision , ed Agent dOi�/ ❑ CW a' A ❑ ES ❑ PTS ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ye-s)/ no PNA ye�/ no f Projr-ct/Activity I& v VV �. length 7,ov atform(s) Z- Q Platform(s) 1--le a d/ Rio-ap length_ distaste offshore uc distan`offshore cannel e bic np ise/ ulldozing 111"TRIPREr ' 01 025 ,INN City f 1 U ! Phone # ( �— Adj. Wtr. Body Closest Maj. Wtr. Body rr qA aim ZIP Z-� Basin CFI I� �k Local Planning jurisdiction) 1- j ',— n ❑ See note on back regarding River Basin r NC Division of Coastal :Mqt. Habitat impactComputer sheet Applicant: Al 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 FIl (Applied for. (Anticipated final (Applied for. (Ar DISTURB TYPE Disturbance.total disturbance. Disturbance dis Habitat Name Choose One includes any Excludes any total includes . Exi anticipated restoration any anticipated res restoration or and/or temp restoration or ten temp im acts impact amount temp im acts)arr Fb (/,- Dredge ❑ Fill ❑ Both ❑ Other Dredge ❑ Fill ❑ Both . ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge [I Fill ElBoth ❑ Other ❑ Dredge ❑ Fill ElBoth ElOther ❑ Dredge. ❑. Fill ❑ Both ElOther ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date' Name of Property Owner Applying for Permit: J-0-ti.'1 !;:. Z4a, 0 rA'L" t� Mailing Address: % LC�/ �iDG< At I certify that I have authorized (agent) 3033 i �'�-'641- to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) / /) o c-lc- , at (my property located at) 3 �'`�"'` ��'`"' >~! ` �-1 2 o Ge . H V. This certification is valid thru (date) A- / - / 6 .3o _ iG Property O(wber Signatuik Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that. I own property adjacent to ��► f,g� ova 's (Name of Property Owner) prop rtx_iQcgtgsJ:# (Address, Lot, Block, Road, ®tc.) T on S P, c �,�, i in C J,c w , N.C. (Waterbody) (City[Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP " (Individual proposing development must rill in description below or tech a site drawing)' 0� a �4 rA C 0 ; 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. 1 do not wish to waive the 15' setback requirement. (Property Owner nformation) (Adjacent Property OWner Information) Sig ure 4—r Print or Type Name / Print or Type e 3/y �-! r let 4of,.iy ��. a U a cJ ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to (Name of Property Owner) property located at 13 � C+q MCzc7 Z) z, ��' (Address, Lot, Block, Road, etc.) on _, in _ 0"1 c-:, u- , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I 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) -431004^ V+l OC.Ak� Aft • to 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.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owf formation) I formation) "'_ Si tore TrIN Print or Type Na (Adj!'arjnt Property Owner formation) r Signc ur 914 / (7 D Print or Type Name a P_ I n 1_ d I�, 135 Camelot - Dock (E Disclaimer— Onslow County provides this GIS data as a public service. NO WARRANTY for the availability or accuracy is provided. t Printed:Jun 200 �� i ✓Dc� — � f*-07— P7ANDILAic ve cc*r- l�oo+ Pr s;-N- A J c � a 4 ? e � U � y O g U CA > M � J O �,0 7 4 o 0 ? 1� V-