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Home My WebLink About66326D - Mennona1CAMA / DREDGE & FILL 0 /�fib l0 ^..N _v A B 3E❑ NERAL PERMIT Previous permit # 1Zi lew ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued rized by the State of North Carolina, Department of Environment and Natural Resources �� i1 /4 ir) :oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC ((JJ !�^-' ❑ Rules hed. t NarrW C�/yC� ¢' f? n Project Location: County /I�i2t�{iL� XY �� Street Address/ State Road/ Lot #(s) StateL ZIP f h�i ✓e . yG�"i 7 y E-Mail _ Subdivision ed Agent X/4 'e'O" mg-"44c ❑ CW )OEW )OPTA ❑ ES ❑ PTS ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: yes Ffl PNA yes / no f Project/ Activity ck)length atform(s) . Platform(s) ier(s) ngth nber I/ Riprap length distance offshore x distance offshore annel iic yards \ ip ,o 6a.tlIf %t 7 X f Z 11161(ng Length — 6C not sure yes um: n/a yes yes ,ttached: r` ye)l� no'• City f ^ ZIP Phone # ( �� "`�^ River Basin _ Adj. Wtr. Body Closest Maj. Wtr. Bodyt (scale: Lam- _ , mot-- i ig permit may be required by: 4 r❑ See note on back regarding River Basin .ocal Planning jurisdiction) ; NC Division of Coastal Mgt. Habitat impact Computer Sheet Applicant Menv)1174, Date: � — 710 — 40 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 FI (Applied for. (Anticipated final (Applied for. (A DISTURB TYPE Disturbance total disturbance. Disturbance di: Habitat Name Choose One includes any Excludes any total includes Ex anticipated restoration any anticipated re: restoration or and/ortemp restoration or ter ternimpacts) impact amount) ternimpacts) an W 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 ❑ RCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary Date �� Name of Property Owner Apply! g for Permit: 'vrj Mailing Address: I certify that I have authorized (agent) � r/Ij t7 to act on my behalf, for the purpose of applying for and obtaining al CAMAPerrmits necessary to install or construct (activity) `F 04-7- %^r a at (my property located at) This certification is valid thru (date) / I/L /i/ ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSIBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to 1 (E11rio11� is (Name of Property Owner) property located at i �{ iti 1,-- L e4 V e- (Lot, Block, Road, etc.) on ,9,y'.�i� , in % t✓/� tC, I .qe�� , N.( (Waterbody) (Town and/or County) Applicant's phone #: ftv 3(� 7 tSq Mailing Address: ' 2 �� ex C -� Hot •nps k�.4 Z:FK,4 He has described to me, as shown below, the development he is proposing at that location, and, have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathous must be set back a minimum distance of fifteen feet (15') from my area of riparian access unles waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) OCV I do wi DESCRI -------------------- (Information fo) for Permit) ■ 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: R,,rr jbr. A. Signature X ❑ Age ❑ Addi B. Received by (Printed Name) C. Date of Di D. Is delivery address different from Rem 1? ❑ Yes If YES, enter delivery address below: ❑ No J. Z5ervlce Type ❑Adul Signature 0 Priority l Il I IIIIII I'll III I ll II I I llllllllll Il l l it III I III 0 Adult l5ertifled Mai ® Restncted Delivery ? Mail- Registered Mail Re ❑ DDelivery 9590 9402 1661 6053 4264 84 0=fled Mail Restricted Dehvary ❑ Return Receipt for 2. Article Number (rransfer from Cary ra i�h n Collect on Delivery Merchandise r ] Collect on Delivery 0 signature Confirm 7015 1730 0002 1686 8199 I Insured Mail ❑ Signature Co Insured Mail Restricted'DeNvery Cover $500 Restricted Delivery PS Form 3811, July 2015 PSN 7530-02-000-9053 - Domestic Return Rec PC7, �aX 3�x3 Mailing Address Sianatu ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOIISE) I hereby certify that I own property adjacent to �CC r'(E�1�10it t.� 'g (Name of Property Owner) property located at i A L L e r-eC %4 ., e- �+ (Lot, Block, Road, etc.) on C'r9 r'V fi L , in J c"P III i� 2�e�- I L N.C. (Waterbody) (Town and/or County) Applicant's phone #: t o 3 7 -Z1 5-5 Mailing Address: Ix t Z SKK 3 He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (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.) ■ Complete items 1, 2, and 3. A. Sign ture ■ Print your name and address on the reverse ❑ Agent yL ri I so that we can return the card to you.jgv�❑ Addressee ■ Attach this card to the back of the mailpiece, B. Received by (Printed Name) C. Date of Delivery ---------------' or on the front if space permits. -'rr Q V n f �, t� ;/ D 1. Article Addressed to: (Z Z Alp LaeW Is delivery address differeMt from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Priority Mail Express® II I �I II III III I I III ❑Adult Signature ❑ Registered MailTM IIIIIIIII I I IIII I I I III Atlutt Signature Restricted Delivery ❑Registered Mail Restricted Certified Mail® Delivery 9590 9402 1661 6053 4264 91 Certified Mall Restricted Delivery ❑ Receipt for ❑ Collect on Delivery MR Merchandise 2. Article Number (Transfer from service label) ❑ Collect on Delivery Restricted Delivery ❑ Signature Confirmation^ ? 015 1730 0002 1686 8182 isured Mail isured Mail Restricted Delivery ❑ Signature Confirmation Restricted Delivery wer $500) PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt ----------------------------------------------------------------------------------------------------------------- - (Information for Property Owner Applying (Riparian Property Owner Information) for Permit) Mailing Address Signature I ► I i ► K I 5 cG I I i James �Orj< / Z `� /�'l .4 fie.