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Home My WebLink About66506D - ManisCAMA / ❑ DREDGE & FILL / is ��'// Ze A B "EM ERAL PERMIT 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 ink of environmental concern pursuant to 15A NCAC o� oastal Resources Commission an area files attached. Location: County NYiS lM� Name �� V ! V l AY1 Project Street! Address/ State Road/ Lot #(s) A �, State zip 1p l0 �� ht�`� Jk' E-Mail Subdivision ��' Co��i'tV<� p City `�v�SC PK.OA\ zip-"�'6 BdAgent ❑ CW >(EW �TA ❑ ES ElPTS f\L•E:f Phone # 5-1 1// - IM 5 River Basin t--VY'N ❑ OEA �❑ HHF ' ❑ IH ❑ USA ❑ N/A ❑ PWS: Adj. Wtr. Body l A, nat r V . � Closest Maj. Wtr. Body yes / no PNA yes Project/ Activity ` m t V CA On � ' e � O ck) len*h' atform(s) ' N ( � Platform(s) ?; 1 X 1( , iier(s) :ngth tuber .d/ Riprap length g distance offshore ax distance offshore Funnel ibic mp use/ Boatlift EX h`o C' 6!!!1}�l�!i�■LW1i ■ C- I C0+T"1N1 (Scale: ❑ See note on back regarding River Basin NC Division of Coastal Mgt. Habitat Impact Con Applicant: P0,0 A1AV\1-S Date: 0 l / I W . 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 F (Applied for. (Anticipated final (Applied for. (I DISTURB TYPE Disturbance total disturbance. Disturbance d Habitat Name Choose One includes any Excludes any total includes E anticipated restoration any anticipated n restoration or and/or temp restoration or to temp impacts) impact amount ternimpacts) a Dredge ❑ Fill ❑ Both ❑ Other a, S 6 : 5 Y Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ 3q V OT-4 �+- �� r`\ WWA NCDE�R North Carolina Department of Environment and Natural Resources Division of Coastal Management Braxton C. Davis Director 'at McCrory Governor AGENT AUTHORIZATION FORM Date: John E. Skvarla, III Secretary ime of Property Owner Applying for Permit: Name of Arized nt� for this project: bra M ti S (�J\' l` thoS f,-777 U� rvner's Mailing Address: 2 1 S H fF%O-1 fi I D'� i- ), L I Vi P, PL H I L L, NC ),-iStS- tone Number 0 1C1) XG u T V� v ent's Mailing Address: Phone Number) ertify that I have authorized the agent listed above to act on my behalf, for the purpose of applying and obtaining all CAMA Permits necessary to install or construct the following (activity): ,6/{ F-PLkCf-IAruT C4 7ECw,5j,AiRS RNo Lc1, ) ( v<- I ),j TZI E c A al P-*�— r3 N i N) -1)4 C- -� e R T`t it my property located at ti l G, -D v t- -PH o�i ST, "SQ N SPT �EACZ + ��J C . 2V Lt 6 is certification is valid thru (date) u L t P Property Owner Signature ZO/ L )Ciu ua ry Date CERTIFIED MAIL • RETURN RECglPT REQUESTED ADJACENT Name of Property Owner: _ Address of Property: '-\` Agent's Name #:( m Agent's phone #: %� DIVISION OF COASTAL MANAGEMENT RIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM h r` 1 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 drawiicn the development they are proposing, `. � l have no obiections to (his proposal. ______ ____ i have obiections to this proposal. 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. CorresgonOence.should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representoovets can also be contacted at (910) 798-7215. No response is considered the some as no objection /f you h" 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.) 1 do wish to waive the 15' setback requirement. 1/ 1 do not wish to waive the 15' setback requirement. �Property Own r Information) (Adjacent Property Owner Information) S' ] alai e - --- Signtrlru e V�W� ---- Print or Type Name Print or Type Name- 1�-\`cto _"`?_l Y 17a d^ s-t. — Mailing Address Mall ng A ress \1 ( it a/Zip City/state/Zip 'rnlnnhnna Ahunhor Telephone Number �Ctnul 27� 5� �e ■ 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: A. Signature X r ❑ Agent ❑ Addressee B. Receivefby(Printed Name) C. Date of Delivery � D. Is delivery address different fro item 11 If YES, enter delivery address below: ❑ Yes ❑ No Service Zype sv a Nnomy red III'I�I'I I'll I'lll III I II III I'III IIIII'll'I� III ❑ Adult Signature El ❑ Adult Signature Restricted Delivery ail'" ❑ Reg istered MaiIT"' ❑ Registered Mail Restricted 9590 9403 0603 5183 4327 83 Certified Mail@ ❑ Certified Mail Restricted Delivery Delivery Return Receipt for Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery Signature ConfirmationT" 2. Article Number (Transfer from service label) ❑ Signature Confirmation 7015 0640 0006 3682 2185 cted Delivery Restricted Delivery PS Form 3811, April 2015 PSN 7530-02-000-9053 "ITIffP u certified Mail Fee $3. 45 0 471 t $ 11 Extra Services& Fees (check bay add tee aff. -q, ❑ Return Receipt (hanicopy) $ sU ��J ❑ Return Receipt (electronic) $ S n . f 1f) Postmark ❑certified Mail Restricted Delivery $ �1� C'IQ here ❑ Adult Signature Required $ $ ram_ ❑ Adult Signature Restricted Delivery $ Postage $0.49 $ 01/27/2016 Total Postage and W. 74 $ �O Sent �-- Otipuzfa, ------------------------------------------ e d o.- C�,st�te,v�n 7 ,t - -------------------- IV,-etJ �Pr-) h �iL Z� 5 Yi v ■ 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: Domestic Return Receipt Postal CERTIFIED o RECEIPT Ln co Domestic Mail Only rq ru ru=-jll r 28468 co 45 0470 I Din 11 Extra Services & Fees (check bar, —tee p re) ❑ Return Receipt (hardoopy) $ r ❑ Return Receipt (elecirmic) $ -- 0 00— Postmark r] ❑ Certified Mail Restricted Delivery $ !h I1A Here O ❑ Adult signature Required $ -- ❑ Adult Signature Restricted Delivery $ V � Postage $0.49 p 01 /27/2016 Total Po tW and F s `L Ln $ .74 t Sent To ----------- ------- Street Apt No., of b Bo u --------------- Signature X ' �t �❑ Age I? Addressee Received by (Printed Name) C. Dat of De very WIZ-41,4 01 e (- D. Is delivery address different from item 19 ❑ Yollc