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Home My WebLink About66313D - Newton�CAMA / ❑ DREDGE & FILL % Ol ,�3�ERAL PERMIT I L W New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue 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 A B Previous permit # Date previous permit issued t Name f 0 Al '" I"-, w Lftl Project Location: County p Rules attached. kfit /11y- Street Address/ State Road/ Lot #(s) ,1!rl/1/ I0A) State C ZIPl'tS zi? i✓- /-�y�.r,C1- t s, �U ( /d AK 7Z6% E-Mail Subdivision ed Agent / /, �'`�+j, /I -1' e �� City r5�! _,.fGfa-'f ZIP G ❑ CW A,& OPTA ❑ ES ❑ PTS Phone # ( ) ^Q� River Basin ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ N/A Adj. Wtr. Body r ��►'l S ��! A /l �%O (Q� ❑ PWS: y��Closest es / no PNA yes / Maj. Wtr. Body f Project/ Activity ,ck) length atforrn�s Platfor ier(s) 5 ngth mber d/ Riprap length_ g distance offshore_ ix distance offshore bic np ise/ ie Length _ 1 VV not sure yes rium: n/a yes yes M (Scale: / it . Attached: /vesO no s ing permit may be required by: r �J See note on back regarding River Basin i Local Planning jurisdiction) NC Divisionof Coastal Mgt. Habitat impact Computer Sheet Applicant: IfoMW lVt4J�-� Date: — ze: � � �'6 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 FII (Applied for. (Anticipated final (Applied for. (Ai DISTURB TYPE Disturbance total disturbance. Disturbance dis 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) art G% Dredge ❑ Fill ❑ Both ❑ Other �� D Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ ' Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary Date ✓ Y� Name of Property Owner Applying for Permit: ki-\,- aS Mailing Address: �O� N. hn I certifythat I have authorized (agent) 4 k' I F0 o I - � A;--, to act on m (g ) Y behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) 0 1-.-'<- c at (my property located at) 60V N - A rJtfsu�,, This certification is valid thru (date) lj�3111 06MM ?p3i11 � ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to D ,17` is (Name 6f Property Owner) property located at 6�$ /v/ y, '��t�:�E-f�J►-� 61'1 `e (Lot, Block, Road, etc.) � Y on Icll�,;c�� '�,1�� , in N., (Waterbody) (Town and/or County) Applicant's phone #: q1y 3 4a7 v?f5J Mailing Address: He, 9� ro t� Ct 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 / boathou must be set back a minimum distance of fifteen feet (15') from my area of riparian access unle waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) 1 do not wish to waive I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) (Information for Property Owner Applying for Permit) (Riparian Property Owner Information) Mailing Address Signal ■ 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: lVle I r Y Cr,.,,. � 8 3 A. Sjontture X A/ B. Received by (Printed D. Is del ) �1 If YES, enter delivdrY ❑ Agent ❑ Addressee I Date of Delivery r ,..G / r . t from item 1? ❑ Yes ress glow: ❑ No s 3. Service Typ Pb ❑ priority Mail Express® II I IIIIII IIII III I III III I I II I I I I I I ❑ Adult Signature ❑Registered MaiIT"' ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted ertified Mail® Delivery 9590 9403 0737 5196 1661 38 Certifled Mail Restricted Delivery 0 Return Receipt for ❑ Collect on Delivery Merchandise 2. Article Number (Transfer from service label) ❑ Collect on Delivery Restricted Delivery ❑ Signature Confirmation— '-1 Insured Mail, , - �. ❑Signature Confirmation 7 015 1730 D 0 0 2 1686 8052 _ Insured Mail Restricted Delivery Restricted Delivery _ )ver$500) PS Form 3811, April 2015 PSN 7530-02-000-9053 Domestic Return Receipt ■ 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: il�� r, ( 14) Ya- ff A. Signature ❑ Agent X (� ® Addressee B Received by (Printed Name) C. Dad� o Delivery e. D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ® No aq( �tX rlGs�iJr. A_ 0 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to D 's (Name 6f Property Owner) property located at k 8 A/ G /f lie - (Lot, Block, Road, etc.) r on D A�.� �` r ��, �.t� , in i �� t / , N.C. (Waterbody) f (Town and/or County) Applicant's phone #: q10 3 (07 c2 Mailing Address: /fA / 02 4 ro1-e C�-. Ive zeyg3 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.) I do not wish to waive _- I do wish to waive that setback requirement. ------------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) 41-,0,-A6 G� ------------------------------------------------------------------------------------------------------------------- (Information for Property Owner Applying (Riparian Property Owner Information) for Permit) lot LcAarr,'e, Or. Mailine Address Signature nX 0r