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Home My WebLink About66189D - PagliariCAMA / ❑ DREDGE & FILL P �( �661 (J'qb ;ENERAL PERMIT Previous permit# A B ZkIew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued ized 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 t �� ❑ Rules attached. :Name 1 i Vl Project Location: County WAAvL)IOl)y� Street Address/ State Road/ Lot #(s) 4f ll, y 4 '7V 7e,-y%'Vi, State ZIP 02 = i 11 (E-Mail Subdivision ` ad Agent p j� r}p(�(,'� City, \ b' 1 ZIP_�� ❑ Cw )(PTA ❑ ES ❑ PTS Phone # ( River Basin ❑ IDEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body Nth i5 d W `l VI nat n ❑ PWS: yes /�o PNA yes / no Closest Maj. Wtr. Body T�1 UvV Project/ Activity :k) length OzjK tform(s) 'latform(s) x er(s) igth fiber / Riprap length distance offshore c distance offshor annel is yards P e/ Boatl Length 'J V not sure yes J im: n/a yes yes ttached: yes g permit may be required by: n� �' Sf Q X AkIv ❑ See note on back regarding River Basin ocal Planning jurisdiction) 2118/2016 John Graham/Lighthouse Marine lJohn Graham I Four Oaks Bank 1688 5200.00 I GP 64773C I Rick WesttJRW/RDW Inc I Leslie Pagliari I First Bank 1 1114 $400.00 1 GP 66189D (M$200 NC Divisaotn of Coastal Mgt, Habitat Impact Computer Sheet \pplicant: `. �Q o'-V (, Permit )ate: )escribe below the HA ITAT disturbances for the application. All values should match the name, and units of measurement ound in your Habitat code sheet. labitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp impact amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/o temp impact amount) MfV 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 ❑ 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM (!J 1 Date -- Name of Property Owner Applying for Permit: Mailing Address: •1 Gr ee ,v J,/, L /V to act on my I certify that I have authorized (agent) — behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to/ install or construct (activity) at (my property located at) This certification is valid thru (date) Date Property Owner Signature AGUSPSCom USPS Tracking® Tracking Number: 70151520000046720327 Customer Have questk Get Easy Sign up for N Your item was returned to the sender on February 16, 2016 at 12:54 pm in SALISBURY, NC 28144 because it wa addressee once the item reached its maximum hold time at the post office. Product & Tracking Information Postal Product: Features: First -Class Mail® Certified MaiITM Return Receipt See tracking for related item: 9590940304355163070661 DATE & TIME February 16, 2016, 12:54 pm STATUS OF ITEM Unclaimed/Max Hold Time Expired LOCATION SALISBURY, NC 28144 Your item was returned to the sender on February 16, 2016 at 12:54 pm in SALISBURY, NC 28144 because it was not claimed by the addressee once the item reached its maximum hold time at the post office. Available Act Text Updates Email Updates Jal lual y GJ, LV 1 V , Q.L I a'u January 22, 2016 , 4:53 am January 20, 2016 , 6:31 pm January 20, 2016 , 12:09 am January 19, 2016 , 2:43 pm January 19, 2016 , 11:59 am V I111ly VVlIIFI4 - Arrived at Unit Departed USPS Facility Arrived at USPS Facility Departed Post Office Acceptance Track Another Package Tracking (or receipt) number 70151520000046720327 HELPFUL LINKS Contact Us Site Index FAQs ON ABOUT.USPS.COM About USPS Home Newsroom USPS Service Updates Forms & Publications Government Services Careers SALISBURY, NC 28144 CHARLOTTE, NC 28228 CHARLOTTE, NC 28228 SHALLOTTE, NC 28470 SHALLOTTE, NC 28470 Track It OTHER USPS SITES Business Customer Gateway Postal Inspectors Inspector General Postal Explorer National Postal Museum Resources for Developers Manage Incominc Track all your packages from a No tracking numbers necessary Sign up for My USPS > LEGAL INFORI Privacy Policy Terms of Use FOIA No FEAR Act E Postal ru r`Domestic Mail • nly Fos I4eUkYt N. ?8 46ru Mail Fee $J. 45 qarvices &Fees (check b", add fee �silpptt! t le)f..3n Receipt (hanlcopY) $rrn Receipt (electronic)Mlled Mail Restricted DeliveryQt $gnatwe Requiredstt Sgmtwe Restricted DeINmYCje $I .4Lnostage and Fee6 4 Ln $ sent To o - ,J I SE _ � ranAp(n� or $ox A1` ,l ' 46V CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: i �C .: -✓ -1p L £ �, c1 Z- J-)d?-, Address of Property: [-/ % 7 l 01 3 (Lot or Street #, Street or Road, City & County) Agent's Name #: 4.), '6 l .) ck�k-S Agent's phone #: > &3W _3e � -066f- Mailing Address:" I hereby certify that I own property adjacent to the above referenced property. The individu; applying for this permit has described to me as shown on the attached drawing the developmei they are pr osing. A description or drawing, with dimensions, must be provided with this letter t ri ' �/ I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Managemer (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices availableat rc:;,,www.nccoastaimanagement.neuweolcmistart-itstrnctorbycallingl-&W-4RCOAS 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, boat ramp, breakwater, boathouse, or lift must be set back a minimum distance of 15' from my area of riparian access unless waived by me. (I you wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. C I do not wish to waive the 15' setback requirement. (Property Owner Information) , ti L Signature Print or Type Name (Riparian Property Owner Information) Signature 6z'c � Print or Type Name �y x,2 0