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Home My WebLink About67941D - Smoot�CAIVIA DREDGE & FILL lot 941 A B ZENERAL PERMIT Previous permit # w —Modification FIComplete Reissue 'Partial Reissue Date previous permit issued ized by the State of North Carolina, Department of Environment and Natural Resources 1 14 :oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC '000 t Name pk D Rules attached. Project ❑ Location: County P_V' -( Y \\06" in Street Address/ State Road/ Lot #(s) V, -►Ck k�' State Lzip 6:3�) SI H - 51 E-Mail Subdivision ed Agent 6 V�-(p ( 0', A < hV Y City oceeto 'wr at zip Lq S E�M El CW DEW D PTA LUBA )U !_nn �e( !I# ) S7 1-9 ff 15 River Basin VVU El OEA EJ HHF El 1H El N/A — Adj. Wtr. Body_ CA V1 (n" El PWS: yes / no PNA yes / no Closest Maj. Wtr. Body — Project/ Activity h itfjA cX10-l"'s �2 V '�t (Scale: -0 1k I cl ME MERE an's No ONE MEE NONNI M 0 rz MEE■0 IN ON RUN MEIN 3111113■ M End ic yards F.9 WE M _q K IN F. I p .41W1111111111111 0071041UNNE-111 Ed NONE HE■M■hiLquommoolin 1111111111111110" ommicab�ll wool mlisirAmpnomma U I A his I 'Ar-kw MEN Mongdoo 111111111111131 M1M■0■NONE■EMWANewommuno a■HOME■MENNEN ■1111111110111111"s■ONE !:40WAFAmm qmwac!4m HE■MMMMMM1M11 MENEM■MEE MENEENEEM 0 ME 0■ONE RINUM 1111190"111111 MENEM■MEN ■�■■■■�■� NI W M MINE Inig CIlY�■■■■■■■■ No MENEM MENEEMENE ocal Planning jurisdiction) I 1 I k — NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Su S V,- S Date: 12, g /2 a Permit #: G-7 °I� I --C Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen found in your Habitat code sheet. Habitat 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 fine disturbance. Excludes any restoration andh temp impact amount Dredge ❑ Fill Both ❑ Other ❑ boo i OD tD 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 [I Both El Other ❑ Dredge [Q Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill [I Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ ❑ Fill ❑ Both ❑ Other ❑ JDredge Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both (] Other ❑ Dredge ❑ Fill ❑ Both 171 Other ❑ 'ayment Proccessing Confirmation )ate Received 11/23/2016 :heck From (Name) Grice Construction of Brunswick County Inc game of Permit Holder Susan Smoot /endor BB&T heck Number 10886 heck amount $1,000.00 Multiple Permits Yes Major/Minor "ermit Number/Comments GP 67941D ($400) teceipt or Refund/Reallocated SF/2845D 6 HCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis Govemor Director John E. Skvara, ill Secretary AGENT AUTHORIZATION FORM AGENT AUTHORIZATION FUKM Date: ame of Property Owner Applying for Permit: ame of Authorized Agent for this project: WAn 5h,( helyd, 5w1oo� rt tuner's Mailing Address: ,27-7 WtIborg ri w%, N C 27370 lone Number 3%A 3 (-+ 3'qqq Agent's Mailing Address: tit 3eq,c� br S� Phone Number lb 51c(� �t;QS 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): Oh �VV l r my property located at f5i'I�l ��'l r0� S � QG h i s Ile s certification is valid thru (date) 1011(o / 1Ql % Property Owner Signature Date CERTIFIED MAIL - RETURN RI T REQUESTED -_ —DIVISION OF COASTAL_ MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM - - Name of Property Owner: Address of Property: - �nQ��----- (I-ot or Street 11, Street or Road, City & Coun�(yy Q--�,,�� 1,,� Agent's Name!I:vCt� W 5�(y�( �f,�n Mailing Address: L1v1 u� RQCV1 ► ) Agent's phone Oq 1An J,$1 ie `U'�W 214 G� _ I hereby certify that I own property adjacent to the above referenced property. The individual applying for this �ennit has described to me as shown on the attached drawing -the development they are proposing. eltsnr�'driilit��>�tlttllt1�i!I_IItiri. V<1 have no objections to ibis proposal. _ I have objections to this propust►I. ✓T / !f you have objections to what. is being proposed, you must -notify the Division of Coastal Management (!)CM) In writing within 10 days of receipt of this notice. Corresp9n0ence.should be / mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represelnttl9ves can also be �✓ contacted at (910) 796-7215. No response Is considered the some as no objection tf you h been notified by 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.) I do wish to waive the 15' setback requirement. do not wish to waive the 15' setback requirement. (P�y Own r nformation) CQ e Cli� �S'1 ntldu/• Print or Type Name Mailing Address cir�i�rRr�izi� T 33c„= 31� —3�qG — djacent Property�Ow r formation) Signature Print or Type Name Moiling Address A)c___ cityistatemp Telephone Number Q -I — 1( Telephone Number ■ 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: z1qt\nc4' W064 %53 'qm&km' S}- U -Icvev-\ IN(- 21315cP X Agent Addressee B. Received by (Printed Name) C.C�ate Delivery 1-1 D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No IIIII'I'I I'II I'I I I I I I I I III' I II II I II I II' II I I 3. Service Type ❑ Priority Mail Expresso ❑ Adult Signature [I Registered MaiIT'" 1-1Adult Signature Restricted Delivery ❑ Registered Mail Restricted 9590 9403 0603 5183 4329 74 gCertified Mail@ Delivery ❑ Certified Mail Restricted Delivery Ar eturn Receipt for ❑ Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery El Signature Confirmation"" ` 7 015 0640 0006 3682 j) 1607 it Restricted Delivery ❑ Signature Confirmation Restricted Delivery PS Form 3811, April 2015 PSN 7530-02-000-9053 Domestic Return Receipt r i O ■ ECEI . In O Domestic ForriesticMail Only LJl UUM 469 Ior n' delivery information. visit our website at wimmusps.com"". LI N - ti fO Certified Mail Fee $3. 30 $ ? 0470 1 Postmark rtif)ed Mali Fee $3. 30 `0 I_1470 m 1 Q Extra services & Fees (check box, add fee roff"e) ❑ Return Receipt (hardcopy) $ �11 ' I� I f ❑Return Receipt (electronic) $ ra Services & Fees (check box, add lee o te) I I I Return Receipt (hardcopy) $ Return Receipt (electronic) $ $0 _ 0 I Postmark t3 ❑Certified Mail Restricted Delivery $ �I - I ii� Here Certified Mail Restricted Delivery $ $ 0 A0 Here C3 []Adult Signature Required $ _ . Adult Signature Required $ ❑ Adult Signature Restricted Delivery $ Postage $0 . 47 $ Adult Signature Restricted Delivery $ 0 i Iq/i Ig/?i 11 b sage 0 .47 To tal Postage and F 09/08/2016 � 7700 fg $ 47 al Postage and Fees 5.47 Sri Sen4ry Wt........ Str %Vz., or is ------ - �et pt. qg, or PCB Box No. ` K_C__3�_+_�_'_� �" -------------------------------------------------- to -- y State, Z +4i �`