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Home My WebLink About66696D - Zuckerf.. �CAMA / ❑ DREDGE & FILL Iry' A B 3ENERAL PERMIT / Previouspermit# ]New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued_ prized by the State of North Carolina, Department of Environment and Natural Resources ,,,Z Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC_�I� z4pU ❑ Rules a c rt Name 44 A64 r1,1 Project Location: County 2eJr f % Street Address/ State Road/ Lot #(s) /'y/ lei-'1'14 StateNc ZIP %C— � l E-Mail zed Agent i ❑ CW EW A ❑ OEA ❑ HHF ❑ IH ❑ PWS: yes (o PHA yes /t�( if Project/ Activity /; -s f/;--J'-' ock) length_ 'latform(s) _ g Platform(s) ength umber ad/ Riprap length vg distance offs iax distance o h channel j ❑ ES ❑ PTS ❑ URA ❑ N/A Subdivision City t l411"r ZIP Phone # l6 AI River Basin �� Adj. Wtr. Body /��' na Closest Maj. Wtr. Body ■■IIH■ni■■MnS■11I®r►.M■N Now MWEV71W, MEN ❑ See note on back regarding River Basin Local Planning Jurisdiction) r•� / �'f-1 /> MC Division of Coastal Mgt. Habitat Impact ComPuter Sheet Applicant: 1✓�X' C 4eCy` {' Permit* ��- Date: 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) feet (Applied for..ted fina Disturbancece. total includes any TOTAL FeetEamount) any anticipatedn and/c restoration oract temp irnpacts.) Dredge ❑ Fill ❑ Both ❑ Other Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both [l 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 0 Other ❑ Dredge 0 Fill ❑ Both ❑ Other L7 KA NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis John E. Skvarla, Govemor Director Secretary AGENT AUTHORIZATION FORM Date: G 3 a -ao) L, Name of Property Owner Applying for Permit: Name of Authorized Agent for this project: % LVL L,- (- Owner's Mailing Address: 3 S SM M>rr` Qrs 100 ., ti� 2��oS Phone Number a lo) j,6 )L" 3 (.y I qn- q-°I-6'l<69 Agent's Mailing Address: tom► ,.P� o ►..r N c- 2�1�j Phone Number fq_ 0 ) I-,q S- flI-Z- & I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct the following (activity): For my property located at 3) s 1-31 S, S %11 Zia s-y 1')t `w. ".J (�- I This certification is valid thru (date) 3 fl - 2-0 1 6c,,a LL -30 201� Property Owner Signature Date ADJACENT RIPARIAN PROPERTY OWNER STATEM N- (FORA PIERMOOXMGPIiCNGSIBOATZIPT/BOATHOUSE- ? htrcby certify that I own property adjecenttolANIA&A 10 (-Ke Q 's (IN mse of Prop" OwnW) proper► locam a: 31 S S Vi' R k q,ot, Blodt, Road, etc:; on A S C_yJ N AWMA- , &C. ,Waterbody) (Town ai&w Coaaty) Applicant's phone #: G< o- a L l- 3 LY J biaiiiug Address. Pill 9b0W N o, Fri W, t_"', N ., N s 2TV05 ze wd described to me, as shown below, the develo ood he is pmposutg at that location, and, l have no objeefim to his proposal- I uxkr9twd mat a pierhrmf ng pilings / boatliB / boathouse -mm be set back a minimum die of frf m feet (151 from my area of riparian access unless waived by me. (if you wish to waive the setback, you must initial the appropriate blank: below.) do not wish to waive I do wish to waive flw seffiwk requirement. DFSCRUMON AND/OR DRAWING OF PROPOS$D DEVXLOPhWXr- (To be f Zled in by individual proposing developmeRk rjc� A �Tpc.HFD . (Information for Property Owner Applying `or permit) MmiftAddmw " Lo v i� �- ritwicr%t rr (Riparian Property Owner Information) signauut Print nr Tvne l tame .-� •t�11 t�� ADJACENT RIEPARLALN PROPERTY OWNER STATEMENT (FOR A PIEERIMOORiilYG PZi f1VGS/BOATZI'FTIBOATHOUSE) I hereby certify that I own property adja=nt to 1 iR f b r,-4 r- 't_' 1 � (Vr < , 's (Name of Property Owner) a -i ioc:aled at p� zo p Y (Lot, Block, Road, etc.) r_ r. on `°' , in Lti3s 1, n, z�.r .; L7 ,1 ill '1 �� ,� , N.C. (Waterbody) (Town and/or County) Rl Applicant's phone #: i f �� 4YY IVIailirtg Address: o he has described to me, as shown below, Che development he is proposing at that location, and, I have no objections to his proposal. I understand that a pierlmooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (IS) 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 not wish to waive C. � I do wish to waive that setback requirement DFSCRn-nOPt AMID/OR DRAWING OF PROPOStb DEVEILOPAIWI NT: (To fie fitted in by indh4dvol proposing development) (Information for Property Owner Applying for Permit) Mailing Address (Riparian Property Owner Information) / -Signature LNn2,16S Swccwi Citv/State/Zio Print or TvDe dame 'CAMA / DREDGE & FILL O � 6 ` 3 L PERMIT Previous permit # Z .� ev _Modification Complete Reissue -Partial Reissue Date previous permit issued rized by the State of North Carolina, Department of Environment and Natural Resources 2 :oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC it Nam j^ [Xirrl—j !� V%les atta Project Location: County �✓�' �if1�i S!✓i�_ f�%ZeS f _ __ _ _ __ Street Address! State Road/ Lot #(s) ter iY{ ti.9 State r ZIP W5 318 �L,rr�s yi �. S f e ( 4i_ 7�7-- , 5�'�%Fax # () Subdivision :edAgent� �f �Lt -i City Al i' 11J7 -- ZIP 2-9 - CW ❑ES PT5 Phone # JA&*' eZZS7 fiver Basin a7 _ OEA - HHF - IH ❑ URA D N/A Adj. Wtr. Body_ _ - P W S: !! =t FG: yes / 0 PNA yes / . no Git.Hab. yes / no Closest Maj. Wtr Body %� d f Project/ Activity i_ J-r Kk)length )ier;s) - - ___ mgth —___ nnber_ -- -- id, Riprap length_ ,g distance offshore ax distance offsho/n flannel ibis yards mp 11 (Scale: - 2''e4Z W 1 j h' rf�Tf G� 3ulldozing__ Y - --- J - �t - -- — - - J ne Length ^`J �• y ` not sure yes � r• y gs: not sure yes rium: n/a yes r ` f✓ 6 'r yes Attached: yes o; ling permit may be required bx: /{l�y /�jLr' Cam(! %�'�L•/J�1ls �►J See note on backregarding River Basir, 16, _ o c� LAMA / DDREDGE & FILL 6` 30WhAL PERMIT Previous permit # 2 - v Modification Complete Reissue -Partial Reissue Date previous permit issued sized by the State of North Carolina, Department of Environment and Natural Resources ? (� :oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC e fl 2M PvMu;�� les attach it Name -2rx lx'r4 e _ Project Location: County 4/10, yd G�9er -2j S 54" r"e,- /Z • _ Street Address/ State Road/ Lot #(s) his 7�7►i State/Le _ZIP 318 A:1, (-Ift)_W,��%Fax # (_) Subdivision :ed Agent m7,il "f � Ct �'i City �1N� i A? ZIP 2+�' CW EW '''PTA C ES PTS Phone # ('1A - iVZ&iver Basin li OEA HHF IH a UBA J N/A Adj. Wtr. Body__ PWS: AFC: -x Closest Maj. Wtr. Body yes /J PNA yes / Crit.Hab. yes / no f Project/ Activity >ck)length n(s) >ier(s)___ ength ember ►d% Riprap length_ ,g distance offshore ax distance offshory :hannel / ibic yards mp 3ulldozing _ ne Length - ti/21 notsure yes 1 gs: not sure yes in mum: n/a yes n yes Attached: yes c ` Ding permit may be required by: (Scale: y QOw% y t% h.Vf- av y ; t1 l - (- —' � lr T—/ j�l°/J�91fs See note on back regarding River Basir