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Home My WebLink About67189D - WaterlooCAMA / ❑DREDGE &FILL�J ENERAL PERMIT I V A B Previous permit # New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued r ed by the State of North Carolina, Department of Environment and Natural Resources 1 �� Zoastal Resources Commission in an area of environmental concern pursuant to I SA NCAC jj ++ I , 1 .)4 i ❑ Rules attached. it Name'Vd fit k r Ol! �C> O to lto �% �'j� Project Location: Coun I t 27 "v tk1 1 V - Street Address/ State Road/ Lot #ls1 State f"'COP L E-Mail :edAgent , i64,L"k ❑ CWEW \ �'pTA El ES ElPTS ElOEA /❑ HHF �❑ IH ❑ URA ❑ NIA ❑ PWS: yes /no ) PNA yes no F Project/ Activity ck)length I�' atform(s) Platform(s) ier(s) ngth i ber d/'Fliprap length distance offshore uc distahce offshore cannel Dic yards_ np ise/ Boatlift i e Length r not sure yes IRf� ium: n/a yes yes \ttached: ig permit may be required by: Subdivision City _. p f I i Phone # �Z4 Adj. Wtr. Body Closest Maj. Wtr. Body CSC ❑ See note on back regarding River Basin rt Local Planning jurisdiction) Nc Division *t moons -cal- ifawm.Pet (0 Applicant: J LA 1 1 V1 Date: - 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 FIN (Applied for. (Anticipated final (Applied for. (An' DISTURB TYPE Disturbance total disturbance. Disturbance dfst includes any Excludes any total inciudes , Exc Habitat Name Choose One anticipated restoration any anticipated rest restoration or and/or temp restoration or tern tem impacts im act amount tem ini acts aml Dredge ❑ Fill ❑ Both ❑ .Other Dredge ❑ Fill ❑ Both. ❑ Other ❑ Dredge ❑ Fill ❑.: Both .❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill M. Both ❑ Other ❑ Dredge. ❑. Fill ❑ : Both ❑ Other ❑ 1i . Dredge ❑ Fill ❑ Both ❑ • Other payment Proccessing Confirmation Date Received 11/15/2016 ;heck From (Name) Allied Marine Contractors Inc Name of Permit Holder Judith Paliotti, Waterloo@ Topsail, LLC Vendor First Citizens Bank Check Number 5095 Check amount $200.00 Multiple Permits No Major/Minor Permit Number/Comments GP 67189D Receipt or Refund/Reallocated JD/2494D 10A RC'DENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary Date 1 1 I I S-l1(, Name of Property Owner Applying for Permit: Mailing Address: I certify that I have authorized (agent) ( to act on my behalf, for the purpose of applying for and obtaining a CAMA Permits necessary to install or construct (activity) COD c-Ice�•,,e..�- at (my property located at) 1( S This certification is valid thru (date) ! — 3 t - 17 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to IAJA�, PA'6 s ✓ �1�� - Lt s _ (Name of Property Owner) property located at � < n ��( ddres ,Lot, Block, Road, etc.) _ on nl" "'-'�' , in '"�.�,(I1d1 I , laQ/i.�� I , N.C. (Waterbody) I— (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. Yy7(&j ✓ 1 have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill In description below or attach a site drawing) WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, 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. I do not wish to waive the 15' setback requirement. (Property Owner Infor tion) (Adjacent Property Owner Information) Si ` L Ir St n tlu ` 1 4 I �— 1 1 P 'nt or Type Na Print or Tyhe Name "gt & 173 Lllers 1,e 10 lllnoAddmB n I Mnifinn Arirfnacc . ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to `J 1� w ma's (Name of Proper Ow r) property located at on j 00� ate' �L) , in TU L , N.C. (Waterbod) (Town and/or County) TT S% 3073 Applicant's phone #: Text Mailing Address: z4W1)h1ydz,4 v AILY tT 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 0 8 f� 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 (Riparian Property Owner Information) for Permit) Mailing Address Signature 4MvvM 0 xl ty�X�/ 4i'l�� C7 0