HomeMy WebLinkAbout66606D - Williams�CAMA / PI DREDGE & FILL 4V
.3JENERAL PERMIT ' Previous permit#
Alew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
irized by the State of North Carolina, Department of Environment and Natural Resources A
Zoastal Resources Commission in an area of environmental concern pursuant to I SA NCAC G �� �la� �L
❑ Rules a7pched.
It Name ,,f!.� 1�// �l/�f-�•y� �j Project Location: County !��. /.,.-syGLs/s�
f� I q 5m , C'a44 fry.-4 Ut y Street Address/ State Road/ Lot #(s)
State Ve' ZIP
E (Ic G14 —�/ E-Mail /fie kJOl/�A1.s' Ael kkwt . Subdivision
:ed Agent �^ h w% City /i/�1/�fS/u�11 ZIP-27 �y
❑ Cw CHEW A 01 / , ElPTS Phone # ( /) J C 1M-940V j, River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A �/L S e�hl
ElPWS
Adj. Wtr. Body (�
yes /Clio PNA yes / Closest Maj. Wtr. Body
f Project/ Activity
ick) length
A&rm�(s).�
platf zfl G X yin. ��X2
�ngth
Ober
Pimp length
g distance offshore
ax distance offshore_
hannel /
bic
np
ise/ Boatlift
�ulldozing
ie Length 601
not sure yes
*ium: n/a yes CV/'
(am" no
Attached: yes 6>
ng permit may be required by:
Local Planning Jurisdiction)
(Scale:./ y
/� ❑ See note on back regarding River Basin r
NIC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant; �e P �/(// l �1`Cr�-� s Permit ai
Date: / 11q114
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑
Fill ❑ Both ❑ Other
Dredge ❑
Fill Both ❑ Other ❑
%
?ZV1
Dredge ❑
Fill ❑ Both ❑ Other F.
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 ❑
at McCrory
Governor
NCDENR
North Carolina Department of Environment and Natural Resources
N.C. Division of Coastal Management
John E. Skvarla, III
Secretary
AGENT AUTHORIZATION FORM
Date: d gn 9
me of Property Owner Applying for Permit: Name of Authorized Agent for this project:
rner's Mailing Address:
ail:
)ne
Agent's Mailing Address:
Phone (
flu
:.:..:
ar ify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
obtaining all CAMA Permits necessary to install or construct the following (activity):
my oroperty located at ��j'�
r N0 6 /�/✓vizl•
s certification is valid 1 year from (date) J�
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: (✓111��'"s
Address of Property:
(Lot or Street #, Street or Road, City & County))
Agent's Name #:� F `�I' Mailing Address:l7_/V-��
Agent's phone #SG
I hereby certify that I own property adjacent to the above referenced property. The individual
appi ing for this permit has described to me as shown on the attached drawing the development
lthe re%1have'
sig. A desenpfion_'or�.drawma. ,with 8iinensions..must be:provided with tE�is-letter.
no objections to this proposal. I have objections to this proposal.
�Jo�$- lltsw�>>37c,:�
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to f27 Cardinal Drive Ext.,
Wilmington, NC, 28405.3845. DCM representatives can also be contacted at (910) 796-7215. No response is
considered the same as no objection If you have been noMed by Certifteri Mail.
WAIVER SECTION //7
1 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.
I do not wish to waive the 15' setback requirement.
(O.,roperty Ownegnfo ation)
Sr allure
LV 111JI)
Print or Type Name
(Adjacent Property Owner Information)
Sigma re
Print or Tvpe Name
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMEN 1
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Proporty Owner. ' '✓1111+%
Address of Property: w t r✓ >,1:-�i l y � l��t l v � �u, �. ?, ���
1(Lot or Street , Sreet or Road, Cdy & County)
Agertd's Name #. , `�tMaifing Address:
Agerits phone IP 51', ✓ `')' G1%nr� l3114( jJL'
I hereby certify th11 I own p-operty adjacent to the above referenced property- The individual
applying for this permit has described to me as shawri on the attached drawing the devc-loprric,lt
j try vp proposing. A dcscrjnbon drawing, ng, with iiimensiorts: must be nrovrded with this kgter
�j I hive rx) ob}xWns to t h 7 rr<m<J hsvc ohiccams to this proposal.
it you have objections to what ;s boing proposed, ycu rru:t rrotity tho Division of Coastal Managarw-,nt (DCM) in
writing within 10 dyys of recaipt of thlc notice. Correspondpnca should bcr. mailed to 127 Csrdlnal Drive Ext.,
Wilmington, IVC. 28405-3845. DCU representarr•rr- can also bi4 contacted at l91al 796-7215. Hu response is
considered the same al. no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a peer, dock, mooring pilings, brea",ater, boathouse, lift, or grain must be se:
bark a minimum distance of 15' from my area of riparian acres:; unless waived by me. (tf you
wish to waive the setback, you must initial the aWopr;ate bl uik betow )
I do wish to waive the 15' setback requirement~
I do not wish to waive the 15' setback requirement.
{� Ownerinforation)
Si ^lure .
Print or type Name
{Adjjaaant Pmpei* Ow/ter iQformatiwre
_--
1
Print or Type Name
1
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