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Home My WebLink About66537D - WiebelLAMA / ❑ DREDGE & FILL > •i'. A B iE)YP-RAL PERMIT p'�nll Previous permit # Vew [-]Modification El Complete Reissue ❑Partial Reissue Date previous permit issued zed by the State of North Carolina, Department of Environment and Natural Resources !'� )astal Resources Commission in an area of environmental concern pursuant to I SA NCAC �� )'0 �7 ❑ Rules attached. /�^ Name q �'' ` 'oj�j yitd Project Location: County �5��►^ 4�N C. K Street Address/ State Road/ Lot #(s) `M(0 State N ( ZIP-s Subdivision d Agent CAR V k AV M city R v\ - �c zip QL g t ❑ Cw KEW )(PTA ❑ ES ❑ PTS C Phone # ( ) River Basin Ly V - ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ N/A Adj. Wtr. Body • v-\nat 14 ❑ PWS: es /o ;; PNA yes / .no Closest Maj. Wtr. Body Project/ Activity tZ 121 �, ,( `6 )� L 0 - -( 0 Gt d 0 <) len h X fdhm(s) �a 'latform(s) gth fiber length offshore offshore (Scale:' NC Division of Coastal Mgt. Habitat Impact Com Applicant: Date: /��((/ Describe below t e 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 FII (Applied for. (Anticipated final (Applied for. (Ai DISTURB TYPE Disturbance total disturbance. Disturbance dis Habitat Name Choose One includes any Excludes any total includes Ex anticipated restoration any anticipated re; restoration or and/or temp restoration or ter ternp impacts) im act amount tem im acts) arr —AW Q V j Dredge ❑ Fill ❑ Both ❑ Other' d 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 Date Name of Property Ow��ner��Applyin for Permit: Mailing Address: I certify that I have authorized (agent) to act on my behalf, for the purpose of applvine for and obtaining all CAMA Permits necessary to install or construct (activity) at (my property located at) This certification is valid thru (date) rty Owner Signature Date ■ 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, — z., + If —nra nermits. Article Addressed to: ❑ Priority Mail ExpressO W I III 3. Service Type ❑Adult Signature Signature Restricted Delivery ❑ Registered MaiIT"' ❑ Registered Mail Restricted II I�Illll I'll I'IIIIIIIIIi IIIII II IIIII�IIiI ❑Adult ❑ Certified Mail@ ❑ Certified Mail Restricted Delivery Delivery ❑ Return Receipt for Merchandise 9590 9401 0024 5071 4927 60 p Collect on Delivery w Delivery Restricted Delivery ❑ Signature Confirmation"" 2. Article Number (Transfer from service �r on 2605 5560 r r Ct on sd Mail Mail Restricted Delivery Signature Confirmation Restricted Delivery 7013 0600 0002 overd Domestic Return Receipt PS Form 3811, April 2015 PSN 7530-02-000-9053 ■ Complete itQfns 1, 2, and 3. ■ Print, -your Game 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. Articl�ressed to: b ree✓ , SL llI'IIl'II'lIl'IIIIIIIIIIIIIII IIIIII'IIIIIIIII _ 9590 9401 0024 5071 4927 77 A. Signature Agent X AAO ❑ Addressee B. eived biy (Printed Nam C. Date of Delivery D.; Is deNyery address different from item 1? ❑Yes ='�1f YES, enter delivery address below: ❑ No Service Type ❑ Priority Mail Expresscw O Registered MaiIT"" Adult Signature Signature Restricted Delivery ❑ Registered Mail Restricted Adult MailO r DeliverCertified ❑ Return Receipt for Certified Mail Restricted Delivery Merchandise Collect on Delivery Signature ConfirmationT"' oe�.•��rori nelivery DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Individual Applying For Permit: �)Wats t Address of Property: S� (Lot or Street #, Street or Road) City and County) hereby certify that I own property a Jacent to the above. I e erence property. The indivi applying for this permit has dw escribed to. me as shown on the attached drawing the development Are proposing. A description or drawing, with dimensions, should be provided with this lem V7 I have no objections to this proposal. It you have objections to what is being proposed, please write the Division of Cc Management, 127 'Cardinal Drive Extension, Wilmington, NI C 28405 or call 910-796• within 10 days�of receipt of this notice. No response is considered the same as no.object you have been notified by Certified Mail. WAIVER SECTION T understand that a pier, dock, mooring pilings, breakm,ater, boat house or boat lift must bck a minimum distance of 15' from my area of riparian access - unless waived by me. wish to waive the.setback,,you must initial the appropriate blank below.) I do wish to wane the 1 5' setback requirement. �- I do not wish to waive the 15' setback requirement. ,0 AIM 'M ►A DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Individual Applying For Permit: Address of Property: P (Lot or Street #, Street or Road) (City and County) 0W.�b-� t nereny certify that 1 own property adjacent to the' above -referenced property. The indi applying for this permit has described to.me as shown on the attached drawing the developme are proposing. A description or drawing, with dimensions, should be provided with this lei I have no objections to this proposal. If you have objections to what is =P P P being proposed, tease write the Division of C b Management, 127 'eardinaI Drive Extension, Wilmington, INC 28405 or call 910-791 within 10 days -of receipt of this notice. No response is considered the same as no _obje( you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, break-Nvater, boat house or boat lift mus bck a minimum distance of 15' from n7y area of riparian access - unless waived by me. wish to waive the.setback,-you must initial the appropriate blank below.) I do wish to waive the 1 5' setback requirement. tt � C I do not wish to waive the 1 5' setback requirement. 116 lv ame a A � ��e1Jyr �� '� �� S �►.�-eQ,.� eJx, s-� � �n s Rol x )J vtl 6LX Y16 - -�14:t+ . . C U-il c,�