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Home My WebLink About68017D - Dodd��1� l� "CAMA / 'DREDGE & FILL 't 8017 A B � ENERAL PERMIT Previous permit # —Modification ElComplete Reissue DPartial Reissue Date previous permit issued rized 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 7 o // 'Do E:1 Rules attached. t Name Project Location: County -" V C -"k Y- 'J 1 , E C_k V%L� 0, — State 5 C- ZIP ; '-/ G) 12; t (�q 3) S 13 -; (�'/ 3 — E-Mail edAgent k�Ati�X 0 Cw tHHF 1�nA 6ES PTS El 00EA E11H El UBA 0 N/A El PWS: yes no PNA Street Address/ State Road/ Lot #(s) 1 r) V, 11-- , � Subdivision U City Phone# River Basin Adj. Wtr. Body— 00 w W - - (nat Closest Maj. Wtr. Body PAWN 1, Project/ Activity C4- 1, ck t r VV\ (Scale: III A III h tform(s) MEMO■MENE NONNI M MENNEN zr(s) !!!!MMl7'latform(s) igth .lber M_EMM_ . �....�MD�.�■ .............. distance offshore distance offshore mnel No Emil IlW 'd N rw 32"MMEWAN—M ENNIN ��ll�� M1 111pp E LIM WERO U MAUMMI'm _M MM NONNI INAMM111551111110.151350MIMEMMIMIN P Ill mmommmmmmmilmsm e/ BoatW�f ME MOM 11MIMM ff MEMO Kwffl 1111111111110111111 ME MM■mmmiimmm n 101PIR11111 MMMMIII MM ME Ill FIFAFY21 mmmui mom I Ildozing MMM Rol Ill 11111PAP-611111 MWA MM Ill ANN= 7 MMM "WI M kimomi M" mmmmmm MM Is MM■Ill lVAPFAM11155 ir, I MMIWAOINJOW1521151 I III ME 011M M 11111111111111110111111 OWEN= ME■111FIR.Allow MUMMIUM41111111111111 IMUMMMIMI 11011111MIUMMUM FAMENIFAME511M 1%■M Emommom ■®■■ELFAMMIErm-M.-C %WWAM 11111MEN OEM ONEEN NU i�r<rYM■I■11m■■imi.■ili■■►�i�i��%nMMll■ m ME MA Nuffivilill ocal Planning jurisdiction) NC 'Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: j �, Permit #: ��0 I%- js Date: bZ 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 FINAL Feet (Applied for. (Anticipated final (Applied for. (Anticipated final Habitat Name DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. Choose One includes any Excludesany total includes Excludes any anticipated restoration any anticipated restoration and/or restoration or and/or temp . restoration or temp impact temp impacts) impact amount) temp impacts amount �j Dredge ❑ Fill Both ❑ Other ❑ 'Z �O U 2 Q W Dredge ❑ Fill 91Both ❑ Other ❑ Z 6 4 Z 0 C) (� G✓ 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Payment Proccessing Confirmation Date Received 2/2/2017 Check From (Name) Allied Marine Construction Name of Permit Holder Dodd, Oc, ") Vendor First Citizens Bank Check Number 5288 Check amount $400.00 Multiple Permits No Major/Minor Permit Number/Comments GP 68017D (Permit fee is $600) Receipt or Refund/Reallocated n OD Payment Proccessing Confirmation Date Received 2/2/2017 Check From (Name) Allied Marine Construction Name of Permit Holder Dodd/ Vendor First First Citizens Bank Check Number Check amount Multiple Permits Major/Minor $200.00 Rol 5287 Permit Number/Comments GP 68017D (Permit fee is $600) Receipt or Refund/Reallocated SF3499D AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION TY MY' - Name of Property Owner Requesting Permit: "a,,, .- , - �- n 4 Mailing Address: , Phone Number: ' Email Address: , I certify that I have authorized d246 Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: C ),,A �k'.�x�+�`c� °,� y.a=.� .w ..� - � � .,:,- �-.4* �w..�*.. �„�I,r,w�a. _ •�-. aptt �r�*.� -a+�l 3:t:"tifr :aw'.�ra:_..s t at my property located at _� �� 5'�yd. �� / r in RIMM County. I furthermore certify that l am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information: Print or Type Name g� y Title. AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: lC'LtJN 2 Oak -TS/X�Y/ Mailing Address: Phone Number: Email Address: I certify that 1 have authorized zj/ l i J - - xn'r/r' 6—liy Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: b/U �� 'rU e ! 7 at my property located at e n;) O in Aian56vkk County. l furthermore certify that I am authorized to grant, and do in fact grant permission tc Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to thi; permit application. Property Owner Information: Signature Print or Type Name 'Sc) pe�2J tSe P" �jyt G w o is Title CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: /50 $ 5� (Lot or ity Street #, Street or Road, C& County) ' Agent's Name #:/ f,c�J /92y)nt-- Mailing Address: q-;� Nel�j t Agent's phone #: 910 - 23 2 -a53U Q 8yzl3 ere y certify a own property adjacent o the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are pro osing. A description or drawing, with dimensions must be provided with this letter. I have no objections to this proposal. I have objections to this proposal. 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. Contact information for DCM offices is available at http://www.nccoastaimanq_qement.netlWeblcmlstaff-listin or by calling 1-888-4RCOAST. No response is considered the same as no objection if you have been notified by Certified Mail WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.) —OL�— I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property nor In/for ation) ,/),f..�`",.,,/' Signature �J Print or Type Name Ala Aela�- 5/- (Riparian Property Owner Information) Sigtiature s7�c. ��t�. /c✓s Print or Type Name y4d r b", Mailing Address Mailing Address DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner. Address of Property: Agent's Name #: ! ! �`rd°tIIV_._ Agent's phone #: 1L).. ) 5- & G (Lot or Street #, Street or Road, City & County) 1 f } Mailing Address: �o� r1 `r'°r d 6 of c;), �0 0' Fh-ereby ceftTyAbat I own props y a Iacen o the above referenced property. The in ivi i applying for this permit has described to me as shown on the attached drawing the developmi they are proposing. A description or drawing with dimen§ions must be provided with this lette l have no objections to this proposal. _ I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Managem (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM office: available at http //www nccoastatmanagemeni netlweb/cm/staff-listing or by calling 1-888-4RCOA No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift mus be set back a minimum distance of 15from my area of riparian access unless waived by me 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 Information) SignatureU 1 C_7- e-,,) Print or Type Name' Mailing Address r (Riparian Property Owner Informatio Signat , e /W Print or Type Name C-e)19, Mailing Address < /►, tyii -q `7 7 CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: _ I-cxy yt 0 04 �S�orilJ Address of Property: �� YPG` r°/tC� C h) l �0 (Lot or Street #, Street or Road, City & County) Agent's Name #: 1411'j /nr,rt, Agent's phone #: � f (� -,-,) 3 a -a S 3<q Mailing Address: hereby certify at I own property adjacent o the above referenced property. The in ivi u, applying for this permit has described to me as shown on the attached drawing the developmei they are roposing. A description or drawing, with dimensions must be provided with this letter I have no objections to this proposal. I have objections to this proposal. if you have objections to what is being proposed, you must notify the Division of Coastal Managemei (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices available athttp:llwww.nccoastalmanagement.net/web/cm/staff-listing or by calling 1-888-4RCOAS No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must be set back a minimum distance of 15' from my area of riparian access unless waived by me. 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 Information) Signatur e;. L- � a-nl e►- J r Print or Type Narrle Mailing Address (Riparian Prop rty Own r Information) t' SignatuFe Print or Type Name k 5 Mailing Address I- i I L'r ,2,and 3. nd address on the reverse turn the card to you. z) the back of the mailpiece, 31pace permits. gnatures 14 an, ❑ Agent ❑ Addressee B. Received by (Printed Name) C. Date of Delivery D. Is delivery address different from item 1 ? ❑ Yes If YES, enter delivery address below: ❑ No . Service Type ❑ PrigMail - ress49 ❑ Adult Signature ❑ Registered Mail eS'gnature ResMcted Delivery 0 Registered Mail Resbicte rtified MailO Delivery 13 0319 5155 0688 15 0 certified Mail Restricted Delivery ❑ Return Rec oo for 0 Collect on Delivery Merchandise 3nsfer from service label) 0 Collect on Delivery Restricted Delivery 0 Signature Confi mationT" rF1 Mail ❑ Signature Confirmation 1, ❑ D ODD - 778 48 8 5 8 7' 50MQ)il Restricted Delivery Restricted Delivery ��- )ril 2015 PSN 7530-02-000-9053 Domestic Return Recelot �A �l