69405D - Eckhardt

CAMA / ❑ DREDGE & FILL , I� A"ENERAL PERMIT (1 Previous permit#
[New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
•ized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ff
p es attached.
t Name .f' G/!/ A, Project Location: County �'
9.,7,,7
kaA
. i Street Address/ State Roaad/ Lot (s)
Stat ZIP b --
Mall Subdivi ion
:ed Agent Gi�1� •�/►'k- City ZIP
❑ CW �W �pTA �S 1-1PTS Phone # ( }-- -'' % River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ElN/A Adj. Wtr. Body ' / t
ElPWS: OG/ rr
Closest Maj. Wtr. Body
ye,� PNA yes ,frai
f Project/ Activity
>ck) length 1P T
latform(s)
ZX
ria rm's'
,ier(s)
ngth
ember
a�iprap length 8S j
tg distance offshore_
iax distance offshore
imp _
Ouse/
Bulldozing
ine Length —5
not sure yes no
orium: n/a yes " �y
s: yes
r Attached: yes no
ding permit may be require%byr:
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(Scale: I /I
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❑ See note on back regarding River Basin

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Postal
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RECEIPT
Domestic
PORT Ci-'rN.T0N.l' 014 434'J:
Certified Mail Fee
/i= ' IYI tL D ,,.
$
Extra Services & Fees (check box, add ree app tiate)
❑ Retum Receipt (hardcopy) $ ��
❑ Retum Receipt (electronic) $ I . l_11 I
Postmark
❑Certified Mail Restricted Delivery $ $ I _ 110
Here
[]Adult Signature Required $
❑ Adult Signature Restricted Delivery $
Postage +n +G
1 Cl j` 1 o i'2tiI %
Total Postage and 71's
,:.84
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Sent To
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ected Delivery on: Thursday, October 19, 2017 by 8:00pm Q
duct & Tracking Information
:al Product: Features:
-Class Mail° Certified MailTM
DATE & TIME STATUS OF ITEM
October 19, 2017, 1:40 pm Delivered
AL
Your item was delivered at 1:40 pm on October 19, 2017 in PORT CLINTON, OH 43452.
ctober 19, 2017, 8:13 am
ctober 19, 2017, 8:08 am
ctober 19, 2017, 7:58 am
Available for Pickup
Distribution to PO Box in Progress
Sorting Complete
p://faq.usps.com/?articleld=Z
Rem(
Delivered
See Available Ac
LOCATION
PORT CLINTON, OH 43452
PORT CLINTON, OH 43452
PORT CLINTON, OH 43452
PORT CLINTON, OH 43452
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property: 461 UJ� ,� �,�} r �� ^ ; „ `� da�
(Lot or Street #, Street or Road, City & County)
Agent's Name #: Mailing Address:
Agent's phone #:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are proposing. A description ar drawing with dimensions must be provided with this letter.
V I have no objections to this proposal. T have objections to this proposal.
If you have objections to what Is being proposed, you mustnottfy the Division of Coastal Management (DCM) In
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 cardinal Drive EA, Mimington, NC, 28405.3845. DCM representatives can also be contacted at [phone]. No response Is
considered the same as no obleetien if tine, h— hna„ ...urr�a j.�._ I— _ ..
WAIVER SECTION
I 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.)
1 do wish to waive the 15' setback requirement.
f do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signs e
Print or Type Name
yob ►�- W`•�dw��� ���-� P�,
Mailing Address
/�a,to J, d
City/State2ip
W - a G ,�- - r-/o V.)--
(Adjacent Property Owner Information)
Signal l
. 1 ,ryas
PNnt or T e Name
q l ( ,\ �in
70-mt"te-,2
g Address J
� 0, C-
City/State
to Ii, 0'1NR. _n rP. ca

Name of Property Owner Requesting Permit: LC h t,
Mailing Address: `�� 5 L ✓ iV� ���
NCSy�/,
Phone Number: �i I UyDy�-
Email Address:
I certify that I have authorized C 4-
Agent / contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
C,
s &
County.
1 furthermore certify that / 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:
Signat
r`er.+- L,r,-� . dt
Print or Type Name
Title
D9llaot�-
Date

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