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Home My WebLink About69255D - Godwin"LAMA / ❑ DREDGE & FILL r A B aENERAL PERMIT `1.Z Previous permit# k levv '--Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued •ized by the State of North Carolina, Department of Environment and Natural Resources �A .oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Rules attached. t Name \ e� 0 � V 0 A'�Vty, Project Location: County J1Z.{'N\<1 T- K F A ., A State ZIP '3 L- ` (�✓ ) �' '" � -Mail :ed Agent (7l ❑ Cyy A ❑ ES ❑ PTS ❑ OEA F ❑ IH ❑ UBA ❑ N/A ❑ PWS: yes / PNA yes / :.y f Project/ Activity 6h xk) length Ll 'latform(s) Platform(s) X2,) pier(s) _ ength umber. ad/ Riprap len �g distance off ore iax distance shore channel ubic yar amp wse/ oatlift 6611dozing line Length �] G1 not sure yes :orium: n/a yes 9 ,s: yes A01) 5- Street Address/ State Road/ Lot #(s) Subdivision -� City . (� � C Ll ZIP__ 2 Phone # (f' O) 3--7� River Basin Adj. Wtr. Body nat / Closest Maj. Wtr. Body ,4- ,- (Scale: ! ` t w Attached: yes C9 ��,, / Iding permit may be required by: ��A 6.a CJ � Lt(/l S�_I�C� G ❑ See note on back regarding River Basir ■ Complete items 1, 2, and 3. Sure ■ Print your name and address on the reverse ❑ Agent so that we can return the card to you. ❑ Addressee ived by (Print�(Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits.az ' 1. Article Addressed to: Is delivery ad ress different Ye � ��79R•jZy � �l � If YES, enter delivery addre ❑ dJd J�� V �C)Do ctri 3. Service Type ❑ Priority Mail Express® ❑ Adult Signature ❑ Registered MailTM Il I Illlll III IIII II ll I II l) I I (l I l IIII I I ❑ Adult Signature Restricted Delivery El Registered Mail Restricted ❑ Certified Mail® Delivery 9590 9402 1363 5285 8761 36 ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise 2. A. J •- ni,,. ',— rr—f— frtuz7 servke label) ❑ Collect on Delivery Restricted Delivery ❑ Signature Confirmation* ❑ Signature Confirmation 7 015 0 9 2 L • 10 417 2 stricted Delivery Restricted Delivery PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt ; ■ 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, or on the front -if-space permits. 1. Artj6le AddresseQto: 4- Jpc tC l o , � 1 �,. .�I1.55 Cl1-(;� gnaiure Agent midu{ 4a;OLOAddressee �B. eived y (Pri a Name) C. Date o Deliv ry C�I C�ti l; i6 r7 D. Is delivery address different from item 1?�❑ e-s If YES, enter delivery address below: ❑ No Vk d-bW 3. Service Type ❑ Priority Mail ExpressO Il I'll Il III II I I II III ll I II I I I I I III ❑ Adult Signature ❑ Registered Mail- 0 Adult Signature Restricted Delivery ❑ Registered Mail Restricted ❑ Certified Mail® Delivery 9590 9402 1363 5285 8761 12 ❑ Certified Mail Restricted Delivery ❑ Return Receipt for 0 Collect on Delivery Merchandise 2. Article Number (Transfer from service labal) ❑ Collect on Delivery Restricted Delivery ❑ Signature Confirmation— ❑ SignatureConfinnation 7 015 0920 0000 7 610 4189 lestricted Delivery Restricted Delivery PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt I NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: ()-N►vt. C ode(.,�Vl Date: V G (-�A40 * . Permit ##: 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 act 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 ` U 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ /dj ba" s T LFIA NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management IcCrory Braxton C. Davis ,ernor Director AGENT AUTHORIZATION FORM Date: 6 `( 6' lb John E. Skvarla, III Secretary of Property Owner Applying or Permit: Name of A horized A ent for this project: y- coo, is Mailing Address: too Tw; [i a t 7)r Number (7dV,) 57- * !�9I Agent's Mailing Address: , 71 I Phone Number �T y that I have authorized the agent listed above to act on my behalf, for the purpose of applying J obtaining /� all CAM/%A� �Perm,ittss necessary to install y property located at ;rtification is valid thru (date) Property Owner Signature construct the following (activity): / ff ./ )/ ( /- s" /7-L7 Date DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Individual Applying For Permit: Address of Property: (Lot or Street #, Street or Road) (City and County) ere b y certi t h at 16wn property a-c jacent to the a ove-reFerence property. The indiv applying for this permit has described to.me as shown on the attached drawing the development are proposing. A d s iption or drawing, with dimensions, should be provided with this lett, I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Cc Management, 127 'Cardinal Drive Extension, Wilmington, IBC 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 I understand that a pier, dock, mooring pilings, break--wnter; boat house or boat lift must bek 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 waive the 1 5` setback requirement. I do not wish to waive the 1 5' setback requirement. la AA Sign Name to DMSION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIV Name of Individual Applying 1 ina For Permit: �_ �t�(•vl Address of Property: (Lot or Street #, Street or Road) (City and County) hereby certl that I own property aT}acent to the a ove-re erence property. The indiv applying for this permit has described tome as shown on the attached drawing the developmen Are proposing. A description or drawing, with dimensions, should be provided with this let-t I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Cc Management, 127 'Cardinal Drive Extension, Wilmington, INC 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 I understand that a pier, dock, mooring pilings, breakm,nter, boat house or boat lift must bck a minimum distance of 15' from my area of riparian access - unless waived by me. wish to Nvaive the.setback, you must initial the appropriate blank below.) I do wish to waive the 1 5' setback requirement. I do not wish to waive the 1 5' setback requirement. e`h aitu:ri IVacnc /J IK ��(- c-) /77Z— Ua.e ♦� W MA 1 o c) 7 N"-(7