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Home My WebLink About68516D - HoldenLAMA / .DREDGE & FILL ��lp S Y- '', 3 A B iENERAL PERMIT Previous permit# New Modification ❑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 15A NCAC / r' U o � Rules attached. Name 0 n Yl a Q W0 Qx Y*A Project Location: County A r) S A) i ( K^ �� S h o e 1 ►� { Q r / Street Address/ State Road/ Lot #(s) V toy fn (� StateA/�— ZIP ( ) E-Mail *s4ubdivision ad Agent l-AYNC IkOyy)s,waltrplat A( C ElPh i� A1�G ZIP_�`'!� (� a Q 1 CW XEW tTA KES *TS one (� 1 �) {� �� Lj g L V Rive Basin 1, ►� �V ❑ OEA ❑ HHF ❑ IH [I USA [I N/A Adj. Wtr. Body t q 0 0 �' c � � � tat7/n ❑ PWS: Closest Maj. Wtr. Body tA)IA� -- yes / j%� PNA yes / �t��a Project/ Activity Co uc� a � Y\ % In i� (Scale: l :k) length atform(s) Platform(s) ��9 ngth tuber d/ Riprap length g distance offshore , ax distance offshore hannel bic yards_ mp ,use/ Boatlift � �■■■■■■■l�Il,�lriillJll�_1�liiil�il��!l11��!!!! oa: ► -Crory -,cverna & kv M- A NDrth Carolina Department of Environment and Natural Resources N.C. D;visior of Coastal Management Ulm AGENT AUTHORIZATION FORM Date V-_Y—t?- Name of Property LO/wneQr App#ytng for Permit Narne of Authorized Agent for this pt Owner's Mailing Address Email - Phone t �l 12?-0V— ` I- _. Email titer L, 26- A C Ph-cne { p- 1 -qq3-" ` i certify that I have authorized the agent listed above to act on my behalf, for the purpose of app for. and obtaining all CAMA Permits necessary to install or construct the following (activity) For my property locared at CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FO Name of Property Owner: Address of Property. 0 N Street X. Street or moan. Lxy 6 County) Agent's Name d: Q,si f-i!„0..hS MaihN Address �l Agent's phone #: 1149-- qzl 3� �� S f I hereby Certify that I own property adjacent to the above referenced property. The a applying for this permit has described to me as shown on the attached drawvV_#* deve they are proposing. A description or drawiry, with dywtsions must be provided with11 thb 1�1µ (,1100, e no objections to this proposal. — - -- I have objections to this propos N you have objections to what is being proposed, you must nottty the Division of ConsW Wnagernen writing within 10 days of receipt of this nodce. Correspondence should be nmaed to 127 Cardbsat L Mnington, NC, 28405-3845. DCAI representatives can also be contacted at (910) 7W7213. Mop considered the sense as no objection if you haw been not[fied by -Ca ed Alail. WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, Lift, or groin must back a minimum distance of 15' from my area of riparian access unless waived by me. (11 wish;to waive the setback, you must initial the appropriate blank below) Ni�y�sl _ I do wish to waive the 15' setback requirement. CQ, L I do not wish to waive the 15' setback regtarement Pn Q z; t /I (Property Owni o'PT%ti ) Signature Y-------�� Dnnl ry Tunn Afnmu aide L01"r-yt W oId-e 0"..& ... T..... ♦t___ ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that l own property adjacent to 's property located at 17 .7 (Name of Property Owner) on // � (Address, Lot, Block, Roa$, etc.) /'y.✓�cc..\ N.C. (Waterbody) 'n (City/Town andior County) ;The Vapplicanas described to me, as shown below, the development proposed at the above location. have no objection to this proposal. I have objections to this proposal. utat,KW I iuN AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) _ i^4wr.) 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.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (rroperty owner Information) Signrrf Pri/1)/ '5`Name/ ' Mailin Address� (A cent Property Owner Information) Ma+J/1A9 X/6 IqA hh4 LlV, - .. - .. - — 'a.-tw};'fivw. 'Y�. r,•sw»s.�.e^trn.^�'.".�.R�+ t.!+•'.•.Trr�`?�RP'� ��CAMA / i^ DREDGE & FILL IN9 66230 GENERAL PERMIT Previous permit# A B OK New �-1Modification ❑Complete Reissue L1Partial Reissue Date previous permit issued authorized by the State of North Carolina. Department of Environment and Natural Resources `j the Coastal ResCAIA Commission In an area of environmental concern pursuant to I SA NCAC (` IZO U y Rules attached. ilimt Na ft C f 11 Project Location: County 64y o So t (% lids 1J �(ff' Street Address/ State Road/ Lot #(s)_� }� G t L, Slice..ZIP _ � klYbIl1id I 'V2 �W ne # E-Mail --- _.. - - - Suion '0 /P% iorized Agent.JAAA1 C4t City A,- r, ---- - — ZIP rted I CW )4EW XPTA Es o rr's Phone #E ( i ) 4- d D I River Basin .(E OEA ❑ HHF O *1 ❑ LISA O WA Adi. Wtr. i�ody, PWS: 1 1 ✓((nat.', WNJ V: yes % no ; PHA gyres rClosest Mai. Wtr. Body a of Project/ Actift r (dock) length Ck%C X ed Piadonn(s) ating Platforms) l� 7 ger pier(s) _ )in length number khead/ Riprap length _ avg distance offshore max distance offshore in, channel tromp thousei/ Boadift —s— •eiine Length = not sure yes atonum rr✓a YU no ,er Attached: yes no ilding permit may be required by: T.�;Y 1) ate Local Planning Jurisdiction)._ es/ Special Conditions 9 . lab NC Division of Coastal Mgt. Habitat Impact Coml Applicant: r'U/tAX �6k1 ,n { Date: Q `A/M / ( -7 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 FI1 (Applied for. (Anticipated final (Applied for. (Ar DISTURB TYPE Disturbance total disturbance. Disturbance dis Habitat Name Choose One includes any Excludes any total includes Ex( anticipated restoration any anticipated res restoration or and/or temp restoration or ten tempimpacts) impactamount)tempimpacts) am r ` l VV Dredge ❑ Fill ❑ Both ❑ Other 1 b V Dredge ❑ FillIABoth ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑