68093D - Harvey

NC Divisionof eoastal:Mgt. Habitat fmpact COn Pater Sheet
Applicant: %Gf ✓ %� ,/�C�ll'�"`
Date:
Describe belowthe HABITAT disturbances for the application.
All values should match the name, and units of measurement found in.)
TOTAL Sq: _Ft. CDaits
(Applied for.
DISTURB TYPE Disturbancetotai '
Habitat Name Choose One includes any MHCDO
anticipated
restoration or
ternimLacts Tyler Crumbley
Dredge ❑ Fill ❑ Both ❑ Other �d LPO
Dredge ❑ Fill ❑ Both ❑ Other ❑
Tara
Dredge ❑ Fill ❑ : Both ❑ Other ❑
DW Review
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Fill Both ❑ Other ❑ Owner rW
Dredge. []. ❑ . -
ther E1
Dredge El El ❑ O

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: l a
Mailing Address: / D 6 �� �i /Z C /
Phone Number: ZZ y- Z l �" ._ d -31_S ,3
Email Address: h r V b l t 0,/o-h c G• c--d,,,7
I certify that I have authorized 4-, E"-r,
ent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 2-T,e
G-2 1571A w q
at my property located at /f 6
in A-)2, County.
/ furthermore certify that I 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:
Signatu
C% K #,rC c2 cn V
Print or Type Na
Title

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to C L.( K I& A1)Jr Y I
(Name of Property Owner)
property located at / 0(0 j94!?/ CAte. CT:
(Address, Lot, Block, Road, etc.)
on�E��Ik peiiy� �ANA� ,in SU9f C1fiEiyDFCo. N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in descdnt�_on below or attach a site drawing
(�2 D F�(�sc 0 2 pb(F_ 130YtT rrf, L� RE OCRTLD FLvrtrlNG DDCk
I �0C K aA+�Y o�aciiN�
AtK V
K---- /S L
1
HAR v A y C* N n
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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 requirem 1
(Property Owner Information) (Adj F
Signature s4lkwture
C la<K /-/tyP, ' y u r, to
Print or Type Name Print nr Tuna
Information)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certifj that I own property, adjacent to •-jr�' S
(Name of Property Owner)
property located at 10,t--
(Address, LQt, Block. Road, etc,)
on 94i!V, r in N C.
(Waterbody) ~ (City/Town 4ndlor County)
The applicant has described to me, as shown below, the davelopmeet proposwd at the above
locattan.
kel I have no objection to this p(oposai,
I have objections to ints proposal
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Individuai proposing development must fill in descAption bWow or attach a site drawing)
M
WAIVER SECTION
understa'hd that a pier, dock, mooring pii(ngs, boat ramp, breaKwater. boathouse, lift, or groin
most be set back a minimum distance of, 15 from my area of riparian access unless waived by
me. (if you wish to ,4ve the setback, you must initial the appropriate blant', below)
-- t do wish to waive the 15'setback requirement,
1 do not wish to waive the 15' setbackreq-ulrement.
(Property Owner Information)
Az
print or Type Name
Owner Information)
V w SI ./ tr�-,
Print or Type [Varne
2-7 0 0 ff 0,55,!!7j2

auu tiiltlikwAY
NEW CAMA LIN
AS OF 11 /19/07
WOOD DOCKS
v
t3 re�g 1
ficg
Al
Al
CHNNAL)Y
LOT 16
0.22 ACRES
CouNECT GUTTER,
DO4vN,,SPOUT TO SYSTEM
(9,745.99 SQ.FT.)
NEW CAMA SETBACK LINE AS
Or i1/19/07
CONNECT GUTTER,
DOGNSPOUT TO SYSTEM
VATH 4" SOUD PVC PIPE
VAT4 4' SOM PVC PIPE
r
25.0'
LOT 17
!
0
LOT 15
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w
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v
am{ a
SYSTEM 2
17 LF tt� �!LTP,r` TtON
17.0 LF INFILTRA 11Cn
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a
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Tr:ENCH
TREFSCFi
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a
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O 1,250.[;0 SC -FT-
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61 I
GUTTEE R
43.0'
(A
CONNECT
QO:"tv'SPOUT -TO SYSTEM
CONNECT GUTTER
DO1:.tS?OIfT TO S`lSTr!.t
OPEN DECK
CQ
�
{r`
`:+17H 4' SCi lD PVC PIPE
VATH 4' SOLID PVC PIPE
t
3.0'
-
O. PERvtOIlS
rs'�r.`PEP%lOuS
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DP,tVE'.:'AY
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DRIVEVIAY
3
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-- EXIST. WATER LINE)
ABIGAIL COURT -. 25' ACCESS C"t UTILITY
EVISi SA��t.
SEVER
EXIST.
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