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Home My WebLink About68009D - Knight1�eiCAMA / DREDGE & FILL A B GENERAL PERMIT Previous permit # IIew�Modification El Complete Reissue ❑Partial Reissue Date previous permit issued or/ized by tSate of North Carolina, Department of Environment and Natural Resources Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ❑ Rules attac ed. m Name Project Location: County nN--S"^7 - s ��-'�_ 1 Street Address/ State Road/ Loot #_(ss) �Gt q`C_ I1 State S� � � (U ( or- _"r Y-Xy - — # t�3 �(O 1- �L 0,-,Mail Subdivision ! ized Agent ��11"` MAN— City �� 6t oVI ZIP ?T'(' ❑ cW �N N(PTA ❑ ES ❑ PTS Phone # ' I D ) 47 a - W Ri er Basin ) , ❑ OEA ❑ HHF IH ❑ UBA ❑ N/A ❑ PWS: yes / rjll�) PNA yes / r>l�f A Project/ Activity Adj. Wtr. Body l k vt (nat Closest Maj. Wtr. Body Al ww ... - ■■■■■■■ ■■ ■ ;■■ ■I. � , ■■■■■■■ ■■■■■■■■■ ■■■■■■■■ MEN ■■■■ rsl�■EN■E■ �■■■■■■ ■■■EM��■P.9 00—MEME■ IwN■■E■■■■LZ31' riii■1' MMOVE■5 WIMn I ME 1 WIN12 Me ME 5 '5 AWAIM R IMF MEOW R MNi1irwo..\0MMMMMIMM �I��i�ir � �r�■■■■■�■■■ ■ 0 MOMEN ►A ��0 �■O►�0. INVA11041111P■■OEM■ I■■r!■MN■MNI MMMEME■ ■ a 2111■VANNAMIA i■Ec��►�cr�►Nl M■■■w■■■■■ A■r®119. M ■►A■ MMB IM■■■■NN■■I - �. 1ENONE ■ ■ ■■■ii■■■i■■■ rAmm I " ■■N■■ENI MMMMNN■ li I'�■■■MEN ENEl l M■■EMENI N MEEN■M■ Rit�N■E■�■M�1■■■■ IN�M■■■M■■ ■■NEM■MM■o ■■■IuIv1■wN"PIP3I WE 01■MEE■■EMEI O■M■NNOEM0 ■E ■Oa QUAR0 1■M■MNM■M■I ■ MEN ■■:■:■m■■■■01111, ■■: NO■■■■.■■■■■■■■■■■■■■■■■■■■■■I i■■■■■NOON ling permit may be required by: 7o\/1n Q T �'�',,V� � Ll El See note on back regarding River Basin Local Planning jurisdiction) ;� NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Ce- I v� Permit Date: 6 t 0 LI/ v l 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 impact 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 03� Both ❑ Other ❑ ( 00 D ( Q Q D 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 0 Payment Proccessing Confirmation Date Received 1/24/2017 Check From (Name) MONTCO Name of Permit Holder Peggy Knight Vendor Woodforest National Bank Check Number 2239 Check amount $400.00 Multiple Permits No Major/Minor Permit Number/Comments GP 68009D Receipt or Refund/Reallocated SF3496D AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Peggy Knight Mailing Address: 140 Greensboro Street Holden Beach, NC 28462 Phone Number: 843-409-1690 Email Address: I certify that I have authorized Jim Montgomery / MONTCO Agent i Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: Installation of a Redi-Rock Retainin I ' - _anal shoreline AN at my property located at 140 G, C41 in Brunswick County. ( 0 co ' i furthermore certify that l am ; :rmission to Division of Coastal Managemet ants to enter on the aforementioned lands alated to this permit application. Property Owner Information: Signature Peggy Knight Print or Type Name Home Owner Tile ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to �•� 4 � n � property located at on �� y� (Addresn. (Waterbody) of�operty Owner) R ad, etc rn �C✓L (City/Town and/or County) } 's N.0 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 description below or attach a site drawing) WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to wai\ the setback, you must initial the appropriate blank below.) _(7-_ 1 do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Pr perty Owner Information), ign ed- Ar—int'or Type N�a�gle / / /SaS- 41 (Adjacent Property Owner Information) ,Sigrialure LGvaEA. - 1- COLL-tOSaaJ Print or Type Name / 3 Sr C•tscus6, W- adiao Address Mailing Address Address of Property. Agent's Name # Agent's phone #. CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner. (Lot or Street #, Street or Road, City b County) Mailing Address 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 or drawing with dimensions must be provided with this letter V 1 have no objections to this proposal. _ . I have objections to this proposal. It 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. Correspondence should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representatives can also be contacted at (910) 796-7215. No response is considered the same as no objection i/ you have been notified by Certified Mail. 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 perty Owner Information) .Signattoe' I Print r e Name Madin Address (Adjacent Property Owner Information) rSignature rr A Print or Type Name \-7bO �S.r��p`��-� Mailing Address T- J 240 Citv/StatelZip 3 7 1 3 �