HomeMy WebLinkAbout69229D - Kane�CAMA / �T] DREDGE & FILL
"ENERAL PERMIT Previous permit# A B
New Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
sized by the State of North Carolina, Department of Environment and Natural Resources n
::oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC l f 4H. 1100 0 q H P 20
�n Rules attached.
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ig permit may be required by:� (�a ❑ See note on back regarding River Basin r
-ocal Planning Jurisdiction)
7
05 i':-2011 (800)275-87/7
----------------
Product Sale
Description Oty
First -Class 1
Mail
Letter
(Domestic)
(WILMINGTON, NC 28411)
(Weight:0 Lb 0.60 Oz)
(Expected Delivery Day)
(Monday 05/08/2017)
Certified 1
(OOUSPS Certified Mail #)
(70162710000101407306)
Return 1
Receipt
(90USPS Return Receipt #)
(9590940223776249995177)
Credit Card Remitd $
(Card Name:UISA)
(Account #:XXXXXXXXXXXX3698)
(Approval #:005996)
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NC Division of Coastal Mgt. Habitat Impact Coml
Applicant:��-
Date: (n %
Describe b /low t e 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
FIP
(Applied for.
(Anticipated final
(Applied for.
(An
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disc
Habitat Name
Choose One
includes any
Excludes any
total includes
Exc
anticipated
restoration
any anticipated
rest
restoration or
and/or temp
restoration or
terr
temp impacts)
impact amount)
temp impacts
am,
Dredge ❑ Fill ❑ Both ❑ Other
Ik
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
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
r_
Name of Property Owner Requesting Permit: 40HAI � / Kfhll(-
Mailing Address: !,12
Phone Number:
Email Address:
I certify that I have authorized ��7✓� �ifif y
Agent / Contrac or
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: e":4 u< &-6*0
at my property located at Z 6 l,57
in I rVOV rt—County.
1 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:
Sig to
c 641 LAIK
Print or Ty e Name
Title
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION[WAIVER FORM
Name of Property Owner: John and Tracy Kane
Address of Property: 1613 Futch Creek Rd
Agent's Name #:
Agent's phone #:
(Lot or Street #, Street or Road, City & County)
Daniel Shirley
910 386-8883
Mailing Address: 3506 Tall Pine Ct.
Wilmington, NC 28409
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.
I have no objections to this proposal. I have objections to this proposal.
If 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. Contact information for DCM offices is
available at http://www.nccoastaimanapement.netlweb/cm/staff-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mai!
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.)
N/A I do wish to waive the 15' setback requirement.
N/A I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
John and Tracy Kane
Print or Type Name
(Riparian Property Owner Information)
elf � e-y'
Signature
H Hartney, Elizabeth F Yeager
Print or Type Name
46240 Durango Dr.
Mailing Address
1609 Futch Creek Rd.
Mailing Address
Page 1 of l
1613 FUTCH CREEK
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April 14, 2017
• Local Addresses
Municipal Boundaries
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Parcel Boundaries
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A 3506 TALL PINE CT John and Tracy Kane Na Description Date PAGE 1 OF 1
WILMINGTON, NC 28409 1613 Futch Creek Road Project Name aodem
ovexsecx 38 910-386-88
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No. Description Dab
j 3506 TALL PINE CT John and Tracy Kane PAGE 1 OF 1
VVILMINGTON, NC 28409 1613 Futch Creek Road Project Name 19 APRIPRIL,,
� G 910-386-8883 Date
Wilmington, NC 2840 Drawn GPS
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