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Home My WebLink About69025D - Mills,CAMA / ❑ DREDGE & FILL � �, • '�V AI A B 'ENERAL PERMIT Previous permit # New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued ized by the State of North Carolina, Department of Environment and Natural Resources 6-7 oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC T (7Rules attached. Name VA O+VA �-1, A StateZIPJ ( ) 5 $ E-Mail ed Agent LU 1-A M+ (' payi ❑ CW AW )�TA ❑ ES ❑ PTS ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: yes / rro 1 PNA yes / ' Project/ Activity V t (A' V, ei1(l5� ck)length -- atform(s) 10 X ZH Platform(s) :ngth mber �d/ Riprap length g distance offshc ax distance offsh hannel ibic mp '` 0 ne Length not sure yes �o )rium: n/a yes yews Jes t st{ no d� D( Project Location: County - ► lx i -1_�'_ Street Address/ State Road/ Lot #(s) 6 1 L-o c Vi 60�i F, !Ifs, Subdivision City BOA �\- ZIP a O C Phone # (9jQ )-15'-INSRiv/erBasin t,()Ml Adj. Wtr. Body Al W W a, Closest Maj. Wtr. Body -Al (Scale: I ' Ping permit may be required by: 5�� 1� LVUN b�, ❑ See note on back regarding River Basin neveiveu - Comments Joseph & Lara Newbridge 3/17/2017 Milligan Timothy Mills Bank 6406 $200.00 GP 69025D NC Division of Coastal Mgt. Habitat Impact Com Applicant: �� 'h M Date: 0.3 / I, a o 1 1 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 FI (Applied for. (Anticipated final (Applied for. (A DISTURB TYPE Disturbance total disturbance. Disturbance di; Habitat Name Choose One includes any Excludes any total includes E) anticipated restoration any anticipated re: restoration or andlor temp restoration or tei ternimpacts) impact amount temp impacts an Dredge ❑ Fill ❑ Both ❑ Other 0 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ 'AWA OE E »M � Neu* R�OUMOS NOM Cam mvmm,af Comm "Womod won G. PAW 41 qOr & J"M 1�Adue1 P. t:s�►, C,crw�*x Authorised Agmt Consent Agm*"ni .......... is i�e�i � Lo ad on myLUZ-- � tAi�} lWrtM af�1wnA in Order to obt�n OnY CAMp► i ts) required for the property below- e spscft movjt�w dewdW in the S"d%d sketch. PR+aPEim R IWuNG ADDRESS: CIV7 pHONE NO-3 A;TIICMMMAXIW IAAMJN° AoaF4M= 3 s G. Q Mo. 1 1 77 , 01*1 -NI--w S-�Q4 .� !!1!1�V ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to T rhJ"i N I1S property located at i &/ - !c i kt,)o)- Fe,/, s ,ner) S>` l �f (Address, Lot, $lock, Road, etc.) // s on t; arc o e.r� uL/ in (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. �c� 11 have no objection to this proposal. 1 have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must rill in descriptionow or attach a site drawing) 1 - I �— O WAIVER SECTION j-1e1 ri` I and: stand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must, a set back a minimum distance of 15' from my area of riparian access unless waived by me. you wish to waive the setback, you must initial the appropriate blank below.) V--Ido wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Inform�atttiiron) (Adjacent Property Owner Information) Signature* rail W #0)kC- Pri t or Type m - , _ -C �1� 111-s-e_ 1 h Pn or ype Nae ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Z�Irkoi)iil fif• l bs is (Na o Property Owner) property located at k e kwuli FEW(' b' i't AC. 2 on (Address, Lot, lock, Road, etc.) �t��.�asf� GT� y (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. F9 L I have no objection to this proposal. 1 have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT Ond%dl UW proposing development must fill in descriptionw or attach,a site drawing) q WAIVER SECTION nd that a ier, dock mooring pilings, boat ramp, breakwater, boathouse, lift, or groir I and sta p 9 p 9 must,. a set back a minimum distance of 15' from my area of riparian access unless waived by e. '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. (Property Owner Information) signt#ftu0re2`l ao-nzi'-- A'1 S (Adjacent Property Owner Information) A, xa4 Sign 'dx640(�. Cawav� Print or Type gfpfp np Print or Type Nage