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Home My WebLink About69028D - MastersI.CAMA /�n DREDGE & FILL 'Ij, \CAI A B 'ENERAL PERMIT Previous permit# New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued Ized by the State of North Carolina, Department of Environment and Natural Resources , / :oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC) /T 1.200 J� Rules a ched. t Name ��J 's Project Location: County %l-�i1�rG> fit �( ✓k r / ---A IF —State NCB ZIP 2: fil—) ;?25" -/(—.'0 E-Mail ed Agent Gt ❑ CW ;QM )IPTA ❑ PTS ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: yes a no . PNA yes no itform(s) Platform(s) X distance offshore x distance off )ihore__ annel 72 X Z-� X Length yes LpOi ttached: Lno ig permit may be required by: nral Plannina hirie`lirtinnl Street Address/ State Road/ Lot #(s /�G S Subdivision ' City _ ZIPS Phone # ( River Basin , Adj. Wtr. Body � 1 w w <917ali Closest Maj. Wtr. Body Soo" t on back regarding River Basin n NC Division Of Goastal:t fit. ti�abitat impact-Co;�puter Sheet Applicant: Date:I— 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 I'D (Applied for. (Anticipated final (Applied for. Disturbance (An d'rsl DISTURB TYPE Disturbance total includes any disturbance. Excludes any total includes. EX( Habitat (dame Choose One anticipated restoration any anticipated res ten restoration or tem impacts) and/or temp im aci amount restoration or tem irri acts am Dredge ❑ Fill ❑ Both ❑ Other Zyo Dredge Fill ❑ Both . ❑ Other ❑� . Dredge ❑ Fill Both ❑ Other ❑ Dredge ❑ Fill ❑ ` Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge. ❑. Fill ❑ . Both ❑ Other ❑ Dredge ❑ Fill 171 Both ❑" Other ET 3/14/2017 Lighthouse Marine Construction/Darryl Erny Coastal Bank Andrew Masters Trust 1386 Comments $600.00 GP 69028D B; Authorized Agent Form Date: / � TA 17 To Whom It May Concern, I certify that I authorize to act on my Name of Agent behalf, for the purpose of applying for and obtaining all CAMA permits necessary for my project located at �� /Ct t1c,5 Address 11144110 rx/f'o / Al Sincerely, rop y Owner Contact number kt * q-29 P ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to �Z 't/� 'f— T5 I (Name of Property Owner) property located at 11/6, :-�0 9� (Address, Lot, Block, Road, etc.) on in 44M//1si,i�?D , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locatign. 5.✓ 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) Im"KL 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 requirement. (Property Owner Information) Signa re Print or Type Name ram, r,�� Z:47-�01,-�; Mailino Address (Adjacent Property Owner Information) Signature Print or Type Name �zac4 Lt!- -zr 4C' (� - Mailing Address, , X A _ ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to /7iy� g"314MAIV ,/10�721RF 's (Name of Property Owner) property located at d,062 (Address, Lot, Block, Road, etc.) on 16. 1H 7A, in ,�j�4n�►i'57)e}D , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locatio 1 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, 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 requirement. (Property Owner Information) ignature print or Type Name AAnilinn drWrace (Adjacent Property Owner Information) AA 149�� Siggn,ature * C;02MS 3 . I gA40veoS Print or Type Name "Ygs /// 8 3 1C Mnilinri drlrlracc ^K C. 13RI5TOW, CERTIFY THAT TH15 PROPERTY WA5 5URVEYED AND MAP DRAWN UNDER MY 5UPERV15ION: 71ON A5 SHOWN ON THE FACE OF TH15 PLAT; RATIO OF PREC1510N A5 CALCULATED BY COMPUTER 000+; THAT THE 5OUNDARIE5 NOT 5URVEYI D ARE 5HOWN BY BROKEN UNE5 PLOTTED FROM UION REFERENCED; THAT TH15 PLAT WA5 PREPARED IN ACCORDANCE WITH 'THE 5TANDARD5 OF t FOR LAND 5URVNNG IN NORTH CAROLINA' (21 NCAC 5G. 1604); MTNE55 MY ORIGINAL 51GNATUU, )RE NUMBER AND 5EAL TH15 30TH DAY OF AUGU5T A.D. 201 G. X C. 5RI5TOW o4 '5 No. L-4148 BOAT BASIN Av DTE: 5URVEY INFORMATION SHOWN FOR FY15TING IMPROVEMENT5 15 FROM SURVEY PROVIDED BY OTHERS. CERTIFICATION AFFIXED HEREON 15 FOR FLOOD ZONE BOUNDARIE5 RELATIVE TO BOUNDARY LINE5. Ir FLQ�t11NG \``\11111111I/)//�'' uu�OnC.K� � (� � FLOATING DOCK EASEMENT CA. �� 0 � 11 f %4C DOCK O.B.25*x7' PER i O.B. .B. 760, PG. 220 ?' Y DOCK S E A L - 3 JIG lbf HED-A FLOATING DOCK DOCK •Q � �� -apt• I o vc �� SF184� y i C. I ;� ACCESS EASEMENT I > N D.B. 760, PG. 220-222J�j N approximate j�l u septic lines I I S _ _ y I GATE ADJOINER'S a' CHAIN FENCE N/F TCHOUROS B. 781, PG. 112 I I I DECK I i I I I n� I it I FWAY I � I � o�x.uA►c I � vIsr �-rfo°0R t . Uk-ATI ON vihQ NOT TO 5CALE 5URVEY REFERENCE DEED BOOK 4492 PAGE 237 NOTE: TH15 LOT 15 LOCATED IN 20NE5 X R VE (EL. 1 1) A5 PE MAP #F 3720420200 J COMMUNITY ID #F 370344 DATED: FEBRUARY 16, 2007 LEGEND O - EX15TING IRON PIPE = CENTERLINE = CONTROL MONUMENT ®= SET IRON PIPE Q= 5URVEY NAIL = RAILROAD 5PIKE — �00,�0 2�7 ROPE FENCEy NCO �I�\7��F 4R18j�T?dIC � �^ v�F by: — BOAT Apprl RAMP ACCESS Date: I --�.� Ring 0% or N /F PH�IL�-IPS nCP . PWI ? PG. CORNER OF BUILDING t #: