HomeMy WebLinkAbout67993D - Moore1 �(,Ip L�e Vx%(00V 0 �_
Subdivision ------------
city 1+y &tV1 zip
�Pone # (�1 a) 6H?-- ')�2q River Basin L Vyvx
Adj. Wtr. Body ( a VN VS (nat /
Closest Maj. Wtr. Body ,k! wid
�,CAMA / L DREDGE & FILL L / /? 1993 A B
.ENERAL PERMIT J Previous permit #
aNew Modification ❑Complete Reissue -'Partial Reissue Date previous permit issued_
prized by the State of North Carolina, Department of Environment and Natural Resources pp
-oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC . ` cc d- d�
j �j ❑ Rules attached.
it Name �Y (Ay-e /V 1 �OVi� _ Project Location: County AMSVvi t k
1--1 5 ` Street Address/ State Road/ Lot #(s)
,V c1 �6"A State ZIP210 S 13
F (�')�Q) S � 5) E-Mail
:ed Agent &N'Pc�vn k�b\ LIVA
❑ CW *W ;`PTA >f S XPTS
❑ OEA ❑ HHF ❑ IH ❑ USA /❑ N/A
PWS:
yes / • no) PNA yes /
f Project/ Activity
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ig permit may be required by: { 0 VJr 0k V�, b `^ K I( ❑ See note on back regarding River Basin ri
_ocal Planning jurisdiction) , I . I ,
MC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: S �AGV'-� Moog-e Permit* �-7 lot
Date: 0 (/oct /Z6 (�
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremei
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 fir
disturbance.
Excludes any
restoration anc
temp impact
amount)
(
"V
Dredge ❑ Fill ❑ Both ❑ Other
V
Dredge ❑ Fill P� Both ❑ Other ❑
Dredge ❑ HIM Both ❑ Other ❑
2 d
2 s
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 Q Other ❑
Dredge ❑ Fill ❑ Both 171 Other. ❑
Payment Proccessing Confirmation
Date Received 1 1/9/2017
heck From (Name) Holden Docks & Bulkheads
Name of Permit Holder Shane Moore
Vendor CresCom Bank
Check Number 3079
Check amount $600.00
Multiple Permits No
Major/Minor
Permit Number/Comments GP 67993D
Receipt or Refund/Reallocated SF3489D
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12/07/2004 19:20 9108429806
GREG HOLDEN PAGE 01
- 3-
DIVISIDN OF COASTAL MANAGE
ADJAQUff, RInRIAN PRDPERTT OMMER V-QTIPXCATION/WAIV'EL FORM
Name of Individual Applying For Permit: C
Address"Of Property: {O S ..e.
(Lot -or Stre`snt trect or Road, City & County)
I hereby certify that I own- property adjacant to the above -
referenced property. The individual applying for this permit has
described to me as shown on the attached drawing the develop ant
they are proposing. A description or drawing, with dimensions,
should be provided with this latter.
I have no objections to this proposal.
I nttidarstand that a pier, dock, mooring pilings, bamakwater, boat
hawse, lift _ • must be set back a mini=am distance of 15'
fray my area of ripnrl= access sunless waived by me. : (If you Wish
to waive the setback, ym =at initial the appropriate blank
below.)
I.:do wish to Naive the 15tsetback requirement_
I do not wish to waive the 15'setback requirement.
Date " s
,�d��
2/07/2004 19:20 9108429BOS
GREG HOLDEN PAGE 01
Name of Individual Applying For Permit:
Address -of Property: - 42
'or Strmat -f, Street` or Road, City & County)
I hereby certify that I own- property adjacent to the above-
rafer+anced property. The indfvidua2 applying for this permit has
described to me as shown on the attachad drawing the development
they are proposing. A description or drawing, with di=ensions,
should be provided with this letter.
I have no objections to this proposal.
I understand that a pier-, dock, mooring pilings, breakwater, boat
house, list _ gust be set back a minim= distance of 15'
fram. my area of riparian access unless waived by so. :(If you Wish
to waive the setback, you Mn initial the appropriate blank
below. )
52 I_ .do wish to waive the 15 t setback requirement _
i dg not wish to waive the 151setback requirement.
Data • ,e
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