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Home My WebLink About68025D - Pearsall!CAMA / ❑ DREDGE & FILL 1ENERAL PERMIT (New ]Modification ❑Complete Reissue ?vA 3,),►-1 El Partial Reissue _8025 A Previous permit # Date previous permit issued B -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 ❑ Rues attached. t Name M 1 � ky, �a Project Location: County —nj YVV i G`t c (A -ab ,; )od &—P{, Street Address/ State Road/ Lot #(s) t'11�i w� ! 0AVCVA State JQ_Lzi 7 (p 1� t� CA0 ( jZ—IE-Mail Subdivision ed Agent ( (A4WC0'V V\ City'fCtCh ZIP ❑ CW 'XPTA ❑ OEA 6 HHF ❑ IH ❑ PWS: ❑ ES ❑ PTS ❑ UBA ❑ N/A PhPhone 0) _ b River Basin rok Adj. Wtr. Body C &V1 nat r i-1----. M-: %Al- O-I.. Ian Y' I X., - ff t � I Il A igth ::■■■:■■■:■■�■::■�■::■■:::■■■::NOJ NOR ■:■■■■EEE■■E■■■■■MU:::N ::«NU::::N ■■■■■■■■■■■■■ 11■!Ciiiil��li i 1.4■'�i111■■/1!1■■■!1■■■� ■■■■■■■■■■■■■ rir■V:u::�r■■■■■':;�ii!1►��71:I■�:�� ■ NONE■■■■� s 11'i■■■■1 i■■■E"■E ��.�, 0■EQN� MEN ®■■EirErpaf ■■■i■■i■�iNE�1 ■"■■■E■■■■:: B■■■:N N GZINNU■■EMENE■:EN Length notsure yes ■■■■■■■■■■■■��►s■■■�uE3a■■■■■■�■■■■■■■■ ��'nip■■■E�i■■■Ei■■■Ei1i��.+, ��niri�.�,� ng permit maybe required by: Tin of �\/VI�{a(,�, ❑ See note on back regarding River Basin ri Local Planning lurisdictionl .f 1 _ I r, NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: %� h U✓�,Q Permit #: Date: 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 tempimpacts) FINAL Sq. Ft. (Anticipated final disturbance. Exdudes any restoration and/or temp . impact amount TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or tempimpacts FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount , / w `� Dredge ❑ Fill ❑ Both ❑ Other 6 'So l 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 [I Dredge ❑ Fill ❑ Both [] Other ❑ Dredge ❑ Fill 0 Both ❑ Other ❑ COMPLETE• ■ Complete'items 1, 2, and 3. 7A.Sign■ Print your name and address on the reverse Aix t, A Agent so that we can return the card to you. ►A ❑ Addressee ■ Attach this card to the back of the mailpiece, B. Received by (Printed ame) C. Date of Delivery or on the front if space permits. C S b GY \ 4 1. Article Addres ed to: D. Is delivery address different from item 1? ❑Yes If YES ery address below: ❑ No 76 7 J 111111111 IIII 111111111111111111111111111111111 0, Adul►S gnturee Restricted Delivery ❑ Re�°i Priority M lles®te N 9590 9403 0603 5183 4334 76 ifibMail® Delivery u7 ieMelt Restricted Delivery Return Recelpt for ❑ (ct�on Delivery erchandise 2. Article Number (Fransfer from service label) _. ❑ Collectn Delivery.Re�dpt livery ❑Signature Confirmation*M �_ ❑ Signature Confirmation i 7 015 0640 0006 36 2 1829 .ad Delivery Restricted Delivery L LL to PS Form 3811, April 2015 PSN 7530-02-000-9053 Domestic Return Receipt L v 0 CD E to o E o 6c")A rUU�U CD CD CD CD a cfl to r— C7 'u o Ca m m I Domestic Mail Only ru ca FIRM I -A HI BQ Ot�i> i 2 2A rLi <t ca Certified Mail Fee $3 . 30 -0 $ m Extra Services & Fees (check box, add fee 9- }p. te) ❑ Return Receipt (hardcop» $ 7l� ❑ Return Receipt (electronic) $ Sri _ I If 1 O ❑ Certified Melt Restricted Delivery $ so Do E3 ❑ Adult signature Required t ❑ Adult Signature Restricted Delivery $ O Postage $0.47 s $ Total Postage and e o I$.47 s - t17 Sen o_ ly pry' 4 L \\t1 ■ Complete items 1, 2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article AdPssed to: 1 047i I 09 Postmark Here 12/20/2016 D. Is delivery addilffss different from itern, If YES, enter elivery address below: A_ ❑ Agent ❑ Addressee Date of Delivery KWA NCDEENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis Governor Director John E. Skvarla, III Secretary AGENT AUTHORIZATION FORM Date: 'Z_ 01- l ame of Property Owner Applying for Permit: N e of Authorized -Agent for this project: �110-a rA Waczt(A (% �U wner's Mailing Addre - Agent's Mailing Address: 1 Phone Number ��V) -► -LV�S ;ertify that I have authorized the agent listed above to act on my behalf, for the purpose of applying it and obtai ng all CAMA Permits necessary to install or construct the following (activity): 7«k or my property located at V� -- CCir -, C. k his certification is valid thr11:Z , Property Owner Signature bate n USPS.com® - USPS Tracking® Page 1 of English Customer Service USPS Mobile USPS Tracking® Tracking Number: 70150640000636821829 On Time Updated Delivery Day: Thursday, December 22, 2016 Product & Tracking Information Postal Product: Features: First -Class Mail® Certified Mail- Return Receipt See tracking for related item: 959094U306035183433476 December 22, Delivered, Left HILLSBOROUGH, NC 27278 2016 , 10:14 am with Individual Your item was delivered to an individual at the address at 10:14 am on December 22, 2016 in HILLSBOROUGH, NC 27278. December 22, 2016, 8:55 am ry Out for Delivery HILLSBOROUGH, NC 27278 December 22, 2016, 8:45 am Sorting Complete HILLSBOROUGH, NC 27278 December 22, 2016,8:42am Arrived at Unit HILLSBOROUGH, NC 27278 December 21, 2016, 3:18 pm Departed USPS Facility GREENSBORO, NC 27498 December 21, 2016, 9:53 am Arrived at USPS Facility GREENSBORO, NC 27498 December 21, 2016, 2:13 am Departed USPS Facility CHARLOTTE, NC 28228 December 21, 2016, 12:50 am Arrived at USPS Origin Facility CHARLOTTE, NC 28228 Register/ Sign In V.;USPS.Cn '• - . CERTIFIED MAILP RECEIPT ru a • . Only ro rq AL USE ru.. t9 Certified Mail Fee $3. 30 047( .0 $ ftl Extra Services & Fees (check bow add be IT aoparr+are) .A El Hato_ Receipt (hardcopy) $ ❑ Return Receipt (electronic) $ I • - I Postmark O M ❑ Certified Mail Restricted Delivery $ i Il _ I 1 u Here O ❑Aduft Signature Required $ []Adult Signature Restricted Delivery $ O Postage $0.47 -D $ 12/20/201t C3 Total Postage and %7 4.7 ib $ r� S To e e.-) M Str e a dN. Np R --- - --- -- x7o / ------------------ Email Updates CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER `NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: ,�� .� CC�r\q1 5u n�C r 1 (Lot or Street #, Str et or Road, City & County) Agent's Name #(L�-1C� &) Mailing Address: l� Agent's phone #:1 J' 5-1q " ' Oq 5 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. ?_ have no objections to this proposal. I have objections to this proposal. fyou 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. Correspohdance 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 ffYOU hive 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. (Property Owner Information) (A 'a t Property Owner Information) r n Signature Si ant t n e P int or Type Name - Yp t or pe Name U� a�� tau �k _ PC), aox 24. 1 -- ailing Address Mailing Address City/State2ip City tate2ip 7—� L-LL7 \-\'I ,z_h P�