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Home My WebLink About68517D - RukenbrodCAMA / ! J DREDGE & FILL IiENERAL PERMIT New —Modification —Complete Reissue Partial Reissue 08517 A Previous permit # Date previous permit issued B zed by the State of North Carolina, Department of Environment and Natural Resources :)astal Resources Commission in an area of environmental concern pursuant to 15A NCAC t)� �� n ou j� �/ j ❑ Rules attached. Name i "'fi F- &Y<&�, �h'fo (! Project Location: County "� kw ( K y f � )AVI'1 - Street Address/ State Road/ Lot #(s) M 1 t1, State ZIP �2� 1 �I A i l i I 1 �. (^ �Vt slti) . ("o ) `o -13 1 E-Mailer w f rw`�Jr�'1 w�`'0'�S•(v1M Subdivision �d Agent Vane. Mo � I-e A.. AMcA dlV1�!' — City sj 0 �- ZIP ❑CW <EW —D A ❑es IP�rs "M a3 L� Phone # ) q�u ��2'ZS'� O ( River Basin -UV1,\ ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body A f 0 f *� �, (atl/rr ❑ PWS: ` �T es / A PNA yes / � Closest Maj. Wtr. Body Project/ Activity n v ��" C.1 C I ►V\ !, C4 t l�a 44 & A- (Scale: 0 !en-h ■■■■■■■■■■■�I■N■■■■N■■■ ■■/�■ 'latform(s) SOMEONE ■■■■.■■■■■■...■..■■GI■■..■■.■.■■■ iber- ■■■!!!•■ill►ll�l■■■■■ice■■■...■■■.■■■■��. ■■■w■■■■■■!9■■■■■■■■■■■■■■■EN! ONE ■_■■■■■■�■■■■■■■■■■■■■■�:l��■■■■■■■ .c yards ■■■■■■■■m—ppU i% ..lIifim re.WOM■I■■■■■IR10MR*r]■■ ■�ii��lll�■Cil■I■H■/its■■■�■■■■I■■■■■iiYi1'�/irrl■■ Ildozing ■■■iili■il■■% ■■iY�!w�l■■■�■■■■■■■■■■■■■■ ■Ifir��l■■■■■■■■�11■■■■■■■■��ti■ilili�ii'li{►r'IiIJ ■1�1■tEz1J4!!]■■!� :i�ll��■■ ■■H■1��tti1R�■lCQR . •• •.. ■1,�■�11�7■■/9■■■111�11�7■�i�'="�!■■I■■■ ii1�WW�lfii■ili ■ill■alv ■�i�■/�i■i�■��I��r��i1i��iH■■■■�■■■■ � ■■■■■/Ili ,J■i� _.__.�..�� ■■��:lid■■■■■■N®■■■■i"r■■■�■��15►!L�ii�>1■■ �■till]!iW■■■■■■■■■■■■■■■iJiSL3ill►'C�■Ji��■■■ ,� . ■■■N■■■■■■■■■■■■■■■■■■EL■■■■■■■■■ ig permit maybe required by: 1 oV 1 ❑ See note on back regarding River Basin rL .ocal Planning Jurisdiction) . I I t , AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit610J Mailing Address: Z32� Qu� n C&f 4 yl-�iL Y/d I 4je- ? Phone Number: 70y— 03q- q39I Email Address: Tt r�Cd G�i^-5JIn41C;V- w�-i IAA$ . KO I certify that I have authorized Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAy`M,�A permits 1 necessary for the following proposed development:R4 � at my property located at h in rA � County. I 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: Signature W &Ido PI't/� Print or Type Name Title CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Vame of Property Owner—i-P d{ ' \ddress of Property: ) yy& M 111: (Lot or Street #, Stre \gent's Name #: \gent's phone #:�U"a3�-a,�7 OA 14J,1,1SbJ or Road, City & County) Mailing Address: hereby certify that I own property adjacent to the above referenced property. The in ivi ua ipplying for this permit has described to me as shown on the attached drawing the development iey 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. 'you have objections to what is being proposed, you must notify the Division of Coastal Management )CM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is vaiiable at http://www.nccoastaimanagement.net(web/cm/staff-listing or by calling 1-888-4RCOAST. 'o response is considered the same as no objection if you have been notified by Certified Mail WAIVER SECTION understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must sat back a Yninimurn distance of 15' from my area of riparian access unless waived by me. (If )u wish to waive the setback, you must initial the appropriate blank below.) -'O�el I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. 'roperty Owner Informati n) gnature int or ype Name Information) Wing Address Mai6nn drlrlraec CERTIFfED MAIL •RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM dame of Property Owner. kddress of Property: �� M 1 N 4Cn�ty)�'�� (Lot or Street #, Street or Ro d, City 8, agent's Name #: mO''I"� Mailing Address: qa nyei) GL %gent's phone #: �1 �" 02 - -') 5 30 _ ig0m'04W /V& 02V Y y 3 hereby certffy that I own property a lacent tothe above referenced prope e m iivi ua 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. ff 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.nccoastafmanagement.neVWeblcmistaff-listing orby calling 1-888-4RCDAST. No response is considered the same as no objection if you have been notified by Certified Mail. 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.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Signature Print or Type Name AA�;h n Arlriro (Riparian Property Owner Information) 74 Si tur Jb Rz 9 _"f5 � Print or Type Name rr;' '� / , 7 ,D Mailing Address J _ , r , t : ��. ', l � tN� �..:� �'t% �� -�t��a� �� r ��R��:� �� .� ,.,... ._ ■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ 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 -narA , .,—;t,. • ry.wic nuure55eO to: �F/2/1n15 C�ocK y� Sti�lldf- a SyTv - •-•, ——U'1iarenttrom item 1? u Yes If YES, enter delivery address below: ❑ No 4.I III I III 111111111111111111111111111111111111111 3. Service Type 1315ertified Mail' ❑ Priority Mail Express," ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail 171 n.11—t— 7015 3010 0000 7848 8600 vy PS Form 3811, July2013 Domestic Return Receipt ■ 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 Addressed to: A. Signature n , , A�a' ❑ Agent dresseedressee B. ived b�. rirg (Name) C. Date of Delivery ��!�l t JJ�SZI I D. Is deliv,6ry address different from item T? ❑ Yes If YES, enter delivery address below: 0 No