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Home My WebLink About69337D - Ross�i�•`lk�.uJ R 11 LAMA / -]DREDGE & FILL .$� .0 q g IIENERAL PERMIT Previous p ermit # ' lew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued ized by the State of North Carolina, Department of Environment and Natural Resources ]Zoe))— ff 4, .��-�7c 0d 71), oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC attached. \Al '"' �f1,�5— � Project Location: CounI e(.: t� : Name J �ko1n Street Address/ State Road/ Lot #(s) �Ir 4viWlen� StateZIP770) 1 1''� Uy : t 0 E-Mail Subdivision {{ ed Agent llAC f W ( f�� Vl ` _ City O l� ZIP Ig ES ❑ PTS �-�r AK. p qG6L one # ( I'V) "7 1 — 1 bJ5 River Basin LV ❑ CW ,PTA ❑ ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body_( A e4(nat JA ❑ PWS: Closest Maj. Wtr. Body 1AAA� yes / n f) PNA yes 169 f Project/ Activity �A I b —� d A N dd (A Old i' 3 Gl iM �t G1'C ck) Iengtl_ atform(s) _ Platform(s) !ngth amber Ld/ Riprap length g distance offshc ax distance offsh hannel ibic yards mp use/ B atlift (Scale: , ' , limp nw .s AEI. t [�■ ■■■ ■■ l�1�1■■■�1■■■■11■■�■■1■�■ low . l';' ■■■■■■■■S�1`r�1;►L:1Il��5ila■■■�■■7�41�i�i�1■ v NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management 3t McCrory Braxton C. Davis John E. Skvarla, III 3ovemor Director Secretary AGENT AUTHORIZATION FORM AGENT AUTHORIZATION FuKm Date: G zl/ q me of Property Owner Applying for Permit: Name of Authorized Agent for this project: ner's Mailing Address: )ne Number (33G ).S /l % - 05rl3 Agent's Mailing Address: de Ale- Phone Number (WO ) 57T— Fk9 .rtify that I have authorized the agent listed above to act on my behalf, for the purpose of applying and obtaining all CAMA Permits necessary to install or construct the following (activity): OBE d- Rona to R.,�(.�� %,k f- R±Ma GQp.Onou-a b�4 A", r my property located at IYO 177m lone, S� ��.�ri S�Q Aka*Li , ,//G .2 wr s certification is valid thru (date) 9�301 / % T Property Owner Signature Date CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIP RIANtt PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: Address of Property:�l�Cl �� 5�, ()CQQ ►1S1S2 k�6 (Lot or Street #, Agent's Name #:G f ICEtlSi�U( �Iy� Agent's phone #: %!J- rJ-1,"go9,5 or Road, City & County) Mailing Address:UltUI� 30QCh & l N( 2,6%q 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. I have no objections to this proposal. _ I have objections to this proposal. if �ou/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. Correspondence 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 if you h" 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) SiQl1 at 1IY(' Print or Type Name U L (IAG) u r Mailing Address) City/State/Zip 3 ` t,'-� '7 - (I. r q -�z (Adjacent Property Owner Information) Signature Print or Type Name Mailing Address City/State/Zip CERTIFIED MAIL. • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIP RIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: �L� +5 Address of Property: A� 1 u br, (Lot or Street #, S i Agent's Name X—rict Agent's phone #: %nr rJ-N -9b9J (pa n.�su '61ix or Road, City & County) Mailing Address1k I� 6000A C— t 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 providedwith this letter. // 7 I have no objections to this proposal. _ I have objections to this proposal. If 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. Correspondance should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representetivos can also be contacted at (910) 796-7215. No response is considered the same as no objection if you large 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.) �L I do wish to waive the 15' setback requirement. �14 I do not wish to waive the 15' setback requirement. (Property Owner Information) ` "Yl&l S'gnahure Print or Type Name Mailing Address) City/State/Zip (Adjacent Property Owner Information) Signalw•e Print or Type Nafne Mailing Address City/State/Zip , /r. / //^_a/`7 /". A-0-0-,J�O, -�I�j L ■ 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: —V"6 v\ _--D A C' rA V�q kt r\Lj 21VASS A. S�jigna �/�'",� � X � t� a I El Agent ❑ Addressee B. Re eived by (Printed Name) C. D to of Yelivery D. Is delivery a d dt ferent from item 1? El Yes If YES,,got (very address below: ❑ No I III' III II I II I I i ( II III II III 3. Service Type ❑ Priority Mail Express® Cl Adult Signature ❑ Registered MailTI 9590 9402 2219 6193 1025 36 ❑ Adult Signature Restricted Delivery ertified Mail® ❑ Registered Mail Restricted Delivery ❑ Certified Mail Restricted Delivery 'EMeturn Receipt for ❑ Collect on Delivery Merchandise 2, Artinla Nllmher (Transfer from service label) ❑ Collect on Delivery Restricted Delivery 0 Signature Confirmation— Ll Signature Confirmation 7 016 0600 0000 8200 4754 Restricted Delivery Restricted Delivery etry PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt r Domestic -Mail Only 7 r For delivery information, visit our website NAY�filt{'t r NC 2145,15 ' Certified Mail Fee c J �JvvJ $ ^� Extra Services & Fees (check box, add tee pr re) ❑ Return Receipt (hardcopy) $� ] ❑ Return Receipt (electronic) $ 111 3 ❑Certfed Mail Restricted Delivery $ $1 I 1_�I II 3 ❑ Adult Signature Required $ ❑ Adult Signature Restricted Delivery $ Postage - $I�•`t` $ Total Postage and Fees L1 Sent ------- ---5-`-- �- tr 4� No., ��--Box No. -----t C, kc $fa i4c l 0 1�! ( 2 M I �: i_1471 I 11 Postmark Here 06/22/2i t1 7 ■ 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: r� 0 O IL ro O E3 0 1:3 O O 0 �D O r1__ A. Signature X Agent ❑ Addressee B. eived by (Pnn ed Na e) A. Date of Delivery D. Is delivery address diffPrPnf frnrn i+o 1,) 171 v