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Home My WebLink About69090D - SpringsCAMA / ❑ DREDGE & FILL q g lENERAL 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� j / f -' �� ❑Rules attached. : Name � (A ( J� SQ r'►Pn � < J t , Project Location: County V (W 5-K Z VA Rt*-4p✓1 l { State_ 1X ZIP 6 d� E-Mail ` ed Agent�� C�nS�vvC�l 0,�(�1 �b 1 Qgb..�3g1 ❑ CW AW PTA ❑ ES ElPTS ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: yes /Psi PNA Project/ Activity e x, z ck) length atform(s) Platforms) ! X 2 D iier(s) :ngth mber .d/ Riprap length g distance offsh e ax distance off ore hannel 3ulldozing l�o ne Length Street Address/ State Road/ Lot #(s) Subdivision — City 1-1'.e✓� l, ICt ( ZIP �1 Phone # River Basin LAW 1 Adj. Wtr. Body_ .i VW (19 /1 Closest Maj. Wtr. Body ftAIIAI (Scale: Town t4 i:6i nn �t*.c ' \ ling permit may be required by: . I ---I DI---;-- - ❑ See note on back regarding River Basin n I C I CAMA / DREDGE &FILL �TO69090 A B ENERAL PERMIT Previous permit# New Modification Complete Reissue Partial Reissue Date previous permit issued \s authorized by the State of North Carolina, Department of Environment and Natural Resources J ! ind the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC O 71 ), 1 � p o (} i ; Rules attached. ,pplicant Name c__ SQ1't� �sr• Project Location: County.__ kddress Street Address/ State Road/ Lot #(s) :ity_ h 'i_ 62iic'� .___.. State 14 ZIP_Ail�%_~ -�-dam ._.. ..... _..... 'hone # { 2 Z Z- O i1 _ E-Mail _ - - Subdivision kuthorized Agent _ j_. C.wth a N�.1 �I (a) 7•�4� City..�'T �1 . _lXt-�_- ZIP CW JAW PTA E5 PT5 Phone # (� v�t�.:J River Basin l .ls1M, �EC(s): OEA HHF i_,tH UBA N/A Adj. Wtr. Body, PWS: �RW: yes / A PNA yes /F9) Closest Maj. Wtr. Body Type of Project/ Activity 4 4U e t Yl 'Pl oG kvV del iic e .v n7 j _, o — -7 L, tr. i 1 /-N-I* .- n�t.vat VI. J A o1, n Pier�dock)length U Fixed Platform(s) _ FloatingPlatform(s) Finger pier(s)_ Groin length - — number Bulkhead/ Riprap length_ _ avg distance offsh e max distance off ore Basin, channel __ __ ___ cubi/ar Boat ramBoathousft S�v�Gwz� w(_ (Scale: c I 0a l rV Itat V , Bea Bulldozing NJ Other tame q kI C Axt l J wf�( Shoreline Length__�t_7_ SAV: not sure yes i �n Moratorium: Na yes i Photos: yes Waiver Attached: yes A building permit may be required by: �16WV1 at See note on back regarding River B,a_siir, ( Note Local Planning Jurisdiction) (_ L _ i�t ►' Notes/ Special Conditions r � 070.0i'r a to Alk !J! vt'' �r�UtL/ I aV 1 tr k4r*o-ArA North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue Braxton C. Davis Governor Director Dee Freemal Secretar AGENT AUTHORIZATION FORM Date: Name of Property Owner Applying for Permit: Name of Authorized Agent for this project: 2LCC- S�rIrN r5 .��. Owner's Mailing Address: _3Z(o E�z�-l-crso r�_ Dr; ve (l?ur, f1e- Beack ;. C- Phone Number( f(r}) ?-L2- 6oZe> "3 ZZZ 3653 Agent's Maflina Address:. H5= 2798 Sea Vista Dr, C"U"CDOM Supply, NC 28462 Phone Number (q16 ) �s 0 - 1;3 S'/ certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying or Ell obtaining all CAMA Permits necessary to install or construct the following (activity): p�^ is ce -(I n,-J t-,r h .,, I-Jnf L- �, n ,Y P /„/le n n A .4 C „" 10. :or my property located D rl e. 'his cAfication is valid thru (date) .3 - /s-- / 7- Owner ftnrliture Date ADJACENT RIPARIAN PROPERTY OWNER_ STATEMENT i hereby certify that I own property adjacent to Spot (� S property located at `5� . G.)1 ( a e of roperly Owner) (Address, Lot, �(ogkaid,on -Tr tAAX -eitg.) (Waterbody) (City/Town and/or County) The ap licant has described to me, as shown below, the development proposed at the abov locati I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fln in description below or attach a site drawing -f4a 49 V( —�6o 11/1(i�� ra cq&p y o x (4) '�'-1 Vaus Pjptoc.e t9oa-- h F M61Z6 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 e. (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. (to perty Owner Info on) Tatu ch Sarin Jr Print or Type Name 32.(, Paf+e- SoN Dr. Mailing Address ( jd4cent Property Owner Information) S' �rre Print or Type Name /ff tn!', WYing Amass ADJACENT RIPARIAN PROPERTY OWNER STATEMENT r I hereby certify that I own property adjacent to } C' � _ 1 '� _ (Name of Property Owner) property located at (Address, Lot, ockRoad, et ) on _ ( i� 1 in ( dfiV` 2o—C L , I (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the al focat� ion. 1 have no objection to this proposal. i have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must flit in description below or attach a site dra% �epjace evq �Z(5 fi 44 pr(G-t —Joc - ) �06ce' 906J rvnbfzry'� WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or c must be set back a minimum distance of 15' from my area of riparian access unless waive 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. P pay Owner Intor n)rt rathPrins or Type Name 3 Zt. Pa,++e.-r'so „) D t-. (Adjacent Property Owner Information Signature* Print or Type Name