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Home My WebLink About69118D - Temple(CAMA / . DREDGE & FILL �ENERAL PERMIT ew -Modification ❑Complete Reissue ❑ Partial Reissue A Previous permit # Date previous permit issued rized by the State of North Carolina, Department of Environment and Natural Resources �I j ! • �, _oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC r 1 it Name 11f rV+ 1i of - Y1AVRV1' �,Q U��► State_ ZIP Z C'V (U) E-Mail :ed Agent P ❑ CW A ES ❑ PTS ❑ OEA '❑ HHF tH ❑ UBA ❑ N/A ❑ PWS: yes / PNA yes ❑ Rules attached. Project Location: County liU� l.4 t!a i 1 tVf V, Street Address/ State Road/ Lot #(s) 21 G C14 41VQ Subdivision City L' lU &Uffi ZIP S Phone # ( ) Z 1 LP 00Z River Basin OAP� Adj. Wtr. Body 1 C Closest Maj. Wtr. Body Project/ Activity 0d1 Li eyI�l1�t Tft,&'1ii,ta A(V GC. t d hna+ 114 (Scale: I ck) length 1% :. - ■ ■ s■■■w■w■�w�lw�■■r�■w■■■�■■1 ■■■�IIWIYii■■■■■■■■A■■■■■■C■r■1 CC ICC'CCCCC�CCCCCC�CCCCCC�CCCI ■ ■■i■/!■■ OEM ■■■■M■■1■■■■■■■M■■■1 ■ ■■■.ul■■■.. 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IIl1 !■�■I l■w■■ldN UOL ZU • , �� 1l!!wt iW . ,,�� ■ ■ I/'wtl!AI�IIRIi11110mm"M �iC■■`lritl,�1■ !. lid Illo d�Niiili�lil idww `� I.■EF:2nm.rWIT.A: --�■■■■�I�Ir■ , �2 f- ig permit may be required by: YL' > l� ��'� f I,t 9(a (A ❑ See note on back regarding River Basin rt _ocal Planning Jurisdiction, • , , Pat McCrory Governor NCDENR North Carolina Department of Environment and Natural Resources N.C. Division of Coastal Management John E. Skvarla, III Secretary AGENT AUTHORIZATION FORM Date: 151A^P012DO N me of Proper%Pwner Applying for Permit: Name of Authorized Agent for this project: Owner's Mailing Address: Email: /ire"kain Phone doSl L Agent's Mailing Address: AV. `"'rightsville B ach, NC 28480 Email: (910) 256-3062 Phone ( 1 I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying the following (activity): For my property located at �)Id jvi 6A 4)4481 kl This certification is valid 1 year from (date) 15T 3-tet� Prope4 Owner Signatu Date f &sAdwo aeow4l%. P.O. BOX M Wrightsville Beach, NC 21 pi 0) 256-3062 /J(A n� JU I �?_h' (�' vA%M -Fa j IF gib feet 100 meters 50 CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY DOWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: DA. Address of PropertyJLp (Lot or Street #, StAt or Rdid, Eity & Courrty)) ,( Agent's Name* L%�` M!� Mailing Address: / Agent's phone # l I hereby certify that I own property adjacent to the above referenced property. The individual aplying for this permit has described to me as shown on the attached drawing the development 4-'hey are proposing. A or dtsnair►D wi#h dltnensi must be provided with ttua ier. I have no objections to this proposal. I have objections to this proposal. tf you have objections to what is being proposed, you mast nofNy the Division of Coastal Management (DCM) m writing within 10 days of rece0t of this notice. Comsspondence should be mailed to 127 Cardinat Draw Ext., INUmington, NC, 28405-3845. DCM representatives can also be contacted at (910) 79&7215. No response is considered the same as no objection gym have bee» noti ied by Ceri//Fed Malt. WAIVER SECTION I understand that a pier. dock, mooring pilings, breakwater, boathouse, lift, or groin must be set Pack a minimum distance of 15' from my area of ri risn access unless waived by me. (if you ish to waive the setback 1 do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Pr Owner Information) et MMLO wner Inforrna MAn .v Signature Signature lae►ystxa�� K. 2(w,,z L� L-• 61K Print or Ty Nam Print or Type Name ;lU AJ, ehosAd 4x. su;Ji, 2o) Mailing Address Mailing Address "iftlig 9WA AJ4 VVL% 2&\ - W toos LWOW CitylStatw0p CitylState2ip �1t. 911- Telephone Number Telephone Number , ), G/ 0 JW) �� L- CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: DA. (+pk Address of Property: �1D � j `'1 1N [/A P4 few', (Lot or Street #, Str t or R d. City & County Agent's Name #: L--/'"`��% Mailing Address: Agent's phone #:Jbp a �,tl'�. / �'�� I hereby certify that I own property adjacent to the ahove referenced praperty. The individual applying for this permit has described to me as shown on the attached drawing the development ey are proposing. n '^�t►on or draw+ng with dimensions must be provided with this "or. X _� I have no objections to this proposal. --- I have objections t.) this proposal. tf you have objections to what is being proposed, you must notify the Division of Coss to) Management (DCM) in writing within 10 days of receipt of this notice, Correspondence should be mailed to 127 Cardinal Drive Ext, Wilmington, NC, 28405-3"5. ocm representatives can also be contacted at (910) 796-7215. No response is considered the same as no objection if you have been notHled by Card- Red-0-al-1- WAIVER SECTION r h I understand that a pie,-. dock, mooring pilings, breakwater, boa ouse, 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. (Pr rty Owner Information) (Adjacent Property Owner Inform ) ,Signature J Sizn!rture `— hm Print or Typd Na Print or Type Name I u, aim kx. Mailing Address al ,-*i �Jt, 2011, Citylstala0p aI d J�I,G�irrr�liling Address d le pr7yi% City/State)Zip Ito-aN� qw, TulcrnhnnR NumhAr