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Home My WebLink About69241D - Woodall�1 4CAMA / DREDGE & FILL 3ENERAL PERMIT Previous permit# A B New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued irized by the State of North Carolina, Department of Environment and Natural Resources �1 Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 0_1 �! 4k a Rules attached. it Name_ (7b� W i �II Project Location: County �� wy ►� �t4A7f L� _ qA_ if I G\ Street Address/ State Road/ Lot #(s) —� State ZlP N L N `'l 4)6m � 4, qq) �� E-Mail Subdivision I , ted Agent a u/i ( City l V k ZIP g� ❑ CW [�ktW PTA ❑ ES ElPT /VVAPhone 4f '( �M 11 q H g q d O River Basin ❑ OEA ❑ HHF ❑ IH ❑ PWS: yes /Ao PNA yes / f Project/ Activity �x s} v Eck) length ❑ UBA ❑ N/A Adj. Wtr. Body C (nat i Closest Maj. Wtr. Body J'fl 110 (Scale:) I �/1� �iZiir'�i■■■�■�■■■■■■■■■■■1 ��■■�Gp!■,w!_ ■ ■■ Wa ngth■■■■■■■0■N■ rnber■■■■■■■■■i■■■■■■■■■■■■■■■■■■■■■■■1 ME �LEMINMEMEMMI■■■■■■■il �i■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■1 �Now ■. ■M■■■�.■.I■■■■�w■�■■��■■� ■■■■■■■■��■■■■■■EM■■■■idol■�■! ■'�■■� ■■■■■■■■■i■■■■■■■■t■■■■■■■:ri�ii�i�iiii iannel �1i�I�Jii■■■■■■VA1l1■■ ��yards �7.1■�■I■Mo E I■■it■■■■O■1 Wit■ np ulldozing ■■■■■■■ , `!�! �11�1■■�:�I■ill■■■■■■■■■1 N■11■■■■■■■■■1 ■NEON W.- IN■�1■�■r■��■�� M� ..�11i1■li�l.■rll ■■llf■ now 111lL�l■■■ ■■■I■■■■I■l1tIN111110 lNl■■!1 1■!:■■iN iw il�i■!I■■�1■rl■��■IY■■M■■Yr1 ■■mom ■■� ■■■■■■■■■■R'!oi■■■1 i■■■■■■■■1 11111101M MEN W.■■■■■■■■■■■■■' a■■■■■■■■■■ im■■■■■1I■■■■■■■■■1 ■ ■■1■■■■■■■■1 ■uJlilM�la 0 ■■■■■■■■No ■■■■�■■1!■/i11ARRO��FAFAMI a Length • not sure yes . ■1■■■.Or. LI■■■■■nTZ711,■i■ r 11191 �I■■li■ Ji�r■■Il■1 �1KFAIM i■■■li■■■■■lid �1W611aLk�:IL�'■MIi MEN ■!WL!11\ll ■i■■■■■■■■ ■■■■�■rl■■■■■■■1 NVINJL'�t� &KA VJi - : ■■■■■■■■■■ ■■■■■■■■ :■■■■� ■�■■ :■■■I J ■■■■■■■■■■i■■■■■■■■■■■■■1■�■■■■■■1 " T L � ng permit may be required by: � (��/y► Q T Mr�< C t Local Planning Jurisdiction) 1 11 1 ❑ See note on back regarding River Basin r l NC Division of Coastal Mgt. Habitat Impact Coml Applicant: T-ml(/ .6 �} d G✓�� CC i Date: iJ('� Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement found in your Habitat code sheet. TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FII (Applied for. (Anticipated final (Applied for. (Ar DISTURB TYPE Disturbance total disturbance. Disturbance dis Habitat Name Choose One includes any Excludes any total includes Ex anticipated restoration any anticipated res restoration or and/or temp restoration or ten ternimpacts) impact amount) temp impacts am / GN Dredge ❑ Fill ❑ Both ❑ Other 0kr"1 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ IV Pa: McCrory 3ovemor Zvi ��-f.-��s��isaassi�a • CDF- HR North Carolina Department of Environment and Natural Resources N.C. Division of Coastal Management John E.Skv Secret AGENT AUTHORIZATION FORM Date - Name ofProperty Owner Applying /for Permit. Nar^e 3f Authorized Agent for this project Owner�ng ddress Z �p Agent's Mailing Address: Igoe .r t Email I _ Email �- n S211 E , yh& C Phone ` l j itq, �qq? Prone -R JR I certify 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 Fo, my property located at This certification is valid 1 year from (date) �- ,2 CERTIFIED MAIL • RETURN RECEIPT REOUESTEb DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner ),ry �, I kQ Address of Property. T (Lot nr S1reei rr b er 0, Kaac ury a County) Agent's Name x L.AA,.e f /I l4ti Mailing Add+ess Agent's phone I hereby certify that I own property adjacent to the above referenced property The individu applying for this permit has described to me as shown on "W attached drsl"flig the developmei they are proposing A Q+'sGrtDiron or d�8wrno with dEmensions must bA .,M IC190 w� i tuh d+v� iha tBcrbr �y "114I�' . I hsv� n<� nb�ectiurs 10 t3tis prol%r- i, I htavc ubjcclions this proposal. 1A `'rr fI you have 04000ons to what is being proposed, you must notify the Divrs/On 01 Coastal Aifanag#mant (DCU) wdUng within 10 days of receipt of rh,s notice Correspondence shouts/ be mailed to 127 Corell a, DNva Ex WNrnlnpton, NC. ?Bops 3Ao5 DCM representativos Can also be contacted at (910) 796.7215 No response considered tho same as no ob ection tt ou have been notJfrod b :&WIlad Mail WAIVER SECTION I understand that a pier, dock, mornr►ng 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 WI$h 10 WBivt: the setback you gust initial the appropriate blank below i do msh to waive the 1 setback requirement I do not wish to waive the 15' setback requirement (Proper�n7,prmI (Adjacent Property Owner Info ationl $igJtltittrr' .Sr),�tuuure 4adtle Print of Type Name rint o, ype Name 1 I hereby certify that I own property adjacent to.tf� rD,^f:=_ S �, ;2 ame cif P any Owner) property located at d s? ,Ay A� k��, r �o ddress. Lot. Block. R . etc.) r on A Nr • .,e -, zjcawr ry i L iC.o0S , N. C. (Waterbody) (City/Town and/or Countvl The applicant has desoribed to me, as shown below, the development proposed at the above )4ocation !' I have no objection to this proposat. I have objections to this proposal, DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Indrvidus,t proposing development muse Tell in description below of sttacb a site drawing) WAIVER� =9MVN 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, 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. ti (Adjacent Prop" Owner htformatlon) r -1 (_a tk %:ri.U(_ 2-71605 ry alA 1 �Sr-