HomeMy WebLinkAbout69142D - WilliamsonCAMA / DREDGE & FILLS u ,� A g
;ENERAL PERMIT Previous permit#
New —Modification El Complete Reissue El Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources C, /• ) �,
oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC } Yf W -
❑ Rules attached.
t(� �j f/
:Name 1^ 1`.1 �.)_Project Location: County
1-01) iS Street Address/ State Road/ Lot #(s)
State. ZIP I-5g6 5 j j is "
() E-Mail
ed Agent ��—� o J % ys
❑ CW ❑ EW ❑ PTA )(ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
yes no PNA yes / no
f Project/ Activity
Subdivision
City C k Ts•,w ZIP Y
Phone # () River Basin
Adj. Wtr. Body �r�` nat i
Closest Maj. Wtr. Body
•-CAC JA,h A t 'N � 5�� D �
ck) length j 3 X
atform(s)
Platform(s) I� XiA
:ngth
amber
id/ Riprap length ^—
g distance offshore
ax distance offshore
hannel
ibic yards
mp
use/ Boatlift
3ulldozing —
ne Length L0 7
not sure yes
>rium: n/a yes
yes
Attached: yes
ling permit may be required by:
(Scale:
I�
❑ See note on back regarding River Basin
6/1/2017
6/1/2017
6/1/2017
6/5/2017
a M0 17
e/,7 ------
TK Cable
Bank Check/Ingram Walters_
or Lathe Pierce
T. Farmer/TRA COM Services
.nnett
:to Marine Construction _
ack Marine Construction__
ending at Snows Cut/Donne__Gurga_nus.
tics Constna:tion -
u/1i;
$200.0 UP_55113D
Kelly and Thomas Williamson
BBB&T _ __
-
_
2725
_ _
_
5200.00 GP 891420
same
---
BBBT
- --
5009388848
$200.00 GP 69185D
same
BBBT
— ___-._T_
5712
$200.00 GP 89221D
Harold and Meredith Muse
-
_ _ BB&T
-
4908
$200.00 GP 89223D
Jeff Lowry -
Coastal Bank & Trust
632
GP 69178D
Mark Cnssey _
First Palmetto Savings Bank i
3430
_ _$600,00
$200.00 GP 69230D
John or Tracy Kane
- -
SunTrust
-- -
_
4836
- -
$400.00 GP 69229D
same
_ First Bank
-
30088078
$10&00 renewal fee MP 68-07 NHCo
Mary LacLeod
BB&T
775R
-- einn nn min.. — ew-- o. MA- -&
�M NC Division of Coastal Mgt. Habitat Impact Com
Applicant: 6���Y �-TL �X kw1jNX
Date: 705 SW 15q. ( jllC�
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
FI
(Applied for.
(Anticipated final
(Applied for.
(A
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
di:
Habitat Name
Choose One
includes any
Excludes any
total includes
E)
anticipated
restoration
any anticipated
re
restoration or
and/or temp
restoration or
to
ternimpacts)
impact amount
ternimpacts)
ar
Dredge ❑ Fill ❑ Both ❑ Other
24
Z
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
k-YA1 -/- �Iljo� ZQe-
Phone Number: �% �5 4- ��� V0-
Email Address:
I certify that I have authorized
ct nt / Contractor
to act on my behalf, for the purpose of appiyir and obtaining all CAMA permits
necessary for the following proposed development: Pc IL- qLA(k Me P N
PdV a A109LGhT IOA�
at my property located at G
in LLn < zt) j� (k County.
I furthermore certify that 1 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:
i
�dZAWVA-
loy
Signature
Print or Type Name
Title
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: y`��—/��� , (A_
Address of Property:�� )
(Lot or Street #, Stre
Agent's Name #:
Agent's phone #:
or Road, City & County)
Mailing Address:
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 provided with this letter.
Nt _ 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. 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 have 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.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Print br Type Name
ZQS 5_X
Mailing Address
(Adjacent Property Own e .Information)
Signature
k-,
Print or Type Name
20-3 � ► ��
Mailing Address
ID
A, it . N - - l -
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 11 bMw, U z tcvw� c's
(Name of PropertyOwner)
property located at c�U S S �� l - n at— i c v , NL
on
(Waterbody)
(Address, Lot,
. in i
NC
(City/Town and/or County)
, N.C.
The applicant has described to me, as shown below, the development proposed at the above 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 fill in description below or attach a site drawing,
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set bai
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to w
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.
(Propert Owner Informa ' ) (Adjacent Property Owner Information)
f �
gnatur Signature
' Name �l� i� Ddha
r Type
Print oe Print or T e Nam S
Mailing Aodre$s i J Mailina Address