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Home My WebLink About76507D - SandlinCAMA / 11 DREDGE & FILL ;ENJ:-RAL PERMIT New ❑Modification ❑Complete Reissue ❑Partial Reissue N° 76507 A B Previous permit # Date previous permit issued ized by the State of North Carolina, Department of Environmental Quality V� f I oastal Resources Commission in an area of environ ental concern pursuant to I SA NCAC LJ i V �'� / �a� /=_ l� Au�ttachecl. Name ` c/ Project Location: County t/� -C/✓ Street Address/1Staatte Road/ Lot #(s) � ✓/ AState Gas ZIP S/� T 1 (J � l %-3 f%/'9) W74'WZ3e9E-Mail Subdivision -d Agent /`�/J� City �r ZIP ❑ CW J EW )dPTA ❑ ES ElPTS ElOEA HHF ❑ IH ❑ URA ❑ N/A ❑ PWS: fes /C,� PNA yes Project/ Activity k) length_ tform(s) _ ?latform(s) gth fiber / Riprap I distance c distance innel is yards P l r` X Z 3 Boatlift Ildozin Length IIr— S a not sure yes im: n/a yes yes ttached: AfesTno Phone # ( River Basin I G Adj. Wtr. Body /U C- �/� na /n Closest Maj. Wtr. Body. &6 � (Scale: g permit may be required by: % —VLJ Cf� L41 ❑ See note on back regarding River Basin ocal Planning jurisdiction) AGENT AUTHORIZATION '.FOR LAMA PERMIT APPLICATION Name of Propeq Owner Requesting Permit:2e_0rn Mailing Address: _�>k0.0 C_ Phone Number: (A w - sqo- Email Address: etx� 4 cv, I certify that 1 have authorized Agmt 1 Contractor to act on my behalf, for the purpose of applying for and obtaining all LAMA permits necessary for the following proposed development:, at my property located at L io -� `j in County. I furthermore certify that I am authorized to grant, and do in fact grant permission to DMsion of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in -connection with eva eating infonnation related to this permit application. Property Owner Infomation. ignature p int or Type Larne V"-( Tide CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MAMIGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIYER FORM Name of Property Owner; � �� e�c-�.c �— (�� c+ Address of Property: I -EA (tot or Street #, Street or R6ad, City & fit+) Q Agents Marne ##: to � ; :-.Q MaiingAddress. 1� C) c-.z Agent's phone t l hereby certify that l omi property adjacent to the above referenced property. The individual applying for this permit has descnibed to me as shown on the attacked drawiru,Lthe devaeJopmKI! they are proposing. A description or drawing with, dimensions, must be ProMed with this letter. _ ✓ I have no objections to this proposal. T have objections to this proposal. ffyonhaveoAWfionstoa tls,betqg~osed,younrwstrwftf?mBfWsbnof ltanagernent(DC1Jio wrfiing wfOdn 10 days of receW -of this holies- a C:nrresparrdsnce shwid ibe mmikd to 127 Cardiina! tie K Yf+f►mirtgiarr, NC, Z8 0 3t: & DCU n pnewnftVms mn also be codatted at IWO) 796-7215 No respwn is considered the same as no abjection if you hays .been notifrect by CvMd Mat WAti#ER SECTION J understand that a pier, dock, rnoori V pkgs, ,breakwater, boathouse, list, or groin must be set back a minimum distance of 15' frDm my area of riparian access unless waived by me. {If you wish to waive the setback, you must JMU the appropriate blank below.) y I do wish to waive the 16 setback requirement. J do not wish to waive the 9 5' setback requirement (Property Owner Inforrnatiion) si�r�e Prin# or Type Name I o : (�L C �<- ,�? k a CA, Maftg Address (Adjacnt Property Owner Information) sip Print or Tjpe Name 5 � C\ 0 ll+failing Aftew M CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM Name of Property Owner: Address of Property: L c4 r c—rDzrn5 {Lot or Street #, Street or Road, CITY d County) Agent's Name #: 'Mailing Address:�9- AgerWs phone #. I (X-SL r\ C. I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to rite as shown on the attached thawing the develolm*nt they are proposkV. A descrrnbon or drawing with dimensions roust be Provided with this letter. -OL1 have no objections to this proposal, f have objections to this proposal, If you /we oboctons to what is ;being proposed, you must notify the Divj6on of CoastalAt wwge ment (DCM) in writrng within 14D days of receipt of this .notice. ,Correspondence should be mailed fo 127 Cardfnai,Drive Ext., Wilmington, NC, 28405-3845. DCA} representatives can .also be contacW at (910) 7W7215. No response is considered the same as no Objection if you have been notified by CartifiedNail WAJVER SECTJON J understand that a pier, dock, mooring pilings, breakwater, boad ouse, lift, or groin must be set back a minimum distance of 16 from my area of riparian access unless waived by me. (If you wish to waive the setback, you ffms_ tt e, appropriate blank below.) I do wish to waive the 15' setback requirement. J do not wish to waive the 15' setback requirement. (ProPerV Owner Information) fAdjacsnt Property Owner Information) c Wgnalure J 5'ignarwe 'nnt or Type Alaarbe � o -<::� 1 `l \ ,c' L fading Address Pint or Type Name �3 -jbMs D MaNng Address Pender County GIS 2(2, 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. Article Addressed to: A. Signature (/'�� y t l t I 1 V (� 0 Addressee X A Addressee B. Received by inted Name) l C. Datenf D jivery D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Priority Mail Expresso III III I III II I III I Iilil I I I IIIII I II III ❑ Adult Signature El Adult Signature Restricted Delivery ❑ Registered Mail'" ❑Registered Mail Restricted II I IIIIII ❑ Certified Mail® Certified Mail Restricted Delivery Delivery El Return Receipt for 9590 9402 4641 8323 6418 77 ❑ Collect on Delivery Merchandise Restricted Delivery Signature Confirmation T" n i�lo �I,, ho rr �f r fry �o�, �o lotion ❑ Collect on Delivery sured Mail ❑ Signature Confirmation - - 7 018 2290 0001 7300 6321 sured Mail Restricted Delivery Restricted Delivery er $500) PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt Postal IED o RECEIPT �il• nly � .. OnlyPam pp�@Fy BuKbAw r :W; ;entfled Mail Fee $ cc O 7 25 I_I5 Ara Services & Fees (check bar, add fee gjTpj j9te) 1/ � ��JJ�� ❑ Retum Receipt (hardcopy) $ 1 1• 0 0 rq ❑ Retum Receipt (electronic) E ❑ Certified Mall Restricted Delivery $ Postmark C3 Here O ❑ Adult Signature Required $ dry— ❑ Adult Signature Restricted Delivery $ O E. ,age $0.55 05/06/2020 Fu ru 'otal Postage and F . 9` lent To - �.tI — ------------------------ co � INo)-..(QQ >tr-eand Apt No., or Box . U�{ ■ 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. A. Signature X �;gent ciclre B. Received by (Pr' ted Name) C. Da of Deli Best �--/, 1. Article Addressed to D. Is delivery address different from item 1? ❑ Yes f ma Namo of Pwm/t Holdw Vanaor Chaok Numbw Chwk cunt Permit NumbvlCammanb t or RNund/RN/IocatW at] Column4 Columns Cok-6 Coknnn7 Ca1rmn8 Columns same stmd ust 6506 $ 200.00 GP •76506D JD rcl 10229 t&n same FCB M7 200.00 GP i78507D JD mt 10Y30 Darden CoasW Bank and Trust 3113 600.00 GP OM608D JD rct 10231 Suramta Branch and Trust MM $ 2110.00 � GP WWGD Ban mt. 10440 mw" Y&COPMO _Bankmp FCB 1061 $ two.00 GP 975815D i 200.00 GP •76402D Ben ret 10447 same UMB Bank JFCB astal Bank and Trust 1221 Ban rct 10446 Down Greer 2174 $ 200.00 GP#76551D 3 200.00 GP 1176552D JD rot.10233 Ann Rose 3133