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Home My WebLink About64703D - Brown7 CAMA / ❑ DREDGE & FILL � � �� r ` ` 64 3"ENERAL PERMIT Previous permit# l.New Modification ❑Complete Reissue El Partial Reissue Date previous permit issued rized 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 L Rules a hed. it�Njame G� j�'�f 1 Cff�'',� /� GG1 Project Location: County Street Address/ State Road/ Lot #(s) 'UTi i fy� State ZIP z"I"WL ( , }PE % i tI N Subdivisi n :ed Agent / 1�4Sta CityZIP ❑ CW ,�ZEW /ArTA ❑ ES ❑ PTS Phone # ( 'r '" River Basin ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body i ►'v nla I ElElPWS: FC: '-- r v 4 V yes t' no o PNA yes no�J Crit.Hab. yes / no Closest Maj. Wtr. Body ' Project/ Activity ck) lengthU X1t! I(s) l ( J G' (er(s) n nber i/ Riprap ngth distance oll, ore x distance offish e cannel )ic yards ip W oatf ►7 X ( 2 a -7, -'?'o r r0 r (Scale: ■■■■■■■■■■■■■■■■�1�11■■■■>�■�■■■ ■■C:�� iiis.w■1■■■■■■11�11 ■1�!■■�■I..�.in�■■■■ aim Milos LA EME M 6/18/2015 Willie Clarence Richardson Jerry and Lisa Sroka Michael Gerke 6/22/2015 Clements Marine Construction Smith Smith B/22/2015 Radiant Investment Inc. Harry L. Kraly 6/22/2015 Dennis or Beverly Morgan same 6/22/2015 -- East Coast Engineering & Surveying, P.C. Alan & Tambra Lewis 6/22/2015 VR Properties, LLC Robert Huckabee Robert Huckabee 6/22/2015 1 Monev order for Brandon Grimes Jerrell & Patricia Brown BB &T First Citizens Bank Crescent State Bar High Point Bank ar First Bank NewBridge Bank Wells Faroo Bank 6038 $400.00 GP 64678D GP 64639D 3826 $1,200,00 GP 64679D GP 64680D 4380 $100.00 renewal fee, M 5001 $200.00 GP for 124 Ch 1419 $100.00 minor fee,491 542 $600.00 GP 64675D C GP 64676D 83451 $200.00 GP 64703D NC. Division of Cssastai Mgt. Applicant: Date: , 2,Z — 15 Habitat Impact Computer Sheet r �. rI (-1c' 67,014) k Permit Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement found in your Habitat code sheet. Habitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp impact amount TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any . restoration and/oi temp impact amount Dredge ❑ Fill ❑ Both ❑ Othery Q n Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill [] Both ❑ Other ❑ Dredge❑ .Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other .❑ Dredge ❑ Fill ❑ Bath ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both El Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date �T Name of Property Owner Applying for Permit: J e ry-ell 6 dL / N C l& / �' tr0[QJ(r_i Mailing Address: wa & c P 1. N. C- , F" i,-6 6 I certify that I have authorized (agent) /7) 4 -,1-kI C/ o I (—�rl ate-5 to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) (`�`�c�ce / � FT // at (my property located at) t! c, / � fle l( ect4l t("C' [ K Hawl)S�Qcul N G; CI-9-5 This certification is valid thru (date) j?PC, > /t �516 l Property Owner Signature Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to �/ ` // �i/�l� I / (Name of /Property Owner) property located ati��l .-� y/ �{ 11C LGf- 2. 'I / (Address, Lot, Blpe, , Ro d, etc.) on ��1/� , in h��- , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locatio 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, 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. (Property Owner Information) Signature Print or Type Name 9 14 9�1' l (Adjacent Property Owner Information) Signature �Lr3EX-7-W C>c,/r✓ Print or Type Name 11 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to %�i- le J/ A, —.a 1, h 's property roperty located at /,1IT 2 (Name of Property Owner) (Address, Lot, Blot Road, on C in of N.C. (Waterbody) I(City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. 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, 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/ I do not wish to waive the 15' setback requirement. (Property Owner Information) djacent r pe ne Information) Signature e Te r r e t( t�/, �'� r,, u.; I I An 1r) Print or Type Name P " t T eMel�) `Q Mailing Address /in gAd ess r J%., //ckc_e x/G. ?.�;y/% 1A1l ,,. I 7.�