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Home My WebLink About66218D - Brooks! CAMA / ❑ DREDGE & FILL GENERAL PERMIT [New ❑Modification El Complete Reissue ❑Partial Reissue ized by the State of North Carolina, Department of Environment and Natural Resources :oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC � - //,,,, "1 -� ❑ Ru�e� at�ta_c�hed. Name 4 t�J�+ / `'� ��? Project Location: County iJ -ext' (� t l� ct' l D d l " Street Address/ State Road/ Lot #(s) N i 'i1 StateZIP ' h ` " j✓ G . . , f `� ( SZ 2 (/ 9 E-Mail �� `7 Subdivision G C N 1-%( a ad Agent /a `1 City —f? S`%� e- �✓ ZIP 7 �i��.�tl h t� ❑ CW EW PTA ES ❑ PTS Phone # (`— �`.- River Basin C-0 ❑ OEA ,❑ HHF ❑ IH 7❑`UBA ❑ N/A Adj. Wtr. Body ik / �� t it ac_k (nat n PWS: ;� t,G?.L ) L. r: ,. r yes /, no PNA yes / no Closest Maj. Wtr. Body e Project/ Activity A) length r W Oorm(s) s 1), x IS Platform(s) I %( -1�O igth nber I/iprap lengtt distance offshore K distance offshore 0 is ya s ,p se/ Boatli dldazing Length 1/ 1 e"� O not sure yes um: n/a yes / yes ktached: yes ig permit may be required by: _ocal Planning jurisdiction) , -1 y 66219 A B Previous permit # Date previous permit issued ("'-la ' / . - . / _r + i I I ❑ See note on back regarding River Basin r Srs LLC Scott Tucker m Brian Hennessee 'action Inc Federal Point Yacht Club truction Inc Ray Sito - same same esame BB &T 6162 $200.00 GP 66187D First Bank _ _ 9922 $400.00 major fee, 910 Basin Road, CB NHCo _ First Citizens Ban—k 3957 $250.kmajor fee, 462 Causeway Dr, WB NHCo B of A 324120 $100.00 renewal fee, MP 61-12 PNC Bank 1007, $600.00 1 GP 66197D Navy Federal Credit Union — 4012 $600.00 GP 66115D ^.COinor Ons.Co - — - - n. ..� ..: ..... fee, 179 Topsail Road, NT3 -- - ^ .minor fee, 230 N Anderson Blvd. TB PN — - - .....1 ...�......�-.. r . ...... r,f DPI _ TM rct. 0441 D TM rct 0440D RIM rct 0381 D RM_rct. 0379D RM_rct. 0380D JD rct. 1054D JD rct. 1053D JD rct. 1056D JD rct. 1057i) _ $536.CC - — - BB &T - - - -- --—742767 $400.00 ht -- - isame g B &T 181681 $200.00 Ni'� �o% 5�50, 536 GP 66219D — y-- - HS rct. 0996J D GP 66216D HS rct. 0994D ldon Grimes Chris Lutterloah Wells Fargo Bank 59183420956 $200.00 GP 66217D JD rct. 1064D construction Co Robbie Brooks First Federal 9640 $400.00 GP 66218D JD rct. 1065D - - -----_----.+....------- t I ---- ---- -- - _L - ---- - t rt --- -----t---- I i /NC Divi ion of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Date: 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 F (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) temp impacts) ar L� 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 ❑ AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Applying for Permit.- C , _ --� Mailing address: Phone Number: �0 I certify that I have authorized r �Age/ tractor to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development of F f ":,� f ��c ✓I / i_ f 1' at my property located at c/-c CoCcv f in - &9�� County. This certification is valid through /Z - 3/ - Ado Date PTRZO!Fn w f Title ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to � ,1 P_ 8/n S 's / a (P1ame of Property Owner) property located at L o4 .2"1 i?r► e. C. au (Address, Lot, Block, Road, etc.) on , in N.C. (Waterbody) City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. C/ 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) Cot'&/JG X� eGC( UO�\ 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.) I do wish to waive the 15' setback requirement. l� I do not wish to waive the 15' setback requirement. (Property Owner Information) Adjacent Property Owner Information) r Si 11R re Sig e-- 'e Print or Typ Nam Pri t or Type ffime ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to I°CoLA i 6/-0Cl ril 's (Name of Property Owner) property located at o ��r1G� (Address, L t Block, Road, etc.) on , in 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. 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 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. (P ope Owner Info mation) Z, Sip-nature // R 4 k �� groo`n Print or Type Na e / i 3, i�17lw0001 br, (Adjacent Property Owner Information) Signature J Print or Type Name lOio +-os L�— ("k bcl)lJ Ll 3 D- -- ) IN L Pr r, t, c 6 X S'O Ff C&� A a b OCI < 15 Ll i Lt4 Iq AnAa (c-,t-.ti4