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Home My WebLink About64767D - Lewis\� '-- 2b L 15 64 fCAMA / DREDGE & FILL 3ENERAL PERMIT Previous permit# 1New JModification ❑Complete Reissue -]Partial Reissue Date previous permit issued •ized by the State of North Carolina, Department of Environment and Natural Resources t� :oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Q1 r �Z t� C; tt t Name r tW IK ❑ Rules attached. Project Location: County V-�Iewyc- r— U CT tJ c.. t)c. D3 Lf- wc- Street Address/ State Road/ Lot #(s) LC- I State ti t.- ZIP 1-76 12-- 1 2(m LX T 1())'.'%�.-=--�1` -IS Fax # ( ) Subdivision Pt ad Agent N+",l re f (��C. City �w `-v ✓L C ZIP 'Z. 4 ❑ CW k EW 'p PTA ❑ ES ❑ PTS Phone # (1" !' River Basin ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body «%� Sf� I L '5O v n1 n nat r 1-1 PWS: ❑ FC: yes 4 no PNA yes /r no Crit.Hab. yes C 9 � OFSA 1 �- �.X� c7 ►..1 Closest Maj. Wtr. Body > Proje Activity i2Ucl I� - :k) length (s) er(s) Z. S igth nber I/ Riprap length distance offshore c distance offshore annel is yams P Boatlift 9 N! �M Length " D. not sure yes not sure yes Jno im: n/a yes yes [[ached: yes g permit may be required by: 9 ❑ See note on back regarding River Basin rt 10/20/2015 Dr. Jeff Morrison 10/20/2015 Antinori Construction Inc 10/20/2015 Custom Island Homes by Ken Kiser LLC 10/20/2015 Custom Island Homes by Ken Kiser LLC 10/20/2015 Custom Island Homes by Ken Kiser LLC 10/20/2015 Custom Island Homes by Ken Kiser LLC 10/21/2015 1 Money Order for Brandon Grimes 10/21/2015 Money Order for Brandon Grimes 10/21/2015 Clements Marine Construction Inc same Roger Lewis IB Ken Kiser ICresCom Ken Kiser -CresCom Ken Kiser _ Ken Kiser Scott Pindell Scott Pindell First Citizens Bank 10494 $400.00 GP 66164D 3890 $400.00 GP 64767D + GP 66 3844 $400.00 major fee, 7404 E. B 3845 $400.00,major fee, 7406 E. B 3846 $400.00 major fee, 7408 E. B 3847 $400.00 major fee, 7410 E. B 59183420318 $400.00 GP 66167D @$600 59183420329 $200.00 GP 66167D @$600 3933 $250.00 major fee, 202 Kings of A Bank Bank CresCom Bank CresCom Bank Wells Fargo Bank Wells Fargo Bank First Citizens Bank Venn Hawkins NC Division 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. (i DISTURB TYPE Disturbance total disturbance. Disturbance d Habitat Name Choose One includes any Excludes any total includes E anticipated restoration any anticipated n restoration or and/or temp restoration or tt temp impacts) impact amount temp impacts)a / t.✓ 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 ❑ N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM -1 Date Name of Property Owner Applying for Permit: Mailing Address: 0�2n�. I certify that I have authorized (agent) CL hjjh �� to act on my behalf, for the purpose of applying for and obtaining all CA?VIA Permits necessary to install or construct (activity) JULk.. , at (my property located at) This certification is valid thru (date) `l-) aceA4-1 &Y 1 r Property Owner Signature Date 9t, nplete items 1, 2, and 3. d your name and address on the reverse :hat we can return the card to you. tch this card to the back of the mailpiece, m the front if space permits. ;le Addressed to: Anna P&4e" a G� Gbh. (vG 16945 A. Signature x v B. I eceived by (Printed N e) C. [ D. Is delivery address different from item 1 . If YES, enter delivery address below: Addressee of Delivery ❑ No IIII'I I'll I'I lI li I li I i III ll'll I I i l IIII' I III 3, Service Type ❑ Priority Mail Express® ❑ Adult Signature ❑Registered MaiIT"' ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted ❑ Certified Mail® Delivery 190 9401 0036 5071 9 711 47 ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise very Restricted Delivery Signature ConfirmationT"" cle Number (rrancfar fm . ^ 0 Signature Confirmation 7 013 3020 0002 0025 6878 estricted Delivery Restricted Delivery (over$500) irm 3811, April 2015 PSN 7530-02-000-9053 Domestic Return Receipt nplete items 1, 2, and 3. Signature it your name and address on the reverse X ❑ Agent :hat we can return the card to you. Addressee Bch this card to the back of the mailpiece, eceived (Pri Name) 7C.pDa of D ive/rym the front if space permits. rn rGf' /1 :le Addressed to: D. Is delivery iddress different from item 1? f ❑ Y If YES, enter delivery address below: ❑ No ,ariil►�.L 1 l a�1%� on tiff co, 3. Service Type ❑ Priority Mail Express® IIIII IIII III II II I II I II II II I I III I I II III ❑ Adult Signature o Registered MailT" ❑ Adult Signature Restricted Delivery ❑Registered Mail Restricted 90 9401 0036 5071 9711 30 ❑ Certified Mail® Delivery ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise :le Number (Transfer from c —i-e 1-11 ^'" Slivery Restricted Delivery El Signature Confirmation"" ❑ Signature Confirmation 6885 7 013 3 0 2 0 0 0 0 2 0 0 2 5 - Restricted Delivery Restricted Delivery rover., 57 CDaits m 3811, April 2015 PSN 7530-02-000-9053 . Domestic Return Receipt MHCDO Tyler Crumbley LPO