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Home My WebLink About65102D - MichaelI N 11 65-- LAMA / ❑ DREDGE & FILL GENERAL, PERMIT Previous permit# Jew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued zed by the State of North Carolina, Department of Environment and Natural Resources -7+� >astal Resources Commission in an area of environmental concern pursuant to I SA NCAC / j❑ Rules ttached. NamProject Location: County J?` 7 t 1 N) <�V\J l C (,( {z� ` Street Address/ State Road/ Lot #(s) State zip �+ � ��X (c �jY ,� l ►?r Z . -, Subdivision AAgent i`(� f +i rA City � o' tt 1 C�� ZIP .. 4 b . ❑ CW LJEW , PTA ❑ ES ❑ PTS Phone # ( ) Rider Basin ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body f`' "� Wy\) (jat [n L'` ❑ PWS: ❑ FC: Closest Maj. Wtr. Body I V\J J res / no PNA yes / no Crit.Hab. yes / no Project/ Activity J-A V Ne � 7r C � `� +• � :r � Z '� �, � iY (Scale: :k) length X 5 er(s) ! i � igth NIA - nber t .e i/ Riprap length_ distance offshore_ x distance offshore cannel sic yards np ise/ Bbatli ax!3 ulldozing r t—' ie Length not sure yes no,, s: not sure yes rio rium: n/a yes no yes no Attached: yes no ing permit may be required by: �) h' 1 ❑ See note on back regarding River Basin i Date Check Check Received Check From (Name) Name of Permit Holder Vendor Number amount Permit Number/C 3/2/2015 Pacula Builders LLC Roy Gilbert & Brenda Madison First Citizens Bank 1138 $600.00 GP 65079D 3/2/2015 Pacula Builders LLC Dennis Michael Security Savings Bank 1847 $400.00 GP 65102D @$20( Dennis Michael GP 65103D @$20( IC Division of Coastal Mgt. habitat Impact COMP ater Sheet Permit #: )plicant: ate: Z/Z7/ �S escribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremer fund in your Habitat code sheet. abitat 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 fin disturbance. Excludes any restoration anc temp impact amount) O �� L—a'-i Dredge ❑ Fill ❑ Both ❑ Other 9-- Dredge ❑ Fill ❑ Both ❑ Other [�J- � () p S ` `' o t�o 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 ❑ r_ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both. [I Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: A�Px,t—�t S Address of Property: (Lot or Street # Street nr Agent's Name Agent's phone #: 3� 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. ov�7- 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. Contact information for DCM offices is available at httpJ/www.nccoastalmanapement.net/web/cm/staff-listina or by cal No response is considered the same as no objectionn if ou have been ling 1-888_4RCOAST.notified b Certified Mail. WAIVER SECTION understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.) _nv�--_ 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 (Rig"Irt Pkoperty Owner Information) Print or Type Name %ot IF - (-)-k TA, D n/, 90� - L�S j� d614 S%r''a( J.c.'nV1v y Flo 3(&t'7 _. . Mc->?2r a ..40 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to --7—C AA l (� , tip / property located at one �� (Address, Lot, Block, Rodd, N.C. in ter .< , (Wabody) etc.), (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) Joc.-.k -�5 12— Y IQ—A-)ek 1 -'51 ;P, q4-A c- 4� 1c, A 4� N c c nn c- �o � WAIVER SECTION understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a ninimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive he setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. —A_ I do not wish to waive the 15' setback requirement. 'roperty Owner Information) (Adjacent Property Owner Information) (41 2wture Signature I.nt or ,T,ype Name Print or Type Name 3llmg Address , „ AA7ihnn A,44. ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to property located at on -17C— L-) (Address, (Waterbody) in_ JA 1 i A .M.>4-n/ 'ame of Property Owner) L� . , Road, etc.) S .4-"" U (City/Town and or County) I N.C. 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) —FICA4-;1�y POC kC-K �'� I S �r 5/ ) S C L� i�o- I X ,9-�V � � �- 1� � -�c F (C) e44 4�n C-- 4-t,j 45-)( ( �� f D 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 do not wish to waive the 15' setback requirement. Property Owner Information) (4Adjnt.Property Owner Information) 'IL nature S J t or Type NameP r Typ ame � Cyr �� . � • X % o'ZU p'Z ■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ 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. 1. Article Addressed to: ce K-C z-7 q65 IT YL6, enter delivery address below ❑ Certified Mail' ❑ Priority Mail Express- 0 Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ Collect on Delivery 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7013 a 13 (Transfer from service label) 3020 0000 7304 0536 PS Form 3811, July 2013 Domestic Return Receipt Postal CERTIFIEDMAILT,,, RECEIPT (DOMesfic Mail Only; .- m Ln 0 m Postage $ 17- Certifi O Retum R� Postmark (Endorsemen eii Here Restricted livery Fee l7-1 (Endorseme t Required i � Total Post ge & Fees $ m Sent o m - a Street, Apt. off; - - -•-" - " I- C3 or PO Box No. L-- C — CDaits MHCDO Tyler Crumbley LPO DW Review Owner -LA'a