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Home My WebLink About65138D - SmithLLC Inc n same Marine Federal Credit Union Henry Von Murray III B of A Andrew Bray Mary Ann Tall Orton Plantation holdings, Allen's Creek Bridges First Bank Thompson First Citizens Bank__-_ Thompson First Citizens Bank same First Citizens Bank same NC State Employees' Credit Union LJoe Smith BB &T 3013 $200.00 GP 64617D 7366 $600.00 GP 64618D @$200 GP 64619D @$200 GP 64620D $200 _ 45408 $250.001 major fee, BrCo 3322 _ $100.00 minor fee, NTB 15-12 _ 3323 $100.00 minor fee, NTB 15-13 1511 $100.00 mod fee, 199-87 check returned 517/15 2806 $200.00 jGP for Jordan 19291, $400.00 GP 65138D IC Division of Coastal Mgt. Habitat licant: ate: 5/ L51, S Impact Computer Sheet Permit #: �9139j) ,scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen and in your Habitat code sheet. ibitat 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 and) temp impact amount) Dredge ❑ Fi I Both ❑ Other ❑ Dredge ❑ Fill Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ OtherX 52o 52 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 ❑ Both C] Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Applving for Permit Mailing aodress Phone Number: r ! L(— 1 certify that 1 have authorized }. ' L 1 `.i`t i!� ;(,t i` ' " r• ,r l' i� "` Agent i contracto- to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development of ( 'l; t t 1C� �7 �' -4 •� ; � �� ! at my property iocatec at ; LD in ?� i i "> ,�: f C, County This certification is valid through Date (Property Owner Inform ) ASignature /� � sr, . = H Print or Type Name �iJdlMr:. Date 7oY- tloo - y9 i o Phone Number - J_5--1 r TN CP j S M r 7-H IWC. c 0,ok� Email Address ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that! own property adjacent to �Qe L y(,r ,r (Nagia` of Property Own r property located at o� �> �mO4c Sp _ny)1 VTa G ro p (Address, Lot, ock, Road, etc.) on �`Ck' "' 4� 7 "�� .l W, in__ M)1-✓/Yi-" iI.0 (Waterbody) I (CitylTown and/or County) The applicant has described to me, as shown below, the development proposed at the above location. 4�,_ I have no objection to this proposal. t 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 ! 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 tt.e appropriate blank below.) I do wish to waive the 15' setback requirement 1 do not wish to waive the 15' setback requirement. (Property Information) Sr nuhn•e � �— A•Jrn rT/� Print or ype Name o liox 5-So nq Address �J7V ..vC ozdoyz ---- citylstatelzip Ave Imo Telephone Number Telep ne IJV m er ` ' S Jr (7(P (lure T--- -^ 5:b7a JACKSON 843-664-0929 F.2 ADJACENT RIPARIAN PROPERTY OWNER $TATFMENT hereby certify that I own property adjacen', to _ {L c Lk1'V►L/2- 5 � � Property own r p�t�y ►ocaieir at �� is � �5r � -� � e. Of (Address, Lot.Aock, Road, etc.) Wes, in Dll-Yibu N C. (Waterbody) (Chy/Town andtor County) The appl has described to me, as snovn Mow, the development proposed at the voovs :ocawn 1 have no objection b this proposa,. I have objections to this proposa`. DESCRIPTION ANDIOR DRAWING OF PROPOSI;DDEVELOPMENT OrPoYvidual Pmposing development must fiU in description beJow or attach a sire drawing) WAIVER SECTION 1 understand that a par, dock mooring plings, breakwater, boathouse, lift, or groin must be set back a mnimam distance of 15' from my area of riparian access unless waived by me. (If you wish to waive the setback, you waist Infttat the appropriate blank oelow.; f,do wish to uraive the 15'satback requirement. I do not wish to waive the 15' setback requirement. (Proper%wner Information) gnar��r Sign of Print or Type Name Prfry Po Aox S'So M g Ad&l 9ss s�urru.v, Ale Z MadL 74 City/S�oe� d� ^5yi/a City/ Tolaphone NumSor Telt acHe Dare Owner I nr 7" N Z kl1 �frs'�srr )g A dldress G 1 wl� --o9--:L 9 Ile n>-. ;- CJl On n 17% i A t , Jo ;- . 77 '7 ,,0r! ZF yr 6LLV TIRENCID N •ao • w X av r eM miaiere worn _._ — 2 � ua <z<rosr a•<Z�w yy wr I i 1 TRGTID � x i f.Mi�MUGus ___J ; I 4 dac flu f.QtNtTm �r r' .trts t f J J @l DO %- -� Z Q �xroiwu w"eu r Y 4 \ TYPICAL SECTION THRU BULKHEAD w.e. Slflbr MY o� rr F W u•� H� trvsnvrt Nw� aMn. m .tYV� ro 1N eu1a1M1 wn b Lvar w awry ..iM UV< •. x qr N W M rw! 6cN � mw Nw W �V ir' �✓ a trn Mnrr- � bTn w� b �mw n ✓ �wu N' .�..+< w � unvoeu�y u✓ a r<r«x �amr. G. 3587 ( t MAY 7, 2015