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Home My WebLink About66192D - TuckerCAMA / ❑ DREDGE & FILL A B GENERAL PERMIT Previous permit # 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 1 ❑ Rules attached. it NamaATAACke - ri Project Location: County kKl-t.(Is t �( !-i .j �L C"a Street Address/ State Road/ Lot #(s) U&I0 State ' ZI E-Mail Subdiv' ion :ed Agent nyko— City i r l ZIP El MY '*W )SPA ❑ ES ❑ PTS Phone # ( ) River Basin ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A i Adj. Wtr. Body ❑ PWS: yes / no PNA yes no Closest Maj. Wtr. Body f Project/ Activity V Eck) length(0 $ C�Lo U atform(s) 14,X Platform(s) X w ' ngth tuber d/ Riprap length ; distance offshore uc distance offshore cannel bic yards np ' �X is oatli �) ulldozing 1 e Length not sure yes nd ` ,ium: n/a yes no yes 4ttached: yes no �--- ng permit may be required by: I h� U� _� t�-ULi 11 A ❑ See note on back regarding River Basin ri Local Planning Jurisdiction) - . , I I J it j I 'I o c 71 a t m= m 0 c COMPLETE•N COMPLETE THIS SECTIONON DELIVERY o i ■ Complete items 1, 2, and 3. A. Signature C � c ■ Print your name and address on the reverse (� � O Ag X `""' N' jd o - so that we can return the card to you. `1 ❑Add see B. Received by (Printed Na e) C. Date of qej ery ■ Attach this card to the back of the mailpiece, n or on the front if space permits. cb Add 1. Article Add essed to: D. Is delivery address differen item 1? A /) l IYES, enter delivery addreSS below. ----t ogcs 3. Service Type I) I'lllll III I'l l l I I III'lll II IIIII II I' it 111 III ❑ Adult Signature ❑ Priority Mail Express® ❑ Registered MaiIT" < m O Adult Signature Restricted Delivery 0 Certified Mail® ❑Registered Mail Restricted Delivery 9590 9403 0293 5155 8965 96 ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery 2. Article Number (Transfer from service label) ❑ Collect on Delivery Restricted Delivery Merchandise 0 Signature Confirmation"' ❑ Insured Mail 7 01511640 111117 6417 6 5 8 7 nsured Mail Restricted Delivery ❑ Signature Confirmation Restricted Delivery over $500) NPS Form '3811, April 2015 PSN 7530-02-000-9053 Domestic Return Receipt DC L • i � u CDaits MHCDO Tyler Crumbley LPO I � Ji III-1 I f O C 0 DW Review L_J - c a? O n c N � O Owner V k 0 C ill�� JC Division of Coastai Mgt, Habitat Impact Computer .sheet ,pplicant: < I X/�' Permit #: late: `` nn Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen >und 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)CW- FINAL Feet (Anticipated fins disturbance. Excludes any restoration and/ temp impact amount Dredge ❑ Fill ❑ Both ❑ Other Dredge ❑ Fill ❑ Both ❑ Other Dredge ❑ Fill ❑ Both ❑ Other �_/O U,10 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 ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date 1! 1 a I S Name of Property Owner Applying for Permit: Mailing Address: 6ka I certify that I have authorized (agent) '41 1/J AW//V— to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary /ltoo install or construct (activity) A"elk 1.JL A4 at (my property located at) This certification is valid thru (date) q is/Zv//s D......o..4.r llaarna+ Cinnntnrn Date CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner:/ _•�_ Address of Property: (Lot or Street #, Agent's Name #: /heed A/1"t" - 44foj_4 Agent's phone #: 2/2 -c-23p �S 32 Road, City & County) Mailing Address: `�a 1a4vld C. - hereby certify that own property adjacent o the above referenced property. The in 7 ua arF;y;„y or this permit h C described to me as shov: n cr !'iv utf�.r:Od drawing ng t he.^�vof rmr_n they are proposing. A description or drawing with dimensions must be provided with this letter. ✓ I have no objections to this proposal __ I have objections to this proposal. ff 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 offrces is available at http://www.nccoastalmanagement.netlweb/cm/staff-listing orby calling 1-888-4RCOAST. No response is considered the same as no objection if you have been notified by Certified Mail WAIVER SECTION I 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.) I do wish to waive the 15' setback requirement. d✓ 1 do not wish to waive the 15' setback requirement. (Property Owner Information) A Signamwe Sc off Tuck, Print or Type Name _UW 2 Ktkcf kt/n�j 2r Mailing Address (Riparian Property Owner Information) Signature M_a.` 17-1 i''lAxwe LL Ne LSou Pnnt or Type Name D- L 7 G L -i h Mailing Address —1 , i- 4- rt- c 0_ C, . c A i ce t' It; s Lynn--Dr,�. z x K 'rt �.[ ♦ 4 � YP/ r •� f'6602 n Kis �fynni Dr �g. rffl' x