HomeMy WebLinkAbout63248D - Allard
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Craig Allard 01-12 67-219/539 2339
Celine Daily
309 Gatefield Dr
Wilmington, NC 28412 "4 z 3 20LY
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1:0S�AO2197,: 1.2673472L311- 123396 3Z4%D
CAMA / ❑ DREDGE & FILL
63FEN E RAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue ❑Partial Reissue a Date previous permit issued -16
>rized by the State of North Carolina, Department of Environment and Natural Resources /
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �� ° / Z
❑ RuI attached.
nt Name_ _ T, A : �-' Project Location: County
State Mc ZIP e7-��
r/ �646 Z. -91 1 `% Fax # ( )
zed Agent}
F CW Cl EW �Z PTA ❑ ES ❑ PTS
OEA = HHF ❑ IH ❑ UBA ❑ N/A
_-- PWS: ❑FC:
yes / no PNA yes no ; Crit.Hab. yes /e�oFJ
Street Address/ State Road/ Lot #(s)
Igi
Subdivision ?ilel- l % e 1
1,61
City 105T ZIP
Phone # ( ) --- River Basin CFn
Adj. Wtr. Body Ma 10SPr ,111- 5-yo b at
Closest Maj. Wtr. Body 7WSA l>rDtJN�
if Project/ Activity i/i?�t� �� �� al'e.ri' , �% �4'�i17 c/ki- �* / Gr
(Scale: ! �-
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fg distance offshore
distance
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ling permit may be required by: r-e-tn, �L V . w ❑ See note on back regarding River Basin
C'A
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icant: Permit#:
;vibe below the HABITAT disturbances for'the application. All values should match the name, and units of measurement
id in your Habitat code sheet.
tat Name
6d
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacttssl
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
emp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑
Fill ❑
Both ❑
Other d
I
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 ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to C
property located at
e of Property Owner)
(Address, Lot, Block, Road, etc.)
I
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.
I have no objection to this proposal_
r
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)
Sec a;t�c�dpla-hs �ao
re+nacd as arc aaded �,g
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) (Adja ent Property Owner Information)
Signature Sig tune
�'L�Y\S 1r1 X i1
Pi t 4r UTPerame Print or Ty,pe Name
OGt iG �r • C 1re&A �V .
011 cKa 61 wa.
R STATEMENT
I hereby certify that I own property adjacent to un
j Y m e of Property Owner
property located at
(Address, Lot, Block, Road, etc.)
on , in
(Waterbody)
(City/Town and/or County)
I
N.C.
The applicant has described to me, as shown below, the development proposed at the above
loca
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)
See a.rFu�d G,rza w „" .
�t lam h-avt
�yC.vibCd w Itu.l Dui- uuJ IYIGlUG2ll6
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) (Adjacent Property OwneflnfprMationb
S � >natur-e
PS or Tt-
e Naae
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