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Home My WebLink About63122D - Edwards1CAMA / VDREDGE & FILL 3ENERAL PEYWIT New —''Modification Vcomplete Reissue Partial Reissue Previous permit # 5 Date previous permit issued •ized by the State of North Carolina, Department of Environment and Natural Resources :oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC z' Name �h v' Rules attached. Project Location: County l le4gl S u !«+ 7 Street Address/ State Road/ Lot #(s) State/ ZIP�ls f phi h (Q) Fax # Subdivision!' W Agent City �i�// 1 "k9 7 ZIP/ ❑ CW OrrW [R*A ❑ems/ ❑ PTS Phone # River Basin OEA ❑ HHF ❑ IH ❑ URA ❑ N/A `! - ❑ PWS: ❑FC: es / no PNA yes /� ,Project/ Activity C "k/ :k) length Adj. Wtr. Body _'! _ >rlH� nat Crit.Hab. yes / no Closest Maj. Wtr. Body w Ei'L�ilf�C■■■��\'rJI1®I1■I (Scale: ❑ See note on back regarding River Basin r ❑LAMA / ❑ DREDGE & FILL IGE ERAL PERMIT Previous permit# 0 New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued iorized by the State of North Carolina, Department of Environment and Natural Resources a Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ❑ Rules attached. ant Name Project Location: County ss :: ft' f Street Address/ State Road/ Lot #(s) State 46 ZIP aF _ # Fax # Subdivision ^ized Agent '.'c. �. ��0,- �'� City 1 �r� /�`��r�'r'r �� ZIP ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin d ❑ OEA ❑ HHF ❑ IH ElUBA El N/A Adj. Wtr. Body (na ❑ PWS: ❑ FC: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body of Project/ Activity (Scale: ■�i■■tom ■I�ii�l■■■■■■■■■■■■■■■■■■■■■1 ■�i■■■fie► 1��>�■�I■■t��■!*!1!:■�■■■■■■RfI■■■1 ■�f■■■■■®■�1■I!■!l�tt3t�fil�iG'/G�Falj�i■■■■■Ii■■■■1 ■■tl�ltl ■■■■l�■�1■■■�i�.l7.�i#i_IN ■■■ ■■■■NI ■l�i■■■■■I�i■■i!■■■■■l■N■il■■■■■■■■■■■■■1 ■■■■■A■■■ j■■■■■■I!!i■UNUM■■■■■■■■■■■1 ■llill■�■�■�■■■�Gr■■■■■■■■/!■■■■■■■■■1 mailm ■■IEWS ■■■■■RLI■■■!■" ■ 19■■■■■1 ■■■■■■■■!IZ:■■■i�■!%�l■■!�■■Ii■■■i■■■■■1 ,.. ■■■■■■■■i�irsil�■■■■■■■■■■■■■■■■■■■■1 ■■■■■■c■■■IN■IIO ■■■■■■■■■■I siiiiiii�iiiMMMIMEi■ii i i�■■■■■■1 ilding permit may be required by: !s/ Special Conditions ❑ See note on back regarding River Bas �plicant: �z r, f_e'e1a�� j Permit #: 6'? /zZ scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement Ind in your Habitat code sheet. TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet (Applied for. (Anticipated final (Applied for. (Anticipated final DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. )itat Name Choose One includes any Excludes any total includes Excludes any anticipated restoration any anticipated restoration and/or restoration or and/or temp restoration or temp impact temp impacts) impact amount) temp impacts) amount) Dredge ❑ Fill Both ❑ Other ❑ Dredge ❑ Fill [Both ❑ Other ❑ J7 f J 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 ❑ Postal Postal MAIL i RECEIPT CERTIFIED MAILT,., RECEIPT .�',ERTWIED D()yrrpstic If9i,#-riv. .. -. VI/ICOUL IgQu -Illy, . . ... u..vv ........ ..'- ------- or delivery information visit our website at www.usps.com;, Postage $Certified Fee ,i �•• HAM 4198 OVERBECK MARINE CONSTRUCTION INC. 3506 TALL PINE CT WILMINGTON, NC 28409 66-46/531 DATE PAY TO THE ORDER OF DOLLARS olld / �lS UN 1 RUST % ACH RT 061000104 HOENR North Carolina Department of Environment and Natural Resources Division of Coastal tvlanagernent Beverly Eaves Perdue Braxton C, Davis lee Freeman Governor Director Secretary AGENT AUTHORIZATION FORM Date i d �i3 Name of Property OwnerAppiying for Permit Name of Authorized Agent for this project: Dwrier's Mailing Address: Phone Number t ) _ Agent's Mailing Address: rt-- Phone Number ( 1, 0 ) 3 8 ( — 889 3 I certify that I have authorized the agent listed above to act on my behalf for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct the following (activity) For my property located at 5 S ct-i& U S Fri AASS'_ ' S -Y I / This certification is valid thru Nate) /�Z/3 i�� y Property Owner Signature Da C i *-A A,) AJ c- CERTIFIED MAiL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATiON/WAIVER FORM Name of Property Owner _-3 G(f Address of Proper y �tict.v/�S j ` e r-, L �c I tAit;t%4+`7c (Lot or Street #, Street er Roa . City & County) Agent's Name #: 00�, Agent's phone #: jritO l 2 Mailing Address _ Sv+`v 72r L_ 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 drawino with dimensions must be Provided with this letter, ._Z 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. Correspondence should be mailed to 127 Cardinal Drive Ext, Wilmington, NC, 28405-3845. DCM representatives can also be contacted at (910) 796.7215, 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, 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.) A%4" i do wish to waive the 15' setback requirement. A2,1A, _ I do not wish to waive the 15' setback requirement. (Property Ow r Inform n) ja ant roperty Owner Information) lgn ure Signature Tc Print or Type Name Print or Type Name /2cl 3 R4&,�a -t- SQ A(Z.0 c� Mailing Address Mailing Address H I LL V4 Z3Z � City/StatelZip CityJState/Zip CERTIFIED MAIL -RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner, .-,% N,Aj Address of Property 50"--114S , P R t� (Lot or Street #, Street or Road City & County) Agent's Name #..SN�>zt� y Mailing Address _-3,5-oG Agent's phone#: 1/0 2 56 .y C- I 3C�S�,2, Gti 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. l% I have no objections to tins 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. Correspondence should be mailed to 127 Cardinal Drive Ext., Wilmington, NC. 28405-3845. DCM representatives can also be contacted at (910; 796-7215. No response is considered the same as no objection if you have been notified by Certified Mail 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 the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Own information) Si aii e _ ors Af G�Jwq fZ1�$ Print or Type Name ! 2J t tz-4 Si3or2,) / 6 Mailing Address (Adjacent Property Owner Information) /�A4._,..�_ / .e, �,, Sig larure Ro%36R% GutZrzA) 2uij Print or Type Name P(; f3v < / yr1C Mailing Address e-l` r�Et Af /L-L , A, (f — 27 City/Statelzip L x,,, t; -,-0 .v C- 2 7 2`i 3 Crty/statelzip