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Home My WebLink About63210D - FowlertC-AMA / DREDGE & FILL I % q 4 62 ' rew ERAL PERMIT y' Previous permit# -Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued rized by the State of North Carolina, Department of Environment and Natural Resources - ' �Ov :oastal Re�cwrces Commission in an area of environmental concern pursuant to 15A NCAC --. Rules attached. t Named Project Location: County I� UY'lSuVt it %( 12-1 o rr�� Street Address/ State Road/ Lot #(s) Lll�✓1�U State�t. ZIP2�13 �N Shari bf1V41 Fax #N6�W4ii'k-o Subdivision tJ�A ;ed AgentCir U u- ZIP_ LL.�� ElCW EW PTA ❑ ES ElPTS Phone # l l ��, .,i� ) 4 LLJJ -I .:Tql1 River Basin L-UM G ❑OEA ❑HHF ❑IH El USA El N/A ❑ PWS: ❑ FC: V Vv yes no, PNA \ yes no Crit.Hab. yes /(n, r ' Project/ Activity t'J C ck)length " 171, 7 i(s) rZ",- t Z—" ngth tuber J/ Riprap length : distance offshc x distance offsh cannel )ic yards_ ip se/ Boatlift ■■■■■■■■■■i ■■■■■■■■■■■1 ■■■■■■■■■1 ■■s■■■■ 0 ■M■■■NEVI mu'v2slow Mw tl Adj. vvtr. Body na i Closest Maj. Wtr. Body F. (Scale: -� ❑ See note on back regarding River Basin r STEVEN T. FAR TRA COPS SERVICES PH. 910-443-7793 PO BOX 1365 SHALLOTTE, NC 28459 BRANCH BANKING AND TRUST COM -2 9 1-800-BANK BST BBT.cww 1:053 LO 1 12 0:0005 21 106 F= 0, 04484 C division of Coastal mgt. Habitat Impact Computer Sheet iplicant: �( 1/� t " VJ l e ✓ Ite: 3125 iy Permit #: � 3 Z l 01` !scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremer and in your Habitat code sheet. bitat 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 ❑ 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ I ..1, 1 "-) ---,) MOM North Carolina Department of Environment and Natural Resources DMelon of Coastal Manager wM Wmel F. E.aWey, Governor Charles s. Jones, DkeeW Authorized Agent Consent Agreement Marn G. Ross Jr., Secetary PI ()I AL i2` is hereby authorized to act on my behalf arder-to obtain arty C s }requited for the property listed below. The autharization is "Mfted to the ecifie activities described in the attached sketch. MATION OF PROJECT: tOPERTY OWNER MAiUNG ADDRESS: &'sue, ) o Ty 1 v X PHONE JTHORMED AGENT MAILING ADDRESS: PHONE NO. gnature of Property Owner: rtn9it fro ^f AA rkkr i-aril DMSION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Individual Applying For Permit:. Address of Property: (Lot or Street #, Street or Road) &� U vtsto l ck. (City and County) hereby certify that I own property adjacent. to the above-referenctd property. The individual applying for this per04as described tome as shown on the attached drawing the.development they Are proposins. A escri tioti or drawing, with dimensions, should be provided with this letter. I have no objections to this proposal. If you have Ujeg inns to what is being proposed, please write the Division of Coastal Management, 127 'Cardinal Drive Extension, Wilmington, INC 28405 or call 910-796.7215 within 10 days�of receipt of this notice. No response is considered the same as no.objection.if you have been notified by Certified Mail. WAIVER SECTIOv I understand that a pier, dock, mooring pilings, breakm-2ter, boathouse or boat lift must beset bck 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� I do not wish to waive the 15' setback requirement. V\ ub Mao, � Print ame A�' j DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM Name of Individual Applying For Permit: Address of Property: (Lot or Street #, Street or Road) (City and County) hereby certify that I own property adjacent to the'above-referenctd property, The individual applying for this permit has described to.me as shown on the attached drawing the.development thev Are proposing. A description or drawing, with dimensions, should be provided with this letter. fl S n T I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Coastal Management, 127 'Cardinal Drive Extension, Viiilrmngton, NC 28405 or call 910-796-7215 within 10 days�of receipt of this notice. 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 pilin;s, breakwater, boat house or boat lift must be set bek 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 1 5' setback requirement. I do not wish to waive the 1 5' setback requirement. Sign Name Date Print Name AZA JNv 0 ��A- ---Q�t-\V�n1 aW-VS -?Ps 0', S OYVJ� ��VVD - q, " w 11S ��71 b-A MA MA t �'4s �� r�{i�`r,.r...sJ _ Wiz. STEVEN T. FARMER TRA COM SERVICES PH. 910-443.7793 PO BOX 1365 SHALLOTTE,NC 28459 i 4484 66-1 ' 2,--3 t BRMCH B KING AND TRUST COIAPANY 1-800-BANK BBT IS cM1 G "p 1:053101 2 11:0005 2 1 10660 04484 -WOOL" PmTmose �U.IarrO GtaM1a v