HomeMy WebLinkAbout63291D - WebbCAMA / El DREDGE &FILL Vir ,r-`\�
iENERAL PERMIT Previous permit #
qew ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources A . ll..� D
>astal Resources Commission in an area of environmental concern pursuant to 15A NCAC --j" Rulesattached.
Name ` li 1 Project Location: County
tV Street Address/ State Road/ of #(s)
C� U y1 State �A ZIP
O_ Fax # O Subdjd�ion
;d Agent Cityt�111i f ZIP
c Ll--�
❑ CW - NEW PTA ElES ElPTS Phone # MI—O) River Basin 111�
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body 'A(J (nat 6
❑ PWS: ❑ FC:
res no PNA yes no Crit.Hab. yes no
Closest Maj. Wtr. Body Alww
f
Project/ Activity
i
ie Length eJ", ✓
not sure yes
gs: not sure yes
,rium: � n/a ,� yes
yes
Attached: yes
(Scale: y L
Date Received I Check From (Name) Name of Permit Holder Check Number I Check amount I Permit Number/Commc
5/5/2014 McKim and Creed Blair Booth 175924 $100.00 1 Transfer 76-97
5/6/2014 John D. & Pamela k DeBell, Jr 7771 $100.00 Minor mod. 114-13
5/6/2014 Catherine Kelly 10649 $497.00 NOV # 14-04D
5/7/2014 Grice Construction $2 6909 00.00 GP fee for 1211 canal Dr
0
w
C Division of Coastal Mgt, Habitat Impact Computer Sheet
iplicant: �t 61A UA Vv e bU o Permit #.
ate:
51��
l
:scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
—A in "stir Nahitat rode sheet.
dbitat Name
DISTURB TYPE
Choose One
Dredge ❑ Fill ❑ Both ❑ Other�'
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 Tina
disturbance.
Excludes any
restoration andh
temp impact
amount)
32—
✓��
Dredge ❑ Fill ❑ Both ❑ Oth
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 0 Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
I C, r�2C I� = 1Z`
/04/2011 23:32 9105799096 GRICE CON PAGE 01
North Carolina Department of Envirc
Division of Coastal M
t Drury Braxton C. D
oovemor Director
AGENT AUTHORIZATION FORM AG
Date: f % %
1e of Property Owner Applying for Permit: Na
oo
ler's Mailing Address:
$ 01 Cv e eA D yL
A L At-�^/A- C&A
and Natural Resources
Authorized
Mailing Address:
'S4-ovl P 0. k i14
John E. Skvarla, III
SKretary
nt for his project:
l)t t�i�
ne Number H o't Z -7 '� � L (o3 Phone umber (_I_o) q q �- 16� o
tify that I have authorized the agent listed above to act on y behatf, for the purpose of applying
ind obtaining all LAMA Permits necessary to install or cons of the following (activity):
my property Tlocated at f q I( v t i
r I r"
certification is valid thru (date) Z
Q /
Property Owner Signature E ate
C _ .28?q(
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: M%6eal `6-b17
Address of Property: k� Q(VWA JunSl► \'IC161 — & At15wVd (lug �t
(Lot or Street , Street or Road, City & County)
Agent's Name #&iCQ C.-)n6 +mil( "3n Mailing Address: �� �� &Qu i- l
Agent's phone #:`W-S-Ick-CM5 ti. Qan T5 t I N( Z106 9
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.
ieacrfntien or dmw ja. with dirmenslone, must be provided with this letter.
J I have no objections to this proposal. I have objections to this proposal.
If yoobjections 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
notifled 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property O T r Information) (Adjacent Property Owner Informati n)
Signature Signature
Print or Type Name Print or Type Name
001 C1�rnc�n`�' D� NL �•y,
Mailing Address Mailing Add ess
��la*11 303&
COVSrate/zip eityostateizip
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: O 1 I Q- eG I "0?-\A)
Address of Property: Q"(-X ,` ID
(__ ( (L-olt or Street 4, Street or Road, City & County) 4
Agent's Name # l��tCQ �.1 >n6i M(_-vK; n Mailing Address: lQ�(� U 1, ad) D-&1�
Agent's phone Qd i Nc ZWA
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 descrintion or drawing. with dimensions. must be orovided with this letter.
, jyie 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.)
I do wish to waive the 15' setback requirement.
�. I do not wish to waive the 15' setback requirement.
(Property 0 n r Information)
Signature
w6b
Print or Type Name
'60I L\�rncnt Uc- N ��
Mailing Address
�1an � 1� 3%JU6
City/State/Zip
roperty Owner Information)
Print or Type Name
D30 Aw�11,A�
Mailing Addres
ity/State/Zip
9-0 `
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Postal
CERTIFIED MAIL,,,
RECEIPT
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For delivery information visit
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Total Postage & Fees
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PS Form :rr rr.
See Reverse for Instructions
CDaits
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Ronnie Smith
LPO
(Domestic
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For delivery information
visit our
website at www.usps.cu
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Postage
$
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$3• iQ
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Return Receipt Fee
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PS
Form :rr August 2006
See Reverse fog
DW Review
MNIDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■Complete items 1, 2, and 3. Also complete A. :7S
item 4 if Restricted Delivery is desired. X y El Agent
■ Print your name and address on the reverse / ❑ Addressee
so that we can return the card to you. B. Re ve by pint e) C. D e of gelivery
■ Attach this card to the back of the mailpiece, l4Jc I� /!
or on the front if space permits.
D. s delivery address different fr item 1? ❑ Yes
1. Article Addressed to: If YES, enter delivery address below: ❑ No
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3.Service Type
ertified Mail
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❑ Expre,¢ Mail
❑ Registered
'�LReturrtteceipt for Merchandise
2O��S
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❑ Insured Mail
O C.O.D:
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7013
(Transfer from service labs-,
1710 0000 3407
0277
PS Form 3811, February 2004
Domestic Return Receipt
102595-02-M-1540
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
�d-�:X li-�' cc�r
� �1 � n Zhu m Rc
SC 29�(l
A. Slgn re
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B. ?Zppived by (
D. Is delivery agdress di1
If YES, enter delivery
❑ Agent
�` Addressee
J4 &Date of Delivery
_.
4r item 1? ❑ Yes
below: ❑ No
3. Service Type
VOCertified Mail ❑ Express Mail
Registered ,Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes