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Home My WebLink About63127D - Yetman�CAMA / DREDGE & FILL 3ENERAL PERMIT Previous permit# New Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued ` sized by the State of North Carolina, Department of Environment and Natural Resources i�.r) �� V :oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC --�" (� N. t\1 ` )�Y ules att�a`�'ed.t me 1 Project Location: County ally H�5 Street Address/ State Road/ Lot #(s) K 120 �L State-L ZI P In (a L Q)D"tG' Fax#(�) :ed Agent ❑ CW 41 EW XPTA ❑ ES ❑ PTS ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ❑ F,C:,_ yes no PNA yes /' no Crit.Hab. yes / no F Project/ Activity i Yl ck) le 1(s) ier(s) ngth mber d/ Riprap length distance offshore uc distance offshore cannel )ic yards rip se/ Boatlift ulldozing s: not ium: i Subdivision ZIP r�(� L12 River Basin Adj. Wtr. Body ILI nat Closest Maj. Wtr. Body i (Scale: I // z \ttached: ig permit may be required by: t ❑ See note on back regarding River Basin r i CAMA / ! DREDGE & FILL 3'ENERAL PERMIT Previous permit # -iNew uModification ❑Complete Reissue GPartial 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 Rules attached. it Name I _ Project Location: County i �� Y L Street Address/ State Road/ Lot #(s) i-L ( State ZIP Fax#( ) ,ed Agent Subdivision CityZIP 1, ❑ CW EJ EW PTA ElES ❑ PTS Phone' # (t ` i6 L t 1 ! ` River Basin ❑ OEA ❑ HHF IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat ❑ PWS: ❑FC: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body T 1 f Project/ Activity ck) liengt 1(s) ier(s) ngth mber d/ Riprap length ; distance offshore uc distance offshore cannel Dic yards np ise/ Boatlift ulldozing e Length. not sure yes l no:: T s: not sure.. yes (no r ium: �&a> yes v^ _ \ttached: yes no (Scale: j ig permit may be required by: L' �� %, ("i`t(_� 1r�j ( ❑ See note on back regarding River Basin r i r .. HrECEIVED be,M WILMINGTON, N1 JAN 1 7 H14 i AMA GE & FILL NV 63127b A4 Em PERMIT Previous permit Complete Reissue partial Reissue Date previous permit issued__ by Me State Carolina Department of Environment and Natw ai Resources anti the Coastal Ries s Commission In an area of envH onmeital concern pmsuzrit to I SA NCAC Applicant me project Location: County Addrp Street Address/ State Road/ Lot #(s) CY 11(. Stare 1\16 ZIP Ati R IUA S lad pho 6 Fax # f. Authorized Agent zip rs Affected cw Fw BETA ES Prs q Li I LI'486 River Basin LIO-K�V AEC(s): OEA I H"F - 1H USA NIA XV At FIW& Adj. Wtr. Body txl-v� 04, ,� (nat. Closest Mai. Mr. Body ij",J ORW. yes nno PNA yes +c, Crit.H.b. yes 1 (1.) Type of Project/ Activity Nit"M Groin tength Bulkhead! Rprav kNth aVX lk-Once afflhiine ,rims diva— alsha,t Basin. channel klAit,, ywds 6't Boa".X.e; B.A41 Wa-twpp Beach Bulldozing Other Shoreline , 2A P" SAV yes 6.') SwAtins sijr C, Photos: moratom" W— Ob (Scale: I n Z-O AbA01 ABC Division of Coastal Mgt. Habitat Impact Computer Sheet A licant: NJ Permit #: Date: Describe below the HABITAT disturbances for the application. All values should match the name, and units of measureme found in your Habitat code sheet. Habitat 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 fii disturbance. Excludes any restoration ani temp impact amount Dredge [IFill ElBoth ❑ 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 ❑ J DEAN BURGE DBA JAB REMODELING 5908 FAIRVIEW CHURCH RD. PO BOX 144 TRINITY, NC 27370 66-219/531 2140 DATE ®Shield" PAY TO THE ORDER OF 1 _ $ ao o. 00 DOLLARS 8 comA(03 I VD»d^, jwnanown, NC 82 / / 3 5 ✓1/a A� ✓'' �O � 1A - �W ' M' Pat McCrory Governor North Carolina Department of Environment and Natural Resources --Divisionn-of-Coastal Management - -- - Braxton C. Davis Director AGENT AUTHORIZATION FORM Date: i + Name of Property Owner Applying for Permit: �'OTntciA A. YETWAt' Owner's Mailing Address: i`JS SUo pF►S1-1 _U �V'C LD c N 3 cYNC. t-t , r`i C 2-&4�,2 Phone Number (00) 942- 719 7 John E. Skvarfa, i Secretary Name of Authorized Agent for this project: e c��dQi ► �� Agent's Mailing Address: Phone Number L35 ,) 11'A _.) -'A `i �! 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): r L C) f i t t\i G, b b C i< For my property located at C 21�-t Z6_�46 2- This ceftication is valid thru (date) Property Owner Signature Date RECEIVEC DCM WILMINGTON JAN 0-6 2014 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacentto e(A-im I c i h* 1 � ' Y E•Jm �- (Name of J tI F ¢G (Address, Lot Block, Road, etc.) on—�Jrtc --- — -c -) t 5 --c (Waterbody) (City/Town and/or County) -7Ivan-nt= a� cribe�fo-me-as-shown below, the-development-proposed-at-the-above-lorcatiorr. i have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must rill in description below or attach a site drawing) WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back 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) (Aqjacent)Rroperty Owner Information) n Si ure xr Print or Type Name 1fafflng Address fling Address Print or type Nale MB 90 / r9�s r , ,-L c'� A. AIDJACgHT RIPARIAN PR RTY OWNER MTEMENT - — Ne—m My that I own nroPeirl7j2 t C i A- A- YE7'47 A-A-J_ t_Nama of Pro propartyl S f)p- t M' C- -i (Address, Lot, Block, Road, etc.) (Waterbody) (City/Town and/or County) Thae aVicant, af� s-t�ercr� Od to- ass own -below; the-deaelo e t- - - " _ pm nt-propo-sed-a"t-the-gbove location: - I have no objection to this proposal. _ I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (/ndYWduai proposh79 development must ffU in description dtalow or attach a site drawing) WAIVER SECPQN 1 understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or grain must be set back a minimum distance of 16 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 IS- setback requirement. I do not wish to waive the i 5' setback requirement. (Property Owner information) (Adjacent Property. Owner Infomution) w &Um Canal canal 191 5wordAsh dr. 20` 14' A0' o'I &ee-t' c�eck -Fo el Ccanc.- cY, f }off den c. )� '• 33 ('. - w� a - �W SC-) i F,A. I JcOO ce-mo►r�oat ya RECEIVED DCM WILMINGTON, NC JAN 13 2014