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Home My WebLink About62595D - AllredAMA / 0 DREDGE & FILL PENERAL PERMIT Previous permit# New uModification ❑Complete Reissue CPartial Reissue Date previous permit issued ized by the State of North Carolina, Department of Environment and Natural Resources �"j I (1 O ��' 'Zu` oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �" Rulesry }ttached ;Name Uvnk-Av- �q�)q1 k1r)-A A- Y(CA1 bcm '`State ZIP_ 7 . O ^- 3 Fax # ( ) a Agent ESQ El CW Xl EW Z PTA ❑ ES PTS ❑ OEA ❑ HHF it IH ❑ UBA ❑ N/A ❑ PWS: ❑ FC: (es no PNA yes / no Crit.Hab. yes Kno Project/ :k) igth nber I/ Riprap length distance offshore K distance offshore annel ,ic yards ip se/ Boatlift Length not sure yes not sWe_ yes rMINEENIn =;1111 ME kttached: ye—, Project Location: County n�'\"(1(�(, Street Address/ State Road/ Lot #(s) Ill {-u v v l f e �, ►��-� Subdivision A City I i �- ZIP C< 1 Ph9ne4 f 1l )5'46 4990 River Basin m �� Adj. Wtr. Body'` Closest Maj. Wtr. Body pq WW' �1 (Scale: /� Z ig permit may be required by: ' %kM (A MO-6— I'XkC.IA- ❑ See note on back regarding River Basin n Ipplicant: � r^ ` �lti' i VQ Permit #: G-zlate: � 1 V escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement fund in your Habitat code sheet. TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet (Applied for. (Anticipated final (Applied for. (Anticipated final ibitat Name DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. 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 ❑ I Dredge ❑ Fill 'A Both ❑ Other ❑ I Z I I I Dredge ❑ Fill El Both ❑ Other IX W Dredge ❑ Fill ❑ Both ❑ Other i --j I Dredge ❑ Fiil ❑ Both ❑ Other ■ 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 mailplece, or on the front if space permits. 1. Article Addressed to: Mrs. Hilda S. Hall 3091 Westminster R. Lumberton, NC 28358 Leo A. Signature �Na�me) ❑ Agent❑ Addressee�B-R�e��celved (Printed C. Date of Delivery D. Is delivery address different frorn Rem 1? ❑ Yes If YES, enter delivery address below: ❑ No ❑ Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes �• ruuuv Numoer (Transfer from serv/ce label) 7002 3150 0004 0 315 5163 PS Form 8811, February 2004 Domestic Return Receipt 102595-02-M•1540 O N E Y WESTERN UNION FINANCIAL SERVICES INC. - ISSUER i D E R Payable at Wells Fargo Bank Grand Junction - Downtown, N.A , Grand Junction, Colorado Englewood, Colorado A 323436 D 090313 T 0947 05 147521442776 L 002546 E HUNDRED DOLLARS AND NO CENTS 14-752144277 $ 500.00 PAYMENT FOR/ACCT. # ��!(t,Cyl&R'S ADDRESS — —` ►► "" �� rr �� PUPLNASEH's SIGN —RE 301: 40 I475 2 L44 2776u' ONEY RDER WESTERN UNION FINANCIAL SERVICES INC. - ISSUER at Wells Forgo Bank Grand Junction - Downtown, N A., Grand Junction, Colorado Englewood, Colorado A 323436 D 090313 T 0947 05 147521442785 L 002546 HUNDRED DOLLARS AND NO CENTS 14-752144278 $ 1 AA AA .LVV s Vv PAYMENT FORIACCT. # IPUAC�F�ASER'S ADDRESS 1111 YY ll !r �n PL;CNAS-S MNAWPE 301: 40 1475 2 L44 2?iRSe Stan uoaa 3004043-yLy4 p. L �t7:5r Joelftss 9*946-3360>> 3366439294 P212 N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date f 7 4/ Name of Property Owner Applying for Permit: Mailing Address: IJ 6 ,,c eXe y r-,^e,,&,d J(?d c rF. •c c ti• ; liga-F f 4- t ;2 7 2/ L.j i certify that [ bare authorized (agent) to act on my behalf, for the purpose of applying for and obtaining all LAMA Permits necessary to install or construct (activity) at (ally property located at) &/ile This certification is valid tbru (date) Property Owner Signature Date 28 1T:57 otan uoaa Joel Klass 910-M-33603-> 3366439294 sib-b4 s-yLy4 P. l P 112 CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER N.OTIFICATIONtWAIVER FORM Name of Property Owner. U-f4M-0-S '�f✓�d Address of Fropeity. //J le I'Ve , /4 �141066vw ' 4C -� (Lot or eel f!, Street or Road. City & County) Agent's Name $1: tfd e. / 44s Maiknq Address: 9M- etla-e5 �6465 vie Agent's phone tt: 71e s--Yo _ o y 90 �uj a.. /�L ---2- ry-2 a x _ IFM - 8'Y� - -3.3 ( Ire 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 desenptlon or drawing, with dimensions, must be provided with this letter y I have no objections to thas proposal. I have objections to this proposal N you have ob)ectiorls to what is being proposed, you must notify the Division of Coastal Ultnagemenr (DCM) in writing wrthin 10 days of receipt of rhos notice. Contact information for OCilt offices is avoiWle at www.nccoastaitnananement.f)eucontact dcm.hin; or by calling 1-084RCOAST No rtsportare is considered the frame as no objection if you have been n otiOmd by CertAied Mail_ WAIVER SECTION i understand that a pier, dock, mooring pilings. breakwater, boathouse, lift, or groin must be set back a minimum distance of 15from 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� I do not wish to waive the 15' setback requirement (Property Owner Information) igrxtrttrP Print or Type Na o / eal Mailing Addmss 1fty'Q eAlszor"!1, N�- � 7Y/Cl City/Stere/�ip T— �TG-%/t7-%75� (Adjacent Property Owner Information) SigturretrP 0 pent or Type Name Pit. 6 ey .?/a) Mailing Address — ;; 'C- n 77� A/- G . o7.�yv�7 c4y/st p Ic -*gt 0 lot AV *4 oGI x TV U. � ixs ze ICI CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: 14"/r1,es A110-t9 Address of Property: /// f ` k % •e Heu s %le. S/ l4e%WeoV (Lot or Sheet #, Street or Road, City 8 County) Agent's Name #: , e7 e_- Mailing Address: / �t - rtSS 144 Agent's phoneL- Si"�y3 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 drawing, with dimensions, must be provided with this letter. 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. Contact information for DCM offices is available at www.nccoastalmattagement.neticontacr dcm.htm or by calling 1-888-4RCOAST. No response is considered the same as no objection if you have been noted 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 Owner Information) Signature ��Mes A//rad— Print or Type Name y LI-7y a i- e Mailing Address ( ent PropeT O r Information) Si attrre � '(I J C SL 4 Al I I Print or Type Name Mailing Address Kd, i!� �'r1!naaah��