HomeMy WebLinkAbout61664D - BreedenCAMA /T ❑DREDGE &FILL
M 611
ENERAL PERMIT Previous permit# -8-
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources -7
oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / ( T
` l y��� � ❑ les attached.
t Name -PEA) Project Location: County �Q.tA e,4.
1 mo� Street Address/ State Road/ Lot #(s)
Stater"r. ZIP
Fax # ( ) Subdivision A�
zed Agent City VV Km /N�7"TOfJ ZIP z"R+
ElCW ❑ EW ' L : PTA --'ES ❑ PTS Phone # ( — River B in ,
i ❑ OEA _ i HHF IH UBA ❑ N/A (f �/
Adj. Wtr. Body
yes P no' PNA yes V no Crit.Hab. yes / no Closest Maj. Wtr. Body LUG(( r
f Project/ Activity (a V ` G( i i lc 4✓ Uu/i
�Y 41
)ck) length
n(s) 1 X / fJ A
angth
ember
id/ Riprap length_
,g distance offshore
ax distance offshore
:hannel
ibic yards
mp
use/ Boatlift
WIdozing
ie Length
not sure
yes
_.
gs: not sure
yes�;--
,,
rium: n/a
yes
yye�ess�
Attached:
14021 r
ing permit may be required by,: LAfV44 C40- ❑ See note on back regarding River Basin i
plicant: �'✓ / e� V� Permit #: /�') ✓
fe:
�0-13-13
icribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
itat 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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑
Fill ❑ Both ❑
OtherA,
V
b
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ElOther
ElDredge
❑
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 ❑
603
15-3/54'
r-3 887
Date
Dollars `• o
OF
Ik
i32L92497Tim 0603
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to !N l a ti K' c; V a cU wlc' i'% Arz e CA4 h 's
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, et )
ony y C r c_e � in S � o I f s H 1 1 , PP N'�M , N. C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
>!<— I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
fC'C N i
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.)
L ?� I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner orm tion)
Si$rat re
Print orT,ype Name
(Adjacent Property Owner Information)
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Width of creek at point of proposed dock = 33'.
♦. ', (a ?I h . " " ? 77'45'34"
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to W; I I a vj Co koct�;, Ar4 ee' h s
/� (Name of Property Owner)
property located at //'7 A4,5� 4'.e 1 ' %Dr,'� �
(Address, Lot, Block, Road, etc.)
on Cr� in Sco�1�S I��� O{y.Qer Cc�...� N.C.
(Waterbody) (City/Town and/or County
The applicant has described to me, as shown below, the development proposed at the above
location.
x I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
A41 C' C '
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 Ow er Information) (Adj cent Property Owner Information)
Signature Sig.napture II
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Width of creek at point of proposed dock = 33'.
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