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Home My WebLink About57447D - CarltonCAMA / DREDGE & FILL ;ENERAL PERMIT M� Previous permit# New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued •ized by the State of North Carolina, Department of Environment and Natural Resources Zf �l0 d :oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC � R I hed it Name Odes 5 f iZ vC.,:1 I O-e N15`L State'jZIP ax # ( ) zed Agent IJA _ CW � EW ,DFITA S ❑ PTS ❑OEA ❑HHF ❑IH ❑USA ❑N/A ❑ PWS: ❑FC: yes no PNA yes no Project/ Activity Inn. k Crit.Hab. yes tnft AID ►/\la -IN arty Project Location: County eL4�z Street Address/ State Road/ Lot #(s) i C(0 f�40 V u L Subdivision I Cityy bJ--*-ZIP Z2y.- Phone # L River Basin �J! Adj. Wtr. Body 1. t" 6,, r4+ok to J^ (nat Closest Maj. Win Body • / �® f1i WE .E■■■■■■■■■■■■■■■■■■■■ ■MEMO ■■■■ONE ■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ OMEN ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■m■O■ .■■■. MEMEME■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ MEMO ■■■■■■■■■■ ■MEME■E■■OEM■■■M■M■E■■■■■■MOMEME■ ■■■■■■■■■■■■■■O■■M■■■■■■MOM■■■■■■M■■ MEMME■M■MEM■■■ NONE ■M■EMME■ME■■E■■EE■ MEM7M,?TT-1 Vgavl'" � SH I ■■MES■!lWWOMMOMM■EM■ ■■MEMO■■ i■■■■■MMM■MEM■M■MMEI MEMO ,�� ■■MMMEM■ROE■■■■M■MMM■MMMEM■tI■■MMMMM ■MOMMEMEME■MI,,/l■■G�II•J�14//aMM■■■t�■O■■MM ■MO■M■■■EME■■fl�iliMii/EE//fiiMM■M!l�EM■■■M■ MEMO■■En■E■■M■■MEMOMEMEMEW L''■M■■■ ■■■■■■■Y [J■MM■■■M■■EMME■MEM MM■MOM EMMEEMMEMEM MEMOEMEMM■M■■■MEM■M■MEEM■MEMEMMMOMM MIMMOMMOMMEN ding permit may be required by: �-Fig-/'�j� J` ❑ See note on back regarding River Basin 55 !an. 29. 2013 11rBr 91- IoP0',`L2(-// I N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM n Date Name of Property Owner Ap lying for Permit: l �ar/ Mailing Address: i N eh u (' S Itic� W3c 7 No. 2326 f certify that f have authorized (agent) to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) ,- ' .01 at (my property located at) This certification is valid thru (date) / -11-4 &I--> rzo &-� � I � ---1 Property Owner Signature Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSIBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to ap i- 41 6 r (fvK- 's (Name of Property Owner) property located at on Cli n it (Waterbody) o1- k Ave (Lo , Block, Road, etc.) in it ge&G , /��rl � , N.C. (Town and/or County) Applicant's phone #: �!C 3/i j Zls� Mailing Address: CI Z 0N (ce Ct lyG 2,8yN 3 He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (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 not wish to waive i'lIq I do wish to waive that setback requirement DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) -------------------------------------------------------- (Information for Property Owner Applying for Permit) fZ G uct,' I lake �� F Mailing Address (Riparian Property Owner Information) Signature Z83`7`-( 0,l(iawt ! . (fro /v ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOOR17VG PILINGSIBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to Aa r `l*G 's (Name of Property Owner) property located at n r (Lot, 4ve lock, Road, etc.) on in / AnA-41—,N.C. (Waterbody) (Town and/or County) Applicant's phone #: �� ' 1 Z l ��j 1 Mailing Address: Z td1d0 G f" He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (IT) 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 not wish to waive N/A / A I do wish to waive that setback requirement. - - DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) IE,c�3fi I ------------------------------------------------------------------------------------------------------------------- (Information for Property Owner Applying (Riparian Property Owner Information) for Permit) Mailing Address Signature P,`ne ✓rg� , �nl� Z8 37t4 7taP.a5 `% a/gk lc�i )licant: (�/l� �� f e- S C"a `/I e — (//J r ZZ 2 r Permit #: 57 �L -7 cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement id 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 ❑ Other ❑ (f Q)01 �6 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 ❑ n . . Bank of America ALLIED MARINE CONTRACTORS, LLC 08-03 ACH R/T 053000196 910-367-2159 92 HAROLD CT. HAMPSTEAD, NC 28443 $ qc,., 4 c P s �`�7 5579 66-19/530 NC 58754 Y u m e 0 pa DOLLARS AV B Y AUTHORIZED SIGNATURE ■ 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. a Addressed to: �' ll of •�►1 i Ak 2771,Z A S%ature X ❑ Agent ❑ Addressee B. R ce' ed by ( Printed Name) C. Date of Delivery D. Is delivery address different from Rem 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number (Transfer fromsery701,2 1640 000o 1119 7884 PS Form 3811, February 2004 Domestic Return Receipt ■ 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: r1 r fZ Gor `I T L- 102595-02-M-1540 A. Signature gent X f .� r; (i L j �! ❑ (.V�Y�- 1 Addressee B. Received by (Printed Name) C. to of D livery �� ,'llfG� , � ��11/-;? D. Is delivery address different from Rem y� ❑ s If YES, enter delivery address below: 3. Service Type Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 2. Article Number 4. Restricted Delivery? (Extra Fee) ❑ Yes