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Home My WebLink About60681D - Custer�CQMA / DREDGE & FILL /` NO. 60f "'IENERAL PERMIT Y Previous permit # ew Modification ❑Complete Reissue _ Partial Reissue Date previous permit issued ized 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 • / 2 oD �{� Rules attached. t Name Project Location: County /V&,Ie f A, "" ►/'/�V/ Street Address/ State Road/ Lot #(s) State ZIP A% t 0) 2 —OJAV Fax # ( ) ,�./.�"" " Subdivision�� :ed Agent �J %/h 0"�! i'/ F+ . City �i�//'/�`�7�.5'1�//1'! /�i �iF' ?G ❑ CW fVeW S;,, A _ ES C PTS Phone # (_ ) River Basin C-0 ❑ OEA C' HHF IH __ I UBA ❑ N/A PWS: ❑ FC: yes /j PNA yes /6� Crit.Hab. yes ' Project/ Activity Al 14 119d 7/_ ,kyl �,rri' fih 516 . :k) length ,(s) 7 ier(s) ngth nber i/ Riprap length distance offshore x distance offshore cannel --- 13. )ic yards ' ip Boadift ts. i illdozing Adj. Wtr. Body 40%W S (_ hat (I Closest Maj. Wtr. Body (Scale: V �( 7 -r � I a Lengthto not sure yes no - _ not sure yes o JJ um: n/a yes no y o 1► /' atached: /yesJ n f ri ig permit may be required by: � t%_ « �� Special }/ Conditinnc / u /,7 _^ if d ❑ See note on back regarding River Basin rt .n-'1...s/%. pplicapt:�7C�{5�c°✓ Permit #: ate: 66 (0/b iiiii' ✓✓✓✓`"`�� ascribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement and in your Habitat code sheet. bitat Name Pw 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 ❑ Both ❑ Other ❑ E ❑ 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 ❑ Wilmington t ni Area E PIERS & BULKHEADS LLC iTSVILLE AVE 910-256-6357 OINGTON, NC 28403 18966 66-21/530 10141 2086170208961 DATE w 6n' i:053000 2 L91: 2086 L 716 2016 96 Lli' NCDERR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue James H. Gregson Dee F Governor Director SE AGENT AUTHORIZATION FORM Date.�- Name of Property owner Applying for Permit: Name of Authorized Agent for this project: Owner's Mailin/gj /Address: e C l C tc a Phone Number L9(0 ) 41 O - q S $ ` Agent's Mailing Address, Phone Number _ 3 i - Sl � / z1 I certify that I have authorized the agent iisted 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): (my property located) at This certification is valid thru (date) /e Ail 31-_ Da Property owner Signature i 1 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORING PILINGSIBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to p��o� 's (Name of Property Owner) roperty located at � i(/� �,��' ��i/ , (Lot, BI c Road, etc.) n� ,✓ is �',g, 4; , in N.C. (Waterbody) own and/or County) .e has described to me, as shown below, the development he is proposing at that location, and, I have :) objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set ick 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.) 1 do not wish to waive I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) reformation for Property Owner/Applicant Applying for permit) [ailing Address (Riparian Property Owner Information) 4 Signature Print or Type Name ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to �'/- le. L= �31,w s (Name of Property Owner) roperty located at (� Al—, L�/i.9.J�li'a�L � (Address, Lot, Block / Road, etc.) n �5 C ti� —,in � ;�f75 Ua-1, /�e�� , , N.C. (Waterbody) (City/Town and/or County) he applicant has described to me, as shown below, the development proposed at the above location. I� 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) RECEIVED DCM WILMINGTON, NC JUL 1 12013 WAIVER SECTION understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a inimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive e 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. roperty Owner Information) (Adja P rty ner Information) gnature Sigma rlt,' 4�, �411 ant or Type Name Print or are