HomeMy WebLinkAbout63119D - Evans�CAMA / DREDGE & FILL
PENERAL PERMIT Previous permit#
ew —Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
)rized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Ames attached.
it Name 0i . Project Location: County
Street Address/ State Road/ Lot #(s) 4
ZIP
Fax #
zed Agent
A
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1'EW 'PTA ES ❑ PTS
❑ OEA
❑ HHF ❑ IH 7 USA ❑ N/A
❑ PWS
❑ FC:
yes no
PNA yes / no Crilt.Hab.
r
yes / no
angth
ember
id/ Riprap length
g distance offshore
ax distance offshore
hannel
ibic yards
mp
ise/ Boatlift
Subdivision
city 1 ZIP_
Phone # ( ) River Basin C
Adj. Wtr. Body \10ii nat
Closest Maj. Wtr. ody
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NC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant: N� "Ev ` ' Permit #.
Date:
l- (v
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 f
disturbance.
Excludes any
restoration ar
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
ZLQ
O
k:;�'
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 ❑
tc
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
JAMES E. EVANS, SR. 1086
714 ARJEAN DRIVE 66-112/531
WILMINGTON, NC 28411-9302
I C� OrOC.tr
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BRANCH BANKING AND TRUST COMPANY I��v
1-SWG-BANK 1B13TBBB/BTA*m
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1: � IIB
.053LOLL2��.0005L04529 7 086
�'..- ADJACENT RIPARIAN PROPERTY OWNER STATEWIENl
I hereby certify that l own property adjacent to (Name of Property Owner)
property located at _ V'Z-CeD`''
(A dress, Lot, Block, Road, etc.) N.0
on �it,rro _ - rvcs t'� _-, in 111 •
(Waterbody) (CitylTown and/or County)
The a pf ant has described to me, as shown below, the development proposed at the above I
I have no objection to this proposal. ' "tk" `
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELUFM v I
(individual proposing development must ffll in description below or attach a site dra
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be
minimum distance of 15' from my area of riparian access unless waived by me. (If you wisf
the setback, you must initial the appropriate blank below.) RECEIVE
NlAf. I do wish to waive the 15' setback requirement. DCM WILMINGTC
1 do not wish to waive the 1 a' setback requirement. DEC 2 3 201
hq-
(Props Owner Information) (Ad' ent Prop rty Own r Information)
Si toe Signatu e
Cl 144 W -5 car f4&(4CdvJ
Print or Type Name Prin�or Type Name
?!y, A h �•eza ,t r�. f0 Lai i031
AA--adnn A,4,4 ne. a 1AJJ---
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 44 W%.XPA AE 11 ` 1A `J - w_
(Narrt�e of Property Owner)
property located at 71�/' � �� �'u.v, °1�.r,
(Address, Lot, Block, Road, etc.)
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
C!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 dra+
1 z
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be sf
minimum distance of 15' from my area o4 riparian access unless waived by me. (if you wish
the setback, you must initial the appropriate blank below.) RECEIVE E
—
do wis-fii to waive the 15' setback requirement. DCM WILMINGTON
I do not wish to waive the 15' setback requirement.
DEC232013-
(ProperWwner Information) (Adjac�4 Pro�erty Owner Information)
S.
e
Print or type Name Print or Type Name