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Home My WebLink About61609D - Harper%CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit # ]New ElModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued rized by the State of North Carolina, Department of Environment and Natural Resources ILL, :oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC �qq t Name ly�&A P. � (>(a{ �/ Rules attached. Project Location: County T/�UY15t�1((t �AVVIVAbt;YA Street Address/ State Road/ Lot #(s) taxi �S ock Stated _ ZIP 2�1 L,-q �%111t '' (I )S Fax # ( ) Subdivision Nip ;ed Agent 6intj `3�Vl41 CL_, city Jll y1n� ZIP 41�Y�Ll ❑ CW ❑ EW J:�, PTA ❑ ES PTS Phone # O 1 " 1 S River Basin V 111 ❑ OEA ❑ HHF IH - UBA N/A Adj. Wtr. Body [ j(1, (nat6 ❑ PWS: ❑ FC: , yes no PNA yes no Crit.Hab. yes,/ no Closest Mal. Wtr. Body f Project/ Activity ck) length iier(s) ength mber d/ Riprap length I g distance offshore ax distance offshore hannel bic yards np ise/ Boatlift iulldozing G x 5c� re Lengtf not sure yes ' no ;s: not sure yes no rium: (n/ate} no T Attached: yes no ing permit may be required by: (Scale: I ❑ See note on back regarding River Basin r I % . 1 . .. ,i r, I I 11_k.. l --I. 1 it - I . �ICDE�R. Resources North Carolina Department of Environment and Natural Division of Coastal Management Dee F Beverly Eaves Perdue James H. Gregson S, Governor Director AGENT AUTHORIZATION FORM Date: N�amef Property Owne Applying for Permit: Lome of Authorized Agent for this project: fyt. S�I Owner's Mailing Address: __ ... . 1-- Phone Numbers 1 S7 q I certify that I have authorized the agent listed 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): M PI(it-� b�11 k1� 4 (my property located) at G',r0 ^ hu This r certification is valid thru (date) _ _ ❑ate dL CERTIFIED MAIL — RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to 1 012 is t(Namne of Prop rty Owner) ty located at rr t, lock, Roaa tc.) 0C in �C� �1� QCo C� , N.C. (Watexbody _ (Town and/o Co nty, �, \ ruxii ant's phone #: `-i�O ��q ��)�S ailing A es : u 0 has described to me as shown below the development he/she is proposing at that location, ave no objections to the proposal. --------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF -PROPOSED DEVELOPMENT: (Individual proposing development must.fll in description below or attach a site drawing) 0�u have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext. Wilmington, NC representatives can also be contacted at (910) 796-7215. No response is considered the same as no objection if you have been notified by Certified Mail erty Owner Information) lure c r or Type Natne ng Addrests � (p (Riparian Property Owner Information) Signature r—� Print or Typ ame Mailing Address l ss U mf s/IA�� IANU UtLIYtn ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to �) t 1 \ 1 ` 1 y r- ri _ 's (Name of Proper Owner) property located at U,p2_ Puri r�� r�,, c� r (Lot, Block, Road, etc.) on S� a Vv�1'1�' w"vi , in _U�'1—� 1 `-� , N.C. (Waterbody) (Town and/or County) Applicant's phone #: S1(i-ciLc35— Mailing Address:LtLC� S 130L c 't O'-su-j (k� Q,13:4-p -& U cf � ]V � 1-1 CC - He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. ------------------------------------------------------------------------------------------------------------ DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by property owner proposing development) ------------------------------------------------------------------------------------------------------------------- (Information for Property Owner Applying (Riparian Property Owner Information) for Permit) Mailing Address —Signature \NX\- I v ✓ v' V i 1 ',��i r i . ,e w � 1 T � � '� � � 9 ■I � � �i1ivi - 1 s 11 litittt! iplicant:/Vt44AYtPermit #: ite: EV I oq � scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement ind in your Habitat code sheet. TOTAL Sq. Ft. (Applied for. �itat Name DISTURB TYPE Disturbance total Choose One 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 ❑ 1 ll Both ❑ Other ❑ (�J ll ❑ Both ❑ Other W l ❑ Both ❑ Other ❑ rDredgeE] l ❑ Both ❑ Other ❑ ❑ 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 0 Fill ❑ Both ❑ Other ❑ GRICE CONSTRUCTION OF BRUNSWICK 8928 COUNTY INC 6618 BEACH DR SW BS. 910-579-9095 66-112/531 OCEAN ISLE BEACH, NC 28469-4710 DATE /1 I -cc t 0 l l u--_-_--' DOLLARS BRANCH BANKING AND TRUST COMPANY 1 1 � �� 1- ANK BBT T.com ICI - ritil,e 'u�= ctn �'L ,� ■ 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: A. Signature ❑Agent X ' /- ro ❑ Addressee B. 'Iiecelved by ( Printed Name) C. Dat of D��ivery A3 D. Is delivery address different from item 1? ❑ As 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 7009 1680 0000 2205 9823 (rransfer from service label) PS Form 3811, February 2004 Domestic Return Receipt 1025$5-02 M-1540 Postal CERTIFIED MAIL,, RECEIPT m(Domestic • . ru "n $0.46 0472 0 Postage $ IU nj Certified Fee 11) 0 C3 Postmark � Return Receipt Fee $•2.55 Here O (Endorsement Required) t3 Restricted Delivery Fee.al,l�l� (Endorsement Required) O co Total Postage & Fees $ $6.11 04/ 15/ 2013 .a r r Sen fr -e r n� ..............•---•-•------- o.................. `5 Street, t.T7- ( �^ or PO Bon No = t"-- ----- � nc l �Jl [` --