HomeMy WebLinkAbout62572D - LanierCAMS+. / ❑ (DREDGE & FILL / 62+
'IENERAL PERMIT `/ Previous permit# 'f'—
,New ❑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 L DU
/ Rules a hed.
Nam A �I !V -Gf W ;lG�Soject Location: County T Wit+
v Q Street Address/ State Road/ Lot #' (ss)
r State / e-- ZIP
,ad Agent " n /—
❑ CW t EW ij PTA ❑ ES C PTS ^
❑ OEA HHF IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
yes / no-' PNA eyes] no Crit.Hab. yes / no
Project/ Activity
:k) lengthIt Y, t'
(s) `mot$
er(s)
igth
nber
i/ Riprap length
distance offshore
x distance offshore
cannel
)ic yards__
ip
se/ Boatlift
illdozing
Length 7/— 5
notsure yes
s: not sure yes 9
ium: n/a yes t
yes
\ttached: yes
ng permit may be rec
;'Sf 9 i' f'I
Subdivision
City v % / ( Ilk
Phone # OtU 247 72
Adj. Wtr. Body
Closest Maj. Wtr. Body
A rl% �#-
ZIP Z5"-V t
River Basin�t
I r V (Scale: I it, I
plicant: %� �Permit #:
t(J
1 C( - /-3
scribe 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. FINAL Sq. Ft. TOTAL Feet
(Applied for. (Anticipated final (Applied for.
Disturbance total disturbance. Disturbance
includes any Excludes any total includes
anticipated restoration any anticipated
restoration or and/or temp restoration or
temp impacts) impact amount) temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
ding, LLC
?190
28445
1 194
BANK OF THE OZARKS 1 779
Wilmington, NC 28405
81-727/829
8/12/2013
`"200.00 °
DOLLARS 8
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16-11
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7911' 1:08290727D: 114270400238ill• 2
GE & FILL 62 577 2
PERMIT Previous permit #
4iF�l ;Complete Reissue -.'Partial Reissue Date previous permit issued
authorized by the State of North Carolina. Department of Environment and Natural Resources
d the Coastal Resources Commission in an area of environinenril concern pursuant to 15A NCAC cr,
1 Rules art—hed
c-Project Location: County___,_.,_
Street Address( State Road/ Lot #(s,)-,
—A�
Subdivision
city zip c3
Vj
Phone# River Basin-
_ ja'J!:�, ----
-11— - OEA f -j HHF AH LMA HIA 11'
�Qs): Ad'. Wtr. Body ink
PWS, FC: Closest Maj. Wtr. Body
W yes t� �q� PNA <��Ts no Crit.Hab. yes no
(pe of Project/ Activity L�, S t -f r
(Scale: Lj 0'
11w ;dock) length
Sroin length
nurnber—,
WkSea&'Riprap length,
avg distance Offrl re -
max distance offshore e
3astn. channel
cubic yards
kat ramp
3coathause/ Boatlift
- ---- ------- 3each Bulwating
Zither_
iAV- WK sure )-S
wa Yes
vVaiveAMthed: yes
jj
k building permit may be required by ftenote on back regarding River Basin rules.
U, i 1 0 j 0 11, t
Q
i`y��-'A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue Braxton C. Davis
Governor Director
Dee Freei
Secre
AGENT AUTHORIZATION FORM
Date: 3 1 /3
ime of Property Ownerr Applying fo( Permit: Name of Authorized Agent for this project:
riner's Mailing Address:
Agent's Mailing Address:
Ook )-55 z
�LI L(
Phone Number( �10 ) Z (n 2-2-43
Brtify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
and obtaining all CAMA Permits necessary to install or construct the following (activity):
r my property located at 5,// w0-1e-I- L A •')I011"'S
s certifinntion is valid thru (date)
Property Owner Signature
Date
�CEIVF—D
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street or Road, Ci County)
PD - �� ��-Agent's Name #: /Mailing Addres :/ �.:�
Agent's phone #: 410 - 3
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM 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.
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,rqp (If F-4V ED
wish to waive the setback, you must initial the appropriate blank below.) DCM WILMINGTON,
I do wish to waive the 15' setback requirement. AUG 1 6 2013
I do not wish to waive the 15' setback requirement.
(Pro rty,)Owner Inform tion)
� � r
Signature
/tom U
Print or ype Name
(Adjacent Property Owner Information)
Signature
Print or Type Name
AA -.'I;-- A,4,4 --
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street or Road,
M " t
Agent's Name #:
Agent's phone #:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM 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
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 waivedb
wish to waive the setback, you must initial the appropriate blank below.) HIL U � f i ft D
DCM WILMINGTON, NC
I do wish to waive the 15' setback requirement. AUG 1 6 2013
1 do not wish to waive the 15' setback requirement.
(Pro qz%Owner Inform tion)
l � r
Signature
,,, P � t or ype Name
Mailing Addre.5s
(Adjacent Property Owner Information)
Signature
Print or Type Name
Mailinn Arldre±.cc
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RECEIVED
DCM WILMINGTON,
AUG 1 6 203
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45,
rECEIVED
DOt,,ii W1LMlNGTON,
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■ 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:
1 /1
WILMING
AUG 16 -
AT —�
A.
X
B. ReceWby (Printed
D. is deliveDfraddressdifferent �om'em1? ❑
If YES, enter delivery address bE�
284�
d, NC
S. 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 from service label) 7006 3450 0003 6742 1123
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 :
�elivery information
visit our website at www.usps.comu
Postage
$
Certified Fee
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;ted Delivery Fee
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Postage & Fees
$
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Apt.
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7U. August 2UUt
■ 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.
m
ru
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Postage
$
m
Certified Fee
F
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Return Receipt Fee
V L [Vl wtLMI i
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Required)
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Restricted Delivery Fee
(Endorsement Required)
o� 1
2013
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Sen ,/�
!cam LIbC(YS /1 �f/� ----------- --------
O Street, Apt. No.;
[� or PO Box No.O
City, t +4PS Form
:rr August 2006 See Reverse for Instruction-
A. Signatu
X i ❑ Agent
❑ Addressee
B. Received by ( Printed N e) C. D e of elivery