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Home My WebLink About62605D - Orazem'CAM,_, / ❑ DREDGE & FILL GENERAL PERMIT Previous permit # ?New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued >rized by the State of North Carolina, Department of Environment and Natural Resources —1 , 1 1 I l Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC +i ! Rules attached. it Name "kLA-) 12_�1 Project Location: County State ZIP" zed Agent A LL4 W AA Atz I WE — t'{'yl, l ❑ CW E�,EW ['PTA 0ES ❑ PTS ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A E. PWS: ❑ FC: Street Address/ State Road/ Lot #(s) Subdivision City lam. � ZIP�� Phone # ( )/ River Basin K'Vl Adj. Wtr. Body yes / no PNA yes / no Crit.Hab. yes / no iosesi real. vvu. Douy ,f Project/ Activity �- i�_ 1 V & t _14 -1 11 A-0 (Scale: 3ck) length n(s) ength ember Wd Riprap length w (O71 ig distance offshore V iax distance offshore :hannel ibic yards mp use/ Boatlift 3ulldozing ne Length 0 not sure yes .;A9 gs: not sure yes ' life mum: n/a yes o Attached: yes o y� ling permit may be required by:�r _ 0 See note on back regarding River Basin Applicant: / �Zia" Permit #: C O� Date: v cl/�loj,3 Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen 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 fins disturbance. Excludes any restoration and/( temp impact amount) Dredge ❑ Fill Fill' Both ❑ Other ❑ �C 1 2 cO Dredge ❑ Fill EIBoth ❑ 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 ❑ Hit ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Bank of America ACH R/T 053000196 CONTRACTORS, LLC 08-03 �-367-2159 AROLD CT. EAD, NC 28443 6027 66-19/530 NC 58754 9 --1& --1 3 (�pv DOLLARS 8 - ----- ------------------ AUTHORIZED SIGNATURE 6027u' i:053000L96i: 00068474373811' AGOAA. NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary Date a Name of Property Owner Applying for Permit: G-erQIC� _- 0rct ZF-Ee Mailing Address: / 5- -4ej-5 Cad I certify that I 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) bcc I a Ol at (my property located at) / 5 �' i'�i a r e This certification is valid thru (date) 1,2--31 --13 19--�T -I3 Property Owner Signature Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to Gelxa 0ro�-z e/,*, 's (Name of Property Owner) property located at ,Sr Ma r, �,er5 (Lot, Block, Road, on N PW 2 V4,4 , in Ida P+ Pex;-� Ca , N.C. aterbody) own and/or County) Applicant's phone #: �h - 623' Y CI Mailing Address: tJD M. �,c� kn,v- ,,, P t- .'v c_ z 7 Y 5 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 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) (So I)IA r, Mailing Address nrG 21 tf 5 -7 -------------------------------------------------------- (Riparian Property Owner Information) Signature sTEFFEb,,-' J4L )Z0N6-� Nk t 's h RIPARIAN PROPFRTY OWNER J 5 STATEMENT ttoK t P/l R N()()kl%'GPIL1.'VG"0..4TUFT/$OATHOUSEj § ......,� :c`ti:(l that I Own pn.{+tm 3dld�Cni It• - r (Name of Property Owe t l.ot, Block. Road, ete.l in (Town and/or County) i 4' Applkaat's phone a: - -- —___ Mailing Address: r tit bw+drA-1 " ; t` s nun bek u. the deselopmrnt he is Proposing Aar sJ p po sin at that location, and, I hu pnposal i undet-.tand that a pier mooring pilings :' boatlift i boathouse n1initnum distan.e of titleen tact (15,) from m} area oFriparian access unless " 1 ` tl f) ou w ish to wane the setback, you must initial the appropriate blank t�ei�rw . 1 { w .'• :.` q E.:� .,: tactKh:k .^ do — reyutrrrnent. -- --------- -- __ DF�tRIPHON%NDORt)RAHTN'COFPROPOSED DEVELOPMENT: ..__ Fo hr /t/Jrd in M' individual props ving devrlopmrntl ------- .._------- — ---- _..._-------------------------------- 1a101matn+n for I`roprrn Owner %pplying (Riparian Property Owner Information) for PernutF /Signature Print or Type Name Telephone Number Datc Date e ALLIED MARINE CONTRACTORS, LLC 08-03 910-367-2159 92 HAROLD CT. HAMPSTEAD, NC 28443 PAY TO THE ORDER OF_ Bank of America ACH R/T 053000196 MEMO 60� G u'005909►l 4053000 L96i: 00068474373E00 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. Article Addressed to: fef-Ce/k J, k1vro.te Ig9Ma 0 r4r'C7 CeAL 7 kocK'i P"hf I Nc- a $ I-JIS-7 A. Sig tGre X ❑ Agent ❑ Addre B. Received by (Printed Name) C. Date of Deli D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type 10 Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number '7 011 2000 0002 2766 9331 (transfer from service label) PS Form 3811. February 2004 Domestic Return Receipt 102595-02-M-1540 . ■ 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: 14r-, �yan /1ofr t3 (Go /"1ar,'ne,,5 Ra, � Y P.,, "re- 8 tfS A. Received qy (Printed Name(/ I C. ❑ Agent ❑ Addre D. Is delivery address different from item 17 fie' 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 7011 2000 0002 2766 9324 (Transfer from servic PS Form 3811. February 2004 Domestic Return Receipt 402595,02-M-1540 .