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Home My WebLink About62674D - PerrinCAMA /❑'DREDGE & FILL ENERAL PERMIT Previous permit# New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue Date previous permit issued ized by the State of North Carolina, Department of Environment and Natural Resources l oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC � �� i � �-- ; El Rulesattached. t Name Project Location: County ►n�� tom' [-tr'a. Street Address/ State Road/,(Lot #(s) UZr�t. t State Ot ZIP2�1 � . J � � { f.1 Yj,� `)J -�.� .Fax 1 ( ) Subdivision (� :ed Agent KJM11 �`-' City � �1N� �cS�1 � � (� l � � ZIP ii •• 11 L ❑ CW EWPTA ❑ ES ❑ PTS Phone # (' River Basin W �� ❑ OEA ❑ HHF IH ❑ UBA -- N/A 7 /� ❑ PWS: ❑ FC: yes nod PNA yes /140 f Project/ Activity ick) ngt %1 ,(sr r' x rier(s) mgth ember �d/ Riprap length g distance offshore ax distance offshore — _ hannel I bic yards i np ise/ Boatlift lu ozing --4 — I - - re Length not sure yes no .s: not sure yes ono` rium:n/a yes no Adj. Wtr. Body hh na Crit.Hab. yes /` no Closest Maj. Wtr. Body��WYV 41 (Scale: 1 // Attached: yes (no ing permit may be req\\uired by. �j i� �(AA1-114 �6 r[t C LI— El See note on back regarding River Basin r ,.-.---- �i 1 1_7 11 n 6 C , -�-11 1 K) I I - ,. ►. 1,11 lA A 1-„i 1..: NC Division of Coastal Mgt. Habitat impact Computer Sheet applicant: Permit #: )ate: ll�zi�� 3 describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement 'ound in your Habitat code sheet. iabitat 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 Tina disturbance. Excludes any restoration and/c temp impact amount) Dredge ❑ Fill ❑ Both ❑ Other O 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 0 NCDL 5716744 66-1121531 NCDL 4103077 Pxm`�'�"'�1i1'f/�// BB&T@WORK NK SOT BBT:aom 1(3 AND TRUST PANY // a 611.0 6A 68 a :9,0 1* 9 as 6 41 s 0 DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION(WAIVER FORM r Name of Individual Applying For Permit:4 h'J Address of Property: (Lot or Street #, Street or Road) (City and County) hereby certify that I own property adjacent. to the above -referenced property. The individi applying for this permit has described to.me as shown on the attached drawing the.development tl are proposing. A description or drawing; with dimensions, should be provided with this letter. I have no objections to this proposal. (n f ' If you have objections to what is being proposed, please write the Division of Cons Management, 127 'Cardinal Drive Extension, Wilrimingtou, INC 28405 or call 910-796-71 within 10 days -of receipt of this notice. No response is considered the same as no.objectioi you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be bck a minimum distance of 15' from my area of riparian access- unless waived by me. (If, wish to waive the.setbacl(,-you must initial the appropriate blank below.) I do wish to waive the 1 5' setback requirement. I do not wish to waive the 1 5' setback requirement. �l Sim am Date N DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Individual Applying For Permit:_ Address of Property: �( (Lot or Street #, Street or Road) --1.5f zryt 1 v, (City and County) hereby certify that I own property adjacent. to the' above-refere-riced property. The individ applying for this permit has described to.me as shown on the attached drawing the. development tl are proposing. A description or drawing, with dimensions, should be provided with this letter. 14 l I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Coas Management, 127 'Cardinal Drive Extension, Wilm' ington, NC 28405 or call 910-796-7: within 10 days'of receipt of this notice. No response is considered the same as no.objectioi you have been notified by Certified Mail. _ WAIVER SECTIOIN I understand that a pier, dock, mooring pilings, breakm,zter, boat house or boat lift must be bck a minimum distance of 15' from rriy area of riparian access - unless waived by me. (If; wish to waive the.setback,-you must initial the appropriate blank below.) I do wish to waive the 1 5' setback requirement. I do not wish to waive the 1 5' setback requirement. ,0�-IWA �% NCDENR North Carolina Department of Environment and Division of Coastal Management 1cCrory Braxton C. Davis ernor Director Natural Resources John E. Skvarla, III Secretary AGENT AUTHORIZATION FORM Date: ) 13 of Property Ovqer Applying for Permit: Name of Authorized Agent for this project: is �Maln Address: i !3 oc Number QCVS) �63-425(ya Age nt'sAf4ifing Address: Zk--14<'N 1�; jc- Phone Number y that I have authorized the agent listed above to act on my behalf, for the purpose of applying Jobtaining all CAMA Permits necessary to install or construct the following (activity): y property located at J 75AF - OC.. C ry artification is valid thru (date) en Pr 4e4 Owner Signature Z522� Date wrlJTM��-- l v?c o u .5 c1 o-qq 3-'7'Ig3 A1U 0 r, 0 Fr- S7-P /S Fr ■ Complete items 1, 2, and 3. Also complete A. item 4 if Restricted Delivery is desired. X ■ Print your name and address on the reverse so that we can return the card to you. g ■ Attach this card to the back of the mailpiece, or on the front if space permits. 4 1. Article Addressed to: ► 4LV- 3 � / 3 `B✓( K� P46e CAAAV) Otb, O , Agent by (Printed Name) Date of ► .D ,04,10"4C. 11,1A Is delivery address different from ' m� `1? �❑y Yes If YES, enter delivery address `�Ll��'c'7'�+ 0 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 1 7007 3020 0001 0995 2566 (Transfer from service labeq PS Form 3811,.February 2004 Domestic Return Receipt 102595-02-M-1540 ■ Complete terns 1;2, and 3. Also complete A,_ Si nature item 4 if-RestricW Delivery is desired.. ' ❑ Agent ■ Print -your name and address on the reverse :..; ❑Addressee so that we can return the card to you:- B.. ived y (p C. Date of Delivery ■ Attach this card to the back of the mailpiece, , , tiZOC or on the front if space permits. �' h D. Is del' ress diffe ' em 1? ❑ Yes 1. Article Addressed tro: If YES r deliver �e w: ❑ No �t 111 PW 15��1 -7cz- FP WJ N ` � ` 1 �� 3. Service Type ` ,� ,t� (l"tr,, ❑Certified Mail ❑Express Mail �' ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7007 3020 0001 0995 2559 (ransfer from service labeq ra. r_� 00� •1 r_�....__. nnn� r.____.._ o......., o......:..a - .. - 1nOCtiS_n2C,LY ren