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Home My WebLink About61679D - Price_- CAMA / URELr3E &FILL GENERAL PERMIT Previous permit# —'New _Modification Complete Reissue Partial Reissue Date previous permit issued orized by the State of North Carolina, Department of Environment and Natural Resources Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC I' Rules attached. nt Name Project Location: County U a�"i W, s E Q� �� i�ti( Q, Street Addres`s/�S'tate Road/ Lot #(s) �1 V IG ! Statek& ZIP Zip 1 �- tJU Y h� YY1 YCU Fax # ( ) -- Subdivision !zed AgentVA01UA'b NUO_I_ Vl"Ccv 1 City ,I&eV,If��lUA, ZIP cW EW PTA _ES PTS Phone # (910 mtis-Hems River Basin U1,Al d LL OEA HHF L IH ❑ UBA r N/A Adj. Wtr. Body (�i�V1 fn-C (nat PWS: ❑ FC: yes / no PNA yes�o Crit.Hab. yes / no '-t Closest Maj. Wtr. Body �l.�*J W A Project/ Activity I F^t, (Scale: I ock) length m(s) pier(s) length umber gad/ Riprap length \ i vg distance offshore iax distance offshore channel ubic yards amp T )use/ Boatlift X Bulldozing ine Length not sure yeskno! igs: not sure yes xium: n/a yesyesAttached: yes ling permit may be required by: •— -.— - -- J.il pplicant: r'1 Permit #: ate: !scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement Lind in your Habitat code sheet. bitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total 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 to 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 (0 l v 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 ❑ S & BULKHEADS INC ER BUCK ESTATES _Y, NC 28462 755-6861 (:5ad / "RUST COMPANY as 01(,,66 D n aii■ i!n c;; in L L 2 L1:000 5 2 L 5 7 28 6703 66-112/531 DATE WIVI-71v11 vi vvalipLa1 I�Ia11uy6111�i111 !rlirhaei F. Easley, Govemor Charles S. Jones, Director ' Viliiam C Authorized Agent Consent Agreement YA (r?C M is hereby authorized to act c (Printed Name of Agent) in order to obtain any C MA permit(s) required for the property listed below. The authorization i; specific activities described in the attached sketch. LOCATION OF PROJECT: I 0�1 r h (I I,n- s r hL 6 ;PROPERTY OWNER MAILING .ADDRESS: �� 1-VIV__, —��'1�` 'S, �✓L' el0� , .rk - �-M PHONE NO, �0 4-- L- 1/42 3 A* 2TI 1/1 Mfi-V T A rir-LIT Al A 11 1&4e% A DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION(WAIVER FORM Name of Individual Applying For Permit: -Sl_ M 1j � L' Address of Property: Ila. atria m 5t- Rolden e5 each NC (Lot or Street #, Street or Road) (City and County) 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, should be provided with this letter. _ I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Coastal Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900 within 10 days of receipt of this notice. 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, boat house or boat lift must be set bck a minimum distance of 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.) XT T I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Sign Name ` Date 11MCMy J• 1%TtUnLicnn �r Print Name Telephone Number with Area Code NCDENR S:lcama�shellsln� parianpropeny.frm 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) (City and County) I hereby certify that I own property adjacent to the above -referenced property. The individu applying for this permit has described to me as shown on the attached drawing the development thi are proposing. A description or drawing, with dimensions, should be provided with this letter. I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Coast Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-39( within 10 days of receipt of this notice. No response is considered the same as no objection 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 s bck a minimum distance of 15' from my area of riparian access - unless waived by me. (Ifyc wish to waive the setback, you must initial the appropriate blank below.) kn NaMS.� I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. 18 :Y3 Date AlIff-w7A f� d -4,1111 fo%�QJQ)� W,qU-)n n -�oi i