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Home My WebLink About60780D - ShellCAMA / ' DREDGE & FILL G NO. 607 OEN ERAL PERMIT Previous permit # . ❑Com lete Reissue -Partial Reissue Date previous permit issued New Modification p zed by the State of North Carolina, Department of Environment and Natural Resources :)astal Resources Commission in an area of environmental concern pursuant to 15A NCAC ❑ Rule attached. Name �"' �r f { �'/ Project Location: County ' ZI Street Address/ State I ;6► i'� '�G Y� _/ZZ StateRoad/ Lot #(s) StateZIP �LvWi Fax # () _ Subdivision !d Agent ' �''1 � '7v t h ��L't City ♦ / ♦ ZIP - CWW ETA - ES C, PTS Phone # ( )`�—^/yam River Basin - OEA ❑ HHF -1H - UBA ❑ N/A Adj. Wtr. Body W A na - PWS: -FC: yes PNA 4 es no Crit.Hab. yes /Oo Closest Maj. Wtr. Body Project/ Activity -f' > ie Length'-- not sure yes no s: not sure yes o rium: n/a yes no Attached: yes yes �o t 11 (Scale: ( Z Z r or 7� �ApOfyZ ,� fS e4.,. ❑ See note on back regarding River Basin ing permit may be required by: Aw 0-1,_' r-- I V' ---1. MAI y �esh� Shyll 126 3 NRO 010 MPRSF4 �J ,Oslo r clr sM SL v I-Sis O Z ,, of 9,4y ail,YN (�92/ c�.sad slob D - — g xZ 9-2010 11:13 From:DCM MHDCTY To:91910347074e Pa9e:4,4 NCDENR of Environmer, Djv]*S'kn. of C�;aatal liana-l'orrent 3eva-!� -Eaves, James H. Gregscn, OjI'3CtCr Date -,T,4)v q ). Applicant Name J---Q5 Mailing Address oia— Po to W11 -3 T 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) 0 2 P4 ew V- 0 at (location) (,,3 This certification is valid thru (date) Signature �n. 8. 2013" 1:16PV 9'Af 1 ac' 2... TREF.SURE REAL':Y No. 0407 P. 1L"1-1 ADJACEN , RIPARIAN PROPERTY QM MR STATE_ I hereby certify that I own property adjacent to (Name of Property Owner) property located at Y b f (I L`.1 K,vee L'or Qo (Address, Lot, Block, Road, on Ati�f � Ivor+ik Tu A"d N� , N.C. (Woterbody) (City own and/or County) The applioant has described to me, as shown below, the development proposed at the above locatior _ I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOFED DEVELOPMENT (Irnflvldual proposing development must fill in deseript(OWDbelow or attach a site drawing) -), &0 9 La r-9 U:J --1- L. . - -- - - -- -- WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set b2 minimum distance of I g from my area of riparian access uniess waived by me. (If you wish to w the setback, you must initial the appropriate blank below.) _T I do wish to waive the.15' setback requirement. V/ I do not wish to waive the 15' setback requirement. (Property Owner_ Information) Signature L --- ic � PC 4 me `l1 __'' �� 9� (Adjacent Property Owner information) Si gtwe Print or type Name t 1 i �LLirrfil ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to property located at (Name of Property Owner) i P.I R 91 ref . 1 (Address, Lot, Block, Road, etc. on ��,� �.��( C U=I.i� , in rvorlti 705A-. ( (Waterbody) I 6'* if , N.C. (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locz �✓ I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description1 below pr attach a site drawirn y GA3.� 16 ',T G� Lx« n ED -WAIVER SECTION _ I understand that a pier dock, mooring pilings, breakwater, boathouse, lift, or'groin must be set k minimum distance of 1 ' from my area of riparian access unless waived by me. (If you wish to the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Informatiq�) (Ad' cen Prgperty Owner Information) Si natur�, I' Sign re _ eve, Print r Zype Name Print or Type Namyt iiFanc t LSId� Shell �: vm� Permit #: 6 or ribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement id in your Habitat code sheet. :tat 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 final disturbance. Excludes any restoration and/or temp impact amount) Dredge ❑ Fill ❑ Both ❑ Other Al7Z / 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 ❑