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Home My WebLink About62546D - Sims et alDES ❑ PTS ❑ UBA ❑ N/A Crit.Hab. yes / no City ZIP 2IVT' Phone # ( 910) River Basin Adj. Wtr. Body 1WW na Closest Maj. Wtr. Body G'G \,/ CAMA / ❑ DREDGE & FILL M 625 PANERAL PERMIT Previous permit# New ❑Modification ❑Complete Reissue [-]Partial Reissue Date previous permit issued !zed by the State of North Carolina, Department of Environment and Natural Resources j j Or oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC O � r / �c sI Rues avtacned. Name d''� / Project Location: County Street Address/ State Road/ Lot #(s) ;Alh State ZIP / Fax # () Subdivision c :d Agent ❑ CW ❑`tW YIPTA OEA ❑ HHF ❑ IH C PWS: ❑FC: yes / no PNA C_. l no Project/ Activity ck)length k1s) ngth mber d COW en_ g distance onshore— ax distance offshore J awnel �y.rds bic mp use/ Boatlift 3ulldozing i ne Length r— not sure yes t gs: not sure yesno" )rium: n/a Q,, no Jing permit may be required by: Neon /T~W/- C- 0• -TA!%O« See' n6te on back regarding River Basin 7*1 . l - - i^ ---? i / / 1AA 4r�c. hh ia��✓ _ rf - 1 nplicant: '�'lf sj vyt S ate: al 'J Permit # scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement ind in your Habitat code sheet. bitat 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 amoouunt) 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 k Fill El Both El Other El ow 25 C�1rJ27 t-1 CJ Dredge ❑ Fill "oth ❑ Other ❑ S 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 0 Both 0 Other ❑ DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM lame of Individual Applying For Permit: 4� 4,OW zez�, kddress of Property: ek�� /' 1)j (Lot or Street #, Street or Road) ,V , / 1/',( " z8ya ity and Count,) 'eC hereby certify that I own property adjacent to the above -referenced property. The individua ipplying for this permit has described to me as shown on the attached drawing the development the3 tre proposing. A description or drawing, with dimensions, should be provided with this letter. I have no objections to this proposal. f you have objections to what is being proposed, please write the Division of Coasta: Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-721! vithin 10 clays of receipt of this notice. No response is considered the same as no objection it ,ou have been notified by Certified Mail. WAIVER SECTION understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set pack a minimum distance of 15' from my area of riparian access - unless waived by me. (Ii ,ou wish to waive the setback, you must initial the appropriate blank below.) :ign Nail I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Dat RECEIVED DCM WILMINGTON, N JUL 1 1 2013 .MWWW. } DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM vame of Individual Applying For Permit: 204)KC S'ZytiS Address of Property: b 16 1 YCk i (&({ �� (Lot or Street #, Street or Road) M (City and Co ty) `�cj 9 hereby certify that I own operty adjacent to the above -referenced property. The individua ipplying for this permit ha described to me as shown on the attached drawing the development the, ire proposing. A descr' tion 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 Coasta Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-721! vithin 10 days of receipt of this notice. No response is considered the same as no objection i 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 se )ack a minimum distance of 15' from my area of riparian access - unless waived by me. (I (ou wish to waive the setback, you must initial the appropriate blank below.) 35ign Name I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Date RECEIVED DCM WILMINGTON, NC JUL 1 12013 TGn�— AAA