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Home My WebLink About61579D - TraskOCAMIA / -` DREDGE & FILL / N Y GENERAL PERMIT Previous permit # "'�%^ '1New :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 {� ❑ Rules attached. .nt Name I FyP~� �}`� Project Location: County �f. %v " (i` — s I Zcv �`f ST ►^ic'r_. r' )ej,4 o Street Address/ State Road/ Lot #(s) State /`:% ZIF%',Y"' O S—' / > Z Z L i+/ DG/" *! Itl # Fax # () ized Agent ' `�// i {'�` }'h'!7 + t C- d CW ❑ EW PTA ES ❑ PTS 011 I HHF IH ❑ UBA ❑ N/A PWS: FC: Subdivision City 1!115, ' L / ZIP Phone # River Basin Adj. Wtr. Body Ty� .5A It SC%Uti `% (nat yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body T �'s� it.- t A Project/ Activity �"� e� y' 7� �,- . �i� ' (Scale: / lock) length m(s) pier(s) length umber gad/ Riprap length vg distance offshore iax distance offshore channel ubic yards imp Boatli X / 3 Bulldozing ne Length not sure yes no : gs: not sure yes ( Q,) Prium: n/a yes ` not yes r n4. Attached: yes ( o�' ling permit may be required by: lcT,S r r �iedr ❑ See note on back regarding River Basin oplicant: �� 5 // ate: l"( Permit #: 6 1 -5� / !scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement and in your Habitat code sheet. bitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet (Applied for. (Anticipated final (Applied for. (Anticipated final Disturbance total disturbance_ Disturbance disturbance. includes any Excludes any total includes Excludes any anticipated restoration any anticipated restoration and/or restoration or and/or temp restoration or temp impact temp impacts) im act amount) temp impacts) amount �. r 4 Dredge ❑ Fill ❑ Both ❑ Othe 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 ❑ ONTRACTORS,LLC 67-2159 TOLD CT. %D, NC 28443 2 A /4OZ-p 08-03 Bank of America ACH R/T 053000196 G1sG- 5728 88-19/530 NC 58754 m 0 0 0 DOLLARS A 8 9 U. y PT AUTHORIZED SIGNATURE 7 28u' i:0 5 3000 L96': 000684 74 3 7 38u' N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date Name of Property Owner Applying for Permit: Mailing Address: /1 I certify that I have authorized (agent) �a % to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to I ' install or construct (activity) at (my property located at) This certification is valid thru (date) 1Z�31-�3 Property Owner Signature Date May, L. zuii I; iirvl UK tLUVitKJ IN0. /1/0 r. [ ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORING PILINGSBO/ATLIFTBOATHOUSE) I hereby certify that I own property adjacent to J1ai f,,� r15 K is (Name of Property Owner) property located at &v-,wo , (Lot, Block, Road, etc.) on _ _ , in �jGv�-� , N.C. (Waterbody) (Town and/or County) Applicant's phone b: Mailing Address: I Z Ea-5t4ly 2� AAc- 2-gK.D3 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 (I Y) 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 d not wish to waive :2.I do wish to waive that setback requirement. --------------------------------------------------------------------------------------------------------- DPSCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individriul proposing development) --------------- --- ------ I ---- ------- - ----- ---- 1--l- ------------------- - --- --1-- ----------- -- ---- (Information for Property Owner Applying (Riparian Property Owner Information) for Permit) 12' Mailing A es ®tirrn NL Z City/State/Zip Signature /Jnesr�•r�� .rJ Print or Type Name ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to 9-, Vv, % P�t 's (Name of Property Owner) property located at 1 b Z 2 (Lot, Block, Road, etc.) on , in i lJ , N.C. (Waterbody) (Town and/or County) Applicant's phone #: Mailing Address: I Z0 2- ,711'1- - ,y-G 7 �3 C/ V 3 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.) A 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) 4�y V)r-- Mailing Address ------ --------------------------------------------- (Riparian Property Owner Information) Signature �lil/�CtatP/71T STATES OF AMERICA DEPARTMENT OF HOMELAND SECURITY UNITED STATES COAST GUARD NATIONAL VESSEL DOCUMENTATION CENTER CERTIFICATE OF DOCUMENTATION VESSEL NAME OFFICIAL NUMBER IMO OR OTHER NUMBER YEAR COMPLETED SECOND WIN 109646 DJ3203 0 HULL MATERIAL 200 HANICAL PROPULSION HAILING PORT TOPSAIL NC FRP FIBERGLASS YES GROSS TONNAGE NET TONNAGE LENGTH FBREADTH DEPTH 12 GIRT 12 NRT 32.5 6.2 PLACE BUILT HOMESTEAD, FL OWNERS OPERATIONAL ENDORSEMENTS RAIFORD G TRASK RECREATION COASTWISE REGISTRY FISHERY MANAGING OWNER RAIFORD G TRASK 1202 EASTWOOD RD WILMINGTON, NC 28403 RESTRICTIONS NONE ENTITLEMENTS NONE ,REMARKS NONE Z_ w x A h h- -JT 12 i �,*)j