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HomeMy WebLinkAbout57401D - Yarborough!`C MA /-TDREDGE & FILL GENERAL PERMIT Previous permit# 1New Modification !Complete Reissue Partial Reissue Date previous permit issued >rized by the State of North Carolina, Department of Environment and Natural Resources �1 Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �17 /jaU ules attached... F,!✓ it Name 7 1,41011/ / �" Project Location: County 1&k7z 'V (t h1i f� State_ k ZIP 2.�%1 1 � ( )., Z ' Fax # zed Agent /= -4. CW ❑ OEA ❑ PWS: yes / no =i EW ] PTA 1-1ES F PTS HHF IH UBA N/A ❑ FC: PNA yes / no f Project/ Activity ­6% lo., k Crit.Hab. yes / no Z r-,; Street Address/ State Road/ Lot #(s) Subdivision ,c ZIP Phone # () - River Basin Adj. Wtr. Body f�"1r7� t��e'e.(n Closest Maj. Wtr. Body /�/���� �<+�r• i Iie.J �i _a ®■■■■■��■■■■�■■■ ■EI 1�■■■■M■■ MEN ■■■!II w■■Er■■�■/alb■s �■■Ii'lt�T.��"1.���s ■■■■■■1 ■ ■II�LIE■G■E ' V`►�� /P■■G9MR". 22IN 00■0■01 ■ ■■■■■■■■ l3E IlA�1■i�a/■ ■■ ■■■� ■ ■■■SEES■ 1imum ■■EE��i1 ommomms ■■■■■■E■E■!%NROMAY■■ff-mr�!!11://■■■■■■■E■■1 ■■!■■■(i M■E■■■G/,■■■■■■■IFIRE■1 E■■E■■l;TiiOAKR/l■■AY■E■■■EE/�■■■■■■!%/IE■1 ■E■E■/A21.'flU s"11111111iffISEE■■■■■ram■■EEEE■ilE■■1 ES■■■�Cl�Jl�t'S�/I■■■■■■■/m■■SEES■■■■■1 - . SEES■E'.�Jfiii■�■■■E■■■%�:����T=��'_1�C�■1 - ■■■■ TIONS/MMOME■■NSEE■E■EESE■E■EEEI ■SEE■G�rVi%■E■■■■ErI■■SEE■SEE■■■E■EEI EE■G/ES■E■■■■■EN■■■o■■ ■■■EEEI ng permit may be required by: li%e� �� y/.�'/ 0 ..�+�5,�l�e�►i� See note on back regarding River Basin r ] 1 rt / / / . _. / Ipplicant: ,"",,I%y �•/�,.�p�o�r Permit #: late: \1 V escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement Fund in your Habitat code sheet. rbitat 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/orternp 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 ❑ Z Dredge ❑ Fill Both ❑ Other ❑ C 3 3 f 0 33 yo 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 UZI CB Ln rm IL Ln co ru r-O r-M N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date � Name of Property Owner Applying for Permit: �►. M �� ` JC�e_ � � S� fir--'1--� Mailing Address: I certify that I have authorized (agent)5 to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) at (my property located at) Vg�5 Gceek 'K A - This certification is valid thru (date) -05/Z8 Za [ 3 Date Signature �� _ CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: V m201-6�= Address of Property: C_ Koj (Lot or Street #, Street or Road, City & County) Agent's Name Mailing Address: r2 R7 Ou - 5�4- Agent's phone #: 02 �� - 3?�l'-�o Sal _14� 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 must be provided with this letter. I have no objections to this proposal. l have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at www.nccoastaimanagement.neticontact dcm.htm or by calling 1-888-4RCOAST. 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, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of riparian access unless waive y_ pq (.If o _. wish to waive the setback, you must initial the appropriate blank below.)t�'EIVLU DCM WILMINGTON, NC I do wish to waive the 15' setback requirement. MAY 2 9 2013 I do not wish to waive the 15' setback requirement. rty rner Information) I 9 l ' or Tvo� Name lszs 3reey.-i�oox1� Mailing Address (Adjacent Proper"wner nformation) Signature i] i Print or Type Name Mailing Address CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: QJt M (1c1(k Address of Property: S (Lot or Street #, Street or Road, City & County) t\�ek's «a�dov Applicant phone #: 1 - rJ Mailing Address: \ 62.S �7�-6-V\ 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, must be provided with this letter. I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at www.nccoastalmangement.neCcontact dcm.htm or by calling 1-888-4RCOAST. 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, boathouse, or lift must be set back a minimum distance of 15' from my area of riparian access unless waived by me±l�ygtlp p waive the setback, you must initial the appropriate blank below.) Ct f� �V/ f�= DCM WILMINGTON, NC I do wish to waive the 15' setback requirement. MAY 2 9 2013 A I do not wish to waive the 15' setback requirement. rty OwnerInformation) Print or (Riparian Property Owner Information) 4 A `LV Signature C0 #--) e- c'40 H LP Print or Type Name I� �S V7 t.4t_In 0-r- .'3 7 B AI-0 (901r5 !-e— Mailing Address Mailing Address Rl��T 4bSL f • Al li DCRECEIVED M WILMINGTON, WC MAY 2 9 2013 low. Legend • Points Lines Polys • Addresses