The URL can be used to link to this page

Home My WebLink About76571D - WhitakerCAMA / E�DIJEDGE & FILL N9 76571 A B iENERAL PERMIT Previous permit# New —Modification El Complete Reissue El Partial Reissue Date previous permit issued zed by the State of North Carolina, Department of Environmental Quality I' � oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 1A . 1(J. O ❑ Rules attached. Name ne W j < Project Location: County �! AS \�L F kgS,A& n Street Address/ State Road/ Lot #(s)rj-Cj �)J State ri L ZIP ZT�) vt- ( ) Ill - 32�-3 E-Mail Subdivision :d Agent (Al -1, (7 e , (-.Q— t !'; City C mac. e ZIP 2_ jNCW ❑EW ,CPTA El ES ❑PTS ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A ❑ PWS: 'es / Q PNA yes / Project/ Activity k) length .form(s) p 'latform(s) gth fiber Riprap length_ distance offshore distance offshore innel e/ Boatlift Ildozing Length C) , not sure yes im: n/a yes yes In i:tached: yes g permit may be required by: ocal Planning jurisdiction) Phone # ( ) River Basin LJ M Adj. Wtr. Body Ck nne �fia rr Closest Maj. Wtr. Body T 5i s W c+ �A l ( h), (Scale: P T ❑ See note on back regarding River Basin AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: od/`e'w , Mailing Address: ! (� Ic�S cQ.a, L A n9-.. �urkrtm OC. 2-�-712. Phone Number: q 19 L-1 ►-- 3 2 (o 3 Email Address: _ r o a ►^ b P � � Coo,\ I certify that I have authorized Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: C'tfl�CLG� r1�1► `t 2D at my property located at �X _ in �cKA-66&11t,.) County. I furthermore certify that l am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information CUvnJriatuijv l Print or Type Name Title C kTIFiED MWL RETURN-RICEIET 899UESTED DIVISION Oil COASTAL MANAGEMENT ADJACENT RtpsarAN PROPORTY OWNER NOTIFICATIONNYAIVER FORM Name of Property Owner. Address of Property: S5 (Lot or Street #, Street br Road, City & Co/uIn_ty) - Agent's Name #:Gr1C� �1'�1 u(��I�s� Mailing Address: r w1� 1 x A Agent's phone #: Q��' cJ�� gbgn -+e�f2 N� Z�Sy�C1 1 hereby certify that I own property tlidjacent to the above referenced property. The individual applying for C this mit has described to me as shown on the attached drowiniLthe development they are proposing. C? wassift.tar` Q 4 have no object�o . __ - I have objections to this proposal, if you have ObOctions to what is being proposed, you must notify the DJqWR of Coastai t' Managartent (OCM) In writing within 10 days of receipt of this notice. Co should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 2WO-394& DCM repress also be contacted at (910) 796-7215. No response /s considered the same as no ob/e .' �n notified b Certified Mail. J G� WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a yminimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must Initlal the appropriate blank below.) I do wish to waive the 15' setback requirement, e 15, setbacK requirement. - (Property Owner Information) Signature Print or Type NAne Mailing Address r YIN� `1-i1Z cityisrerealp (Adjacent Property Owner Informs Signature Marl 1'.aa2hAd-1 t) Print or Type Name Mailing Address toll a-1f-/,Q--7i,G1- DIVISION OF COASTAL. MANAGEMENT - ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner. Address of Property: .::)Ct SNP % (Lot or Street #, Agent's Name#:�T('�L �rotu�-�(��1 Agent's phone #: `\\Cr- 5—NA - C ()R,5 Road, City & County) -- Mailing Address:lQtirKJ h Dc— � � 4(6n N( zt4tq I hereby certify that I own property adjacent to the above referenced property. The individual applying fo this permit has described to me as shown on the attached drawing —the development they are proposing 55jections to this proposal I have objections to this proposal. N you .have objections to what Is being proposed, you moat n4Wy the DI of Cassia Management (DCM) In writing within 10 days of receipt of this notice. Co should M mailed to 127 Cardinal Dive Ext., Wilmington, NC, 28405.3845. DCM repress alsofivb� • contacted at (910) 798-7215. No response is considered the sams as no objection es notified Py CerMed Mall. 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 waived by me. (if you wish to waive the setback, you Must Initial the appropriate blank below.) I do wish to waive the 15' setback requirement. (Property Owner Information) n T� c nt Pr pe Owner Information Signature Signature Print or Type Print or Type Name INA MsHing Address Mai . g Address City/statealp I City/statemp 7 0665 CC>, Y-,, Ck \ S--1 �4c �l 271 IZ ■ Complete, items 1, 2, and 3. A. Signature ■ Print your name and address on the reverse x^ E so that we can return the card to you. ■ Attach this card to the back of the mailpiece, B. Received by (Printed Name) C. Dat( or on the front if space permits. Article Addressed to: n, �\ C\cxr� vic 9590 9402 2219 6193 1039 22 2 ,., -, rr--f r trnm service label) 7017 0660 0000 7487 PS Form 3811, July 2015 PSN 7530-02-000-9053 ■ Complete items 1, 2, and 3. ■ Print your. name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: Z� v 1,'h 1111111111 111111111111 111111111) 9590 9402 2219 6193 1039 15 2. Article Number (Transfer from service label) _ 7017 0660 0000 7487 PS Form 3811, July 2015 PSN 7530-02-000-9053 D. Is delivery address different from item 1? L If YES, enter delivery address below: [ 3. Service Type ❑ Priority Ma ❑ Adult Signature ❑ Registered ❑ Adult Signature Restricted Delivery ❑ Registered AT -Certified Mail@ Delivery ❑ Certified Mail Restricted Delivery Return Re( ❑ Collect on Delivery Merchandi. ❑ Collect on Delivery Restricted Delivery 0 Signature n 1--.1 nnall ❑ Signature 0665 1 Restricted Delivery Restricted Domestic Ret A. Signature x Z [ C �. �eceived�y ,Printed Named C. Dal 1, l�l S/ D. Is delivery address different from item 1?r [ If YES, enter delivery address below: [ 3. Service Type ❑ Priority M, ❑ Adult Signature ❑ Registere( ❑ Adult Signature Restricted Delivery ❑ Registerec 4ftGertified WHO Delivery ❑ Certified Mail Restricted Delivery 4156eturn Re ❑ Collect on Delivery Merchand ❑ Collect on Delivery Restricted Delivery El Signature — ❑ Signature 0672 Restricted Delivery Restrictec Postal , CERTIFIED O . • rU Domestic Mail Only It —0 For delh 2ry informption, visit website at o rn 4{i+our cc, Certified Mail Fee $'y « 0470 $ ^ R5 52 Extra Services & Fees (check bar, add reaprre) ❑ Return Receipt (hardcopy) $ _ Domestic Re