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Home My WebLink About57564D - Dorman� CAMA / DREDGE & FILL 3ENERAL PERMIT Previous permit# �Wew . Modification ❑Complete Reissue El Partial Reissue Date previous permit issued rized by the State of North Carolina, Department of Environment and Natural Resources -oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC % i 3c�U ❑ les attached. it Name_ Project Location: County�A 5� Street Address/ Statee � S`�-- ad/ Lot t#(s) �UJI � State �L-- ZIP 3� q ( b ( `1 J Fax # ( -� '�-- Subdivision �+ :edAgent AN.rl-tn►o"t ('°�t�lJ ��. City SU ►' ZIP2aLt' ❑ CW ❑ EW ❑ PTA Fj ES PTS ❑ OEA ❑ HHF L-1 IH ❑ UBA 1 N/A ❑ PWS: ❑ FC: yes k! = PNA yes / no) Crit.Hab. yes /� f Project/ Activity ,L\ le.,.,'k Phone # ( ) River Basin Cri Adj. Wtr. Body G{AN Apt. OF;F ( W 6t) (nat-/I Closest Maj. Wtr. Body—SDu)J> (Scale: ( / / - —EENEM■■■■■■■■■■■ ■■��M■i��l��■■■,E■■■■ ■■■■■■■■p■■■■�■■�■�■■■■�■■■■ ngth- ■■■■ ■■■ ■■■■■■■■■■■■■■■■N ■MEN MEMO MEMME■■■ Riprap length_ M■■MME■■M■MM■■MMEM■■■■■■■■■■■■■■■■■■■ distance offshore --x distance offshore-' iannel ■■■■■■■■■■®■��■■■■■■■■��■O�■�w/I■■■■ tic yards ■■■EE■■E■■Eif 1E �[j�� ■M�E11V ��ilii■i�iifrl■ilfl� ■p9m, agoG�■M�■■E■�■■MEM■I■ Aldozing.,,,� ._ EEO OEM ■E■ O ■E■■ ■■ME■E ■ ■■i� �11 E JL.fiEEt■■IE■EE ., /Z1IiW/■MEE■i■MEME■ Ems ME■ME■EE M■■EEN■ ■■MM■EM■E■■ K. Emu 16aiiaiidFOE EEO■■■OEM ■ 5 Length■■EE■ME■E■■E�1�■E■ ■■EE■M■MEM■EE■MEM■ not sure yes n7 EE■OEM■■■■ i:.Al -- RME■EMEEM ■■E■MM■ not sure yes no,. E■MEEMEM■■EM■■EME MEM■MEEMMUA■■EE■■ EEE■EEE■� `� ■■EM■MME■■MEME■N■ iiNONE EE■ •' ■■■EEl1■E■■I■ L�■■■E■■■MMEMM■ME■■ ■FEMME■ yes :+ E�■Ei��7E■■■ ■■EMEEM■EEE■EE■E ■■EOM■E■ 'Attached: yes �[,1►.� L■,■FEN■ME■E■MEMEM■■■■i■MN■E■ ig permit may be required by: S l , ❑ See note on back regarding River Basin rt - .— ..-. �,t _l) L_ _ _ n _ I,, i . - d i ' , A•' 1 :✓ c� i i 4'. C~ W,_.:a •.1 --xt .s 41,1-17w, i V•:'��m.x r.. •.y. .N!!M^.w... .,.y,.,r, . .S 4 + "" wti."y. , :ems• - , _,_ �'. '�.. _._..,. .. . fr � ..)J • A r) viRll..Ia..f . ae1.'�w'..+. *:s ��e . r.. ...�Q.:N.s'�.y,..� r. r � j4411r• ' r.. _ .++..,...� ...�.« .... .. _ ,. ...r .r..,....w.. o...r....... n «. .....w ��.... ... .... �.... «— - ...� ter. r `'-T ln'.. 1 NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management ael F. Easley, Governor Charles S. Jones, Director William; G. Ross Jr., Se Authorized Agent Consent Agreement I I i I I I t I u Lit U ) V Li I r i I l.a t[if 1 is hereby authorized to act on my beh; (Printed Name of Agent) er to obtain any CAMA permit(s) required for the property listed below. The authorization is limited to :ic activities described in the attached sketch. 1TION OF PROJECT: VA �,C,+- )UVT a- W (Zt, 2UA) 'ERTY OWNER MAILING ADDRESS: 3 (4o Us L-1a I si ,±b WE--vi I r) a g 3 q (0 l2P52 c(Or-)U PHONE NO. ��(� - (D�iSC aD `7 ORIZED AGENT MAILING ADDRESS: I u li PHONE NO. lure of.Properfy Owner. --�r R0, Q. Z&, '�� Y\ ADJACENT.RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORIIVG PLUMGSBOATLIFTBOATSOUSE) I hereby certify that I own property adjacent to AAkjbpx%' i-L-m D w nyn 's u (Name of Property Owner) Property located at f i q-th (Lot, Block, Road, etc.) on , in N.C. (Watery) C&wn and/or County) anhnoka exru uaz41-1 Applicant's phone Mailing Address: i 45- I(1 fGi ii�ld. CYi sus err r Nr, 2$4(Qv 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 -beset -back a minimum --distance ef--fifteen-%et (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 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-Prope e�PPlyinb for Permit) u2i Mailing Address '�-4w i n , N-6 a 339 City/StatPJ7.in (Riparian -Property Owner Information) Signature �,�RG -Af 1-7-/-/ `-i 10.5 LiT11 S1t- ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGS' `BOATLIFTBOATHO USE) I hereby certify that I own property adjacent to NVyU )' j' Q•U }�'1 POY IrY w is I 1 l (Name of Property Owner) property located at ` L4 fb S+— (Lot, Block, Road, etc.) on li U n a,J S in f� , N.C. (Waterbody) (To and/or County) �( n orU COnsfrxCh on Applicant's phone #:!110 3a-73U15 Mailing Address: b (,h fU He has described to me, as sh&M-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.) I do not wish to waive k 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) %H0 Vs u-),► o J-fh Mailing Address C, a g 33q City/State/Zin (Riparian Property Owner Information) TCc + x )plicant: ate: 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 amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/o temp impact amount) Dredge ❑ Fill Both ❑ Other ❑- Z-116 Dredge ❑ Fill ❑ Both ❑ Other ❑ l 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 ❑