HomeMy WebLinkAbout60702D - FuscokCAMA / -- DREDGE & FILL
NO. 60
GENERAL
PERMIT
Previous permit #
�New ❑Modification
'Complete Reissue - 'Partial Reissue Date previous permit issued
Drized 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"` �t.� C:
tWtw`
Rules attached.
Bleykisy4I
nt Name
Project Location: County cic,
s us N j Vr
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Street Address/ State Road/ Lot #(s)
On" 6
StateN ZIP 2? 3 `3
i 3 I M a 1 n S ram+
# ( ) P
Fax # ( )
Subdivision NSA
'
IzedAgent Id"DakS>,-
city 1-T - ��✓1 G a" ZIP Z-2.6
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P ne # (1QQ IU 'b j V River Basin wYY<<
d
ElOEA ElHHF _
IH ElUBA El N/A
_
Adj. Wtr. Body a OL t (nat`
ElPWs:
ElFC:
yes P no PNA
yes /t"no ' Crit.Hab. yeses`,
Closest Maj. Win Body
)f Project/ Activity
(Scale: ✓
ock) lent
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pier(s)
en h
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umber
ad/ Riprap length
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✓g distance offshore
iax distance offshore
-hannel
ibic yards____ —
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-
use/ Boatlift
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3y�d
;" '1 x L; a i
"ozing
MP x
f
ie Length
not sure yes no _
gs: not sure yes-
num: n/a no
Attached: yes
ing permit may be required by{f�i�
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❑ See note on back regarding River Basin i
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e2/07/2004 19:20 910B429806 GREG HQl_UEN PAGE 91
ADJAct�xr F COASTA a a� �,r � ._
- e RIP $T�� nnOPERTY c3WNER "�'
NOTIlZ aTTnta �g,. �Q ORK
Name Of Individual Applyi-ng For PermiC_
Address -of Pro ert. �V � C O
(Lot -or Street Street or Roe
C ty 6 County)
Y hereby certify that I Own-r
referenced property_ The individuaapplyy adjacent to the above -
described to me as shown on the attachav for this permit has
they are Proposing• A description or drawing, the development
should be brovided with this letter. _ �f� dimensions,
I have no objections to this proposal.
house. understandithat a pier, dock, aoorin
rust be set pa 4 pilings, brnakvater, boat
fran my area of riparian a ck a Minimum distance of 15
to waive fife setback, Yon a unless waived by so. (If You wish
below.) Rust initial the appropriate blank
I do wish to Waive the 15'setback requirement.
o Waive the 15'setbeck requirement.
.IV,r1r.
r r a � i : U • s U
The purpose of this form is to provide proper notice to you as an adjacm riparian property owner to the individual or
individuals listed below_ The CAMA General Permit application pr-�tuts raquira that applicanm provide the pivisi
Coastal Management contirmmtion that a wrinen smteamt has been obtained s4nod by the adjacent riparian property 4
indicating that they have no objection to the proposed work PE that the adjacent riparian property owners have been no
by certified mail of the proposed work. Often these forms arc submitted to the adjacent riparian property owners by n
contractor or other individuals acting as an authorized agent on behaltof the applicant.
This foam w►as sent to you by the following ittdlvidttai or company designated by the applicant as as
authorized agent;
Name of Individual Applying For Permit:P�, !/.S L�
Address of Property_ L,3 / ' �j✓�/% /D k'
(Lot or Street tb, Street or Rom
(City and County)
I hereby certify that I own property adjacent to the above -referenced "property. The individual applying for t1
has described to me as shown on the atr9ched drawing the development they are proposing. A description or
with dimensions. should be provided with this letter,
I have no objections to this proposal,
if you have objecdoas to what is being proposed. please write the Division of Coustai Nrlanaget
Cardinal Drive Extension, Wilmington. NC 28405 or calf 910-796-7215 within 10 days of receipt of t
No response is considered the same as no objection if you have been notified by Certified V12iL
WAIVER SECTION
1 understand that a pier, dock. mooring pilings. breakwater, boat house or bout lift joust be ;
minimum dih-taoee of 15' from my area of riparian access -.unless waived by me_ (tf you wish to
setback, you most initial the appropriate blank below.)
i do wish to waive the 1 S' setback requirement.
kpplicant: �U Permit #:
Pz
late: ifl
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
fund in your Habitat code sheet.
DISTURB TYPE
ibitat Name 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/or
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other ❑
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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 ❑