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Home My WebLink About60632D - HaighCAMA / ❑ DREDGE & FILL / NO. 606 iENERAL PERMIT Previous permit# Vew ❑Modification ❑Complete Reissue EPartial Reissue Date previous permit issued zed by the State of North Carolina, Department of Environment and Natural Resources ''Z )astal Resources Commission in anYarea of environmental concern pursuant to 15A NCAC _ Rules attached. Name ( r LO Y\ 11J— Project Location: County � {�- �Street State Road/ Lot #(s) } 1 t"L(t , State_ (r ZIP 1 ! D � ✓tb i�t' t%F �' -Z" (�O Subdivi ion Fax # `` ` q ' ity 1��vt iGijn ZIP ;d Agent ❑ CW EW r TA ❑ ES ❑ PTS "Pkne # (qk) Z�31"--�4 ZS River Basin ❑ OEA HHF ❑ IHIH ❑ UBA ❑ N/A Adj. Wtr. Body C&A 0-11 (nat (r ❑ PWS: ❑ FC: f�1WW Body- yesCno>PNA yes no Crit.Hab. yesCno Closest Maj. Wtr. Body Project/ Activity ti L t (Scale: ! , �k) len th -k) ngth tuber d/ Riprap length g distance offshore_ ix distance offshore hannel bic yards -np ise/ Boatlift iulldozing__ ne Length )Q not sure yes no t-- gs: not sure yes o " )rium: ( °n/a' yes no �`� no Attached: yes n.; ling permit may be required by: "IIl I ,IS1�1 n t)kn I de>��{�t [ _• t [� See note on back regarding River Basin 1,71. r, ('111IAIS-Lr(At.AI I V1f.4) 1AA-i,1+h /I !)L%ill-- 11 ADJACX N'T RiPAWAN PROPERTY OWNER STATEMENT (FOR A PIL'RAMOOR11% PILI C,,VIBDAILIFfBOATII(!()SF-) 1 hereby certify (fiat I own property adjacent to 6ti 'S (Name of Property Owner) property located at (Lot, Block, .Road, etc.) MFeW on_ (Waterbodv) (Town and/or County) Applicant's phone d; :Mailing Address: //�(.�r9�/��`/�_�5� _ r lie, has described to me, as shown below, the development he is propo:,ing at that location, and, I have no objections to his proposal. I understand that a picrrlmooring pilings / boatlift / boathouse must be set Muck a trtinimum distance of fifteen feet (151 from n:y area (if riparian access unle&s waived by mc. (If you wish to waive the setback, you must initial the appropriate blank below.) 1 tto not wish to .-Yaivo 1 do wisla to waive that setback recluimment -.---------------------------------------------- ---•--------- '4i DESCRIPTION ANWOR DRAWING Off PROPOSED DI,;VELOPMENT: (`ln hc/illed in lip individual proposing devrlopmenr) til ,Informalion for Property Owner Applyin� (Riparian Property Owner Information) for Permit) 41 ._....__.... rMailing Address C71 j �ignaturc Ail C'it� %titatc/Z.ip I ' } Hitt or Type "Name 0 ADJACENT RIPARIAN PROPERTY OWNER STA`1 LME,N`t' (FOR A PIE, R/410ORING PILINGS%BO,17Z.1I.TBOATHOUSE) I hereby certily that f own property adjacent to ljt(rt,- ?, l `l (Nance of Property Owner) property located atQ-- (Lot, Block, Road, etc.) J , in (Watcrbody) ("Down and/or County) Applicant's phone tl:. ...-._-_— Mailing Address:, Ile has dcscribe;d to me., as shown WOW, the devc[Oprnent he is proposing at that location, and, l have no ob ecticnrs to his proposal. l till derstarui that a pier/nrool-Ing pilings / hcmtli11 / tx}nthouse must be set back a minimum distance of fifteen feet (15) fl-oni my area of riparian access unless waived by me.. (if you wish to waive the setback, you most illitial the appropriate blank - below.) I do not wish to wail"c _ wish to waive that setback requirement. --------------------- IMSCRIPTION A POR DRAWING OF PROPOSED DEVI,1,01'MEl\ 1': (To befilled in hr itndividua/ proposit ti developmtvrt) (infornimion for Property Owner Applying for Permit) Mailing Address (`tt�l5t.t,cr7,ip (Riparian Property (honer Information) �i�;i13t1t1'l S.C�P i f'rit.t 01 Type f aln-'. NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue James H. Gregson Dee Freeman Governor Director Secretary AGENT AUTHORIZATION FORM Date:�g/y� ame of Property Own r Applying for Permit. M / Mailing Address: A` be-4 >T546 Phone I certify that I have authorized (agent) _ �� ► C. lK 1-1 C, {. °.t, - to act on my behalf, for the purpose of applying for and obtaining all LAMA Permits necessary to install or construct (activity) _ AC, , v? ►`) 10 c't%� 1`t` � at (my property located at) _ This certification is valid thru (date) Property Owner Si Date ,--,e 4)1 C Permit #: ��\\ 31 (2 scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement nd in your Habitat code sheet. )itat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Sq. Ft. TOTAL Feet (Anticipated final (Applied for. disturbance. Disturbance Excludes any total includes restoration any anticipated and/or temp restoration or impact amount) temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount) 2jo 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 ❑ Dredge 0 Fill ❑ Both ❑ Other ❑