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Home My WebLink About60642D NCWRCkCAIMA / DREDGE & FILL / NO. 60E MNERAL PERMIT Previous permit # Flew Modification ❑Complete Reissue --Partial Reissue Date previous permit issued •ized 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 16,(100 les attached. t Name d' ":TT- Project Location: County 100v��2 t Street Address/ State Road/ Lot #(s) State ZIP 7 ZI Fax # O Subdivision ed Agent ! CityZIP ❑ CW ❑ EW ❑,PTA L ES I.'t'TS Phone # (- ) River Basin ❑ OEA ❑ HHF ❑ IH UBA ❑ N/A Adj. Wtr. Body r 1"Q (nat /i ❑ PWS: ❑ FC: yes / PNA yes /�) Crit.Hab. yes / no Closest Maj. Wtr. Body L f Project/ Activity �� ``�: h (Scale: ck) length — r-- — —--T--- ------ 1---�— iier(s) !ngth -- -- — -. _ amber d/Sraplength g distance offshore I ax distance offshore—VOL .-- -- - hannel ibic yards mp use/ Boatlift ling permit may be required by: —T aa El See note on back regarding River Basin — r n .-a:. --1 t t.- ,_,/ l I i,— n 1A CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: L.I.� 14 �'i' h-'�' 1Z 11-} ��y �►t' �) Address of Property: Z1 1 S vl%,-' l4 tool (Lot or Street #, Street or oad, City & County) _ r Agent's Name #: �/ ��'�''�)` , ��'- Mailing Address: '73 � i c_-� �L�'Z tit Agent's phone #: `? G -E;I k ' � � C� i t_ 4-71 J<a t; 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 wv✓w✓.nccoastalmanactemer;<.; : J� ; �d�< i;:r i.,';„� 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 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. I do not wish to waive the 15' setback requirement. 7J(p$� %Te[ Information) J .,-% SiA) ture > Print or Type Name (Adilcent Propertx Owner Information) Signature Print or Type Name OZO Mi Mailing Address Mailing Address tems 1, 2, and 3. Also complete mtricted Delivery is desired. lame and address on the reverse can return the card to you. card to the back of the mailpiece, ont if space permits. ssed to: :�.eived lij Agent \1 Addressee by (Printed Name) C. Pate q Delivery 1-2-- D. Is delivery address different from item 1? ❑ es If YES, enter delivery address below: X No 3. Serge Type ffCertified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes er 7servic 7012 1010 0001 9852 0104 1, February 2004 Domes i 102595-02-M-1540 JSPS.com® - Track & Confirm Page 1 of English Customer Service USPS Mobile USPS.... , Register r Sign In Search USPS.com or Track PackaOes Quid Tcols Ship a Package Send Mail Manage Your Mail Shop Business Solutions Track & Confirm PRINT DETAILS YOUR LABEL NUMBER SERVICE STATUS OF YOUR ITEM DATE & TVAE I ocATIoN FEATURES RE89074613SUS First -Class Mail Delivered August 16, 2012, 1:16 pm CANADA Registered Mad - International Return Receipt Attempted Delivery - August 13. 2012, 3:14 pm CANADA Item being held, addressee being notified Addressee not available August 13, 2012, 11:59 am CANADA - Addressee advised to pick up the item Arrival at Post Office August 13, 2012, 8:49 am CANADA Customs clearance August 08. 2012, 6:25 pm CANADA processing complete Processed Through Sort August 08, 2012. 10:43 am CANADA Facility Customs Clearance August 08, 2012, 10:43 am Processed Through Sort August 04. 2012, 10:05 am ISC NEW YORK NY Facility (USPS) Arrived at Son Facility August 04, 2012, 10:03 am ISC NEW YORK NY (USPS) Depart USPS Sort July 28, 2012 FAYETTEVILLE, NC 28302 Facility Processed at USPS July 27, 2012, 10:21 pm FAYETTEVILLE. NC 28302 Origin Sort Facility Dispatched to Son July 27, 2012, 6:17 pm WILMINGTON, NC 28405 Facility Acceptance July 27, 2012, 4:30 pm WILMINGTON, NC 28405 Check on Another Item What's your label (or receipt) number? Find LEGAL ON USPS.COM Privacy Policy > Government Services Terns of Use > Buy Stamps & Shop, FOIA , Print a Label with Postage, No FEAR, Act EEC Data, Customer Service , Site Index , Copyright`, 2012 USPS. All Rights Reserved ON ABOUT.USPS.COM .,,bout USPS Home Plewsroom , Mail Service Updates, Forms & Publications Careers , OTHER USPS SITES Business Customer Gateway > Postal inspectors , Inspector General, Postal Explorer , N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date J-5 % Z, Name of Property Owner Applying for Permit: (3 C. CrZC Mailing Address: Q ZA lylq) -�A Lt✓ i q ft / t\� C z7 GI7 I certifythat I have authorized (agent) r'" � SE �V �' (g ) C I` ?E- to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) �= �'�� z� ��( It h J3lh<)� j oni 1 L �) ]? )�' I ) at (my property located at) 123! 0 kit M 14 O�GW/�kjL This certification is valid thru (date)Z- 51 iz� Property Owner Signature Date Division of Coastal Mgt. Habitat Impact CornplAter Sheet )Iicant: ric W Permit #: 6z4L e: 1/6/1z' scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen nd in your Habitat code sheet. Oat 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 fin< disturbance. Excludes any restoration and/ temp impact amount) OWDredge ❑ Fill Both ❑ Other ❑ 1 � Dredge ❑ Fill Both ❑ Other El 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 ❑