59292D - Rockett

QCAMA / ❑ DREDGE & FILL
3ENERAL PERMIT Previous permit#
New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
Ozed 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
V �j Rules attached.
rt Name Project Location: County t /Y VV�SI�
Street Address/ State Road/ Lot #(s)
State ZIP �C�3 hh
Fax # O Subdivi n
zed Agent 1y(���,7,� c' City44n#
G �1 ZIP
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❑ OEA /❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat
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yeno '1 PNA yet / no Crit.Hab. yes `1 Closest Maj. Wtr. Body
f Project/ Activity
)ck) length
n(s)
pier(s)
ength
ember
ad/ Riprap length
rg distance offshore
iax distance offshore
:hannel
ibic yards
mp
use/ Boatlift 3 x
3ulldozing
ne Length
not sure yes ( no
gs: not syre.., yes �no l
mum: �2(aiyes no
no
Attached: yes no
ling permit may bb r€4uired by:
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OVWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: _ M6A eocee_-ft-
Address of Property: 1 3-7 Scc) fc h [% i /i C-�
(Lot or Street #, Street or Road)
(City and County)
I hereby certify that I own property adjacent to the above -referenced property. The individ
applying for this permit has described to me as shown on the attached drawing the development tt
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coas
Management, 127 Cardinal Drive Extension, Wilmington, NC 23405 or call 910-395-39
within 10 days of receipt of this notice. No response is considered the same as no objection
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If yl
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
lop' I do not wish to waive the 15' setback requirement.
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Date
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pplicant: ,l�l� ✓� I�oz,ice
ate:
Permit
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
ibitat 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/or
temp impact
amount)
Dredge ElFill ❑ Both El Other
l (p
(0 —
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 ❑