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Home My WebLink About60769D - Scenic,- 4 No. 607 CAMA / . DREDGE & FILL i�NERAL PERMIT Previous permit# New ❑Modification ❑Complete Reissue EPartial Reissue Date previous permit issued ized by the State of North Carolina, Department of Environment and Natural Resources �OD�� oastal Resources Commission in an area of environmen I concern pursuant to 15A NCAC ules attached.t <<�� Name Xa�'nl` xC✓. Lrd L L � � Project Location: County New Q 1Box ' '4-4j Street Address//State Road/ Lot #(s) S tt+11/yf t V� State_ ZIP &q a & w lr a� Gtvi %LOdd At ) 4f bt Fax # ( ) ''� Subdivision ed Agent n n City_�/li t �rNi f�►'! ZIP Z y — CW EW 'PTA s v PTS Phone # ( ) River Basin - OEA ElHHF ❑ IH ❑ UBA = N/A Adj. Wtr. Body ❑ PWS: ❑ FC:� G/1ti Or(L—J�Li. Closest Maj. Wtr. Body es / no PNA (& now Crit.Hab. yes / no s,C ' Project/ Activity ck) length iier(s) Ingth /^to tuber s[ I Riprap length gg distance offshore ax distance offshore ne Length >0100 ling permit may be required by: (_I r-% i .- - See note on back regarding River Basin N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date = SD 12d t z- Name of Property Owner Applying for Permit: Mailing Address: -v->, a: o K 3 6 AfC :09�4046 1 certify that I have authorized (agent) t" s �1'Yl4R WE- e, � to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) R6�2 � � Q�P�14G� �(,p VA16 located at) 4 U A I L V-u/� �C7 �' . 760M at (m1 property — V4 tL M 1 ►S6rHC Z�� This certification is valid thru (date) 25" g t L, 26 c 3 Property Owner Signature � W j"eate ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to ��'�/ LYp L LL 's (Name of Proq�l Owner) I t d at 2, IV {�'a" I L '� U1f1! a-6-417 k -t propee�rty oca e l,� on top h4SA (Waterbody) (Address, Lot, Block, Road, etc. in' L KA,1 14- TV*J _, N.C. (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above loc 'on. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site drawing) 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. (Property Owner Information) (Adjacent Property Owner Information) Signalure Signc lure G h 1 t/ j Print Type N Print Type NlO Ma7ing� ,ess.� orMai1�A�res�� N _C Z V IYAC /M ors , ADJACENT RIPARIAN PROPERTY OWNER STA ET ENNT / I hereby certify that I own propert�W��(�N ��VLF✓, U A UC�N of Property Owner) +,ropeitylocatedat ,-II (Address, L t, clock, R ad, e C. ,n�%isl►i f F / l✓' in ✓I`L rbo (C ITo nand/or County) (Wate dy) 'he applicant ~as described to me, as shown below, the development proposed at the above Ocation I have no objection to this proposal I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site draivinJ) WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, iiffj r groin must be set back a minimum distance of 15' from my aroma of riparian access unless wnived 6y'rhe_ (If you wish to waive the setback, you must initial the appropriate blank below.) _ do wish to waive the 15' setback requirement. X ; do not wish to waive the 15' setback requirement. (Property Owner Information) Cif�rrlteu�c punt or Type Name M—Hing Address C'rT y%Statc�L�p Telephone Number ),.(Adjacent PropertyrQtivne� Informs . S7Imtllrur William B. Cocke, Jr., Trustee of the Ju Print or Type Name GoCke Revocable Trust P .0. Box 606R__ Mailing Address Newland, NC ,72 iM7 Telephone Number November 1, 2012 earth feet 200 meters 80 t;v srw R�r% 02 �d'GAD/NS .a��%ILN (yJGd lJFVAY/Al /li�la cc� �lifTiA aal�%� 7Y 1Al L�'�fT•Yj Fiji3, RECEIVED DCM WILMINGTON, NC NOV 0 7 2012 ---- - - - . Division of Coastal Mgt. Habitat Impact Computer Sheet )licant: ScP�I� c v. for; GEC Permit #: 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. (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 LI/ Dredge ❑ Fill ❑ Both ❑ Other / tD 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 0 Both ❑ Other ❑