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Home My WebLink About59145D - ThompsonCAMA / DREDGE & FILL iENERAL PERMIT Previous permit# New Modification ❑Complete Reissue []Partial Reissue Date previous permit issued rized by the State of North Carolina, Department of Environment and Natural Resources Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC _ Rules attached. nt Name Project Location: County TV-L) Yk c lc. t t Street Address/ State Road/ Lot #(s) V1^✓ _ State ZIP�2 # (n _) `f " f Fax # ( ) Subdivision N/A ized Agent _ . (}� W\ kI t ✓S ity r f. aAj ZIP 20 Cw EW ,d w PTA a ES PTS (� I River Basin OEA HHF — IH ❑ UBA L N/A rl PwS. ❑FC: yes / no PNA yes( no of Project/ Activity Adj. Wtr. Body Y% '' ,, `` (nati Crit.Hab. yes no Closest Maj. Wtr. Body �1 �� W �'■MEN■■ ■L■■■■■ length iumber ad/ Riprap length kvg distance offshore_ nax distance offshore- channel ■■■■■■■■■ ■■■■■■■ 'ME ME SOMEONE ■■■■ ■■ ■■ ■■■■■■■■ MENOMONIE ■■■MOM■■ :ubic yards amp ■■■■■ :)use/ Boatlift -�M ■pp■�■■■ Bulldozing Kh �.' M :■G IEMEN ■W �M■■■ MMMMMMMMWT MEE■■ ■■ (Scale: ❑ See note on back regarding River Basin DIVISION OF COASTAL, MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION IVER FORM Name of Property Owner: Address of Property: (Lot or Street #, Street or Road, City & County) Applicant phone#: SUP, 8'9& — D q4 Failing Address: IA IC 121)10 G 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 draw ng the development they are proposing. A descri tion or drawing, with dimensiAns Lrpg be Prov ded with this Ie e , have no objections to this proposal. T have objections t this proposal, if you have objections to what is being proposed, you must notify the Division of stal Management (DCM) in writing within 10 days of receipt of this notice. Contact lnformatio for DCM offices is available at www.nccoastalmangement,neVcontact dcm.htm or by calling-888-4RCOAST. No response is considered the same as no ob action if you have been notified b ertified Mail. WAIVER SECTION i understand that a pier, dock, mooring pilings, breakwater, boathouse, or I minimum distance of 15' from my area of riparian access unless waived by waive the setback, you must initial the appropriate blank below.) �._ m I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) nature Print or Type Name 1 I r /�I r fi,► j'. Mailing Address �!iry Salmi.., NC- must be set back a ie. (If you wish to (Riparian Property O er Information) Print or Type Name ?A_ 1 Mailing Address OAg,,!a N(c N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date Name of Property Owner Applying for Permit: f �"a►�l ces Ji�J.�nso �, Mailing Address: s-1 l]? I certify that I have authorized (agent) Ar(� OA I C14- ..r to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct activity) rervxo✓I pip s�; n at (my property located at) 3C7 ��y6c This certification is valid thru (date) Property Owner Signature I Date LV CAA c r- 17' - ---- -- - --- L /2012 03:51 9105798507 RWMCCLURE PAGE 01 CERTIFIED FAIL. - RETURN RECEIPT l EQUESTED DIVISION OF COASTAL. MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM Name of Property Owner; Address of Property: (Lot or Strtaet #, Stre% or Road, Cl� & County) Applicant phone* 3 3� Mailing Address: 1/qq 16tr rl►,r-t- r, 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 descriptJor drawin.a, with -dim nsmu. st be wrovided Witithis _letter. knave iao objections to this ry osa1, I have objections to khis ro osal. J � P - J � � if you have objections to what is befng proposed, you roust notify the Uivision of Coasial Management (DOM) in writing WiMin 70 dop of rec#ipf of this notice. Conftat information for D(W offices is available at www.nccoas IM-Rogement.neVcot?#aGcLdcmJyVn or by calling f,0884RGO,ASI; No response is considered the same as no obfe0ion if,you harp, been notffi%a by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distance of 15' from my area of riparian arc;6in unless waived by me. (If you wish to waive the setback, you pWLAi ' 'a! the appropriate blank below.) db vAsh to waive tlie-15` Setbavk requirement. I do not wish to waive the 15' setback requirement. (Property Owner information) Signature - , -600 C� . (Ripon ropert r wv r formation) ' re Division of Coastal Mgt. Habitat Impact Computer Sheet ilicant: Permit u: 5ll mi;� cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement id in your Habitat code sheet. TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet (Applied for. (Anticipated final (Applied for. (Anticipated final DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. itat Name Choose One includes any Excludes any total includes Excludes any anticipated restoration any anticipated restoration and/or restoration or and/or temp restoration or temp impact temp impacts) impact amount) temp impacts) amount) Dredge ❑ Fill ❑ Both ❑ Other ❑ 1 Dredge ❑ Fill ❑ Both ❑ Other ❑ U.S. Postal Service,, CERTIFIED MAILU, RECEIPT Dredge ❑ Fill ❑ Both ❑ Other ❑ Provided) (Domestic Mail only; No insurance Coverage Dredge ❑ Fill ❑ Both ❑ Other ❑ Ir 0-. C 01'K K 224,r, Z tij Dredge ElFill [IBoth ElOther ❑ Postage $ $0.45 0459 ru Certified Fee 0 �2.95 Ul Postmark O Return Receipt Fee Here O (Endorsement Required) $2.35 Dredge ❑ Fill ❑ Both ❑ Other El Dredge ❑ Fill ❑ Both ❑ Other ❑ o Restricted Delivery Fee (Endorsement Required) 0 Dredge ❑ Fill ❑ Both ❑ Other ❑ .tea Total Postage & Fees $ 75 02/01/2012 rq Dredge ❑ Fill ❑ Both ❑ Other ❑ -------- p Lento ii:;� o.------------- --------- Dredge ❑ Fill ❑ Both ❑ Other ❑ -- --- - IP+4 Dredge ❑ Fill ❑ Both ❑ Other ❑ PS Form :11 August 2006 see Reverse for Instri Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑