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Home My WebLink About56566D - Cochran... ..I...M c cur 3; r �,ar :1t„ sa Huai u i iGi iL Ui m iVii ui it i1Ci i! al lei IvaLufal t'SestIrUxes , ichaei =. Easley, Cowr-or James H. Gregson, Director _ e of Property Owner Appiy�� nor �er�ait; ` laid 4 dd ess - k' V (a0 t cS CbN('Gn WHYsm G. Ross Jr., Secretary emit fhas _ nave aauthori.eu ��C��i�."_€/ V � i qq ^^[ m�,r� 2 � / v -£F.cL V� L'3f for fs purpose of appllyiisgg .nor and obI'allaim ah C=-1 'L," Permits necessi r,; to OtaH or coustrtact (actti-vity") �y� �fi �«A- 4 ape loom ed at) s-7-- G Aor7 o� 3�� 7 Ws cer canon is valid -mot 3 (date) %��'C_ 1f Sim at-dre 127 Cardinal Drive Ext., i.IArnington, North Caroline 28408-3845 Date // n O� fr Q/ le X f/ �ww 1,111E-L g , �,L CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM 'he purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual or idividuals listed below. The CAMA General Permit application procedures require that applicants provide the Division of 'oastal Management confirmation that a written statement has been obtained signed by the adjacent riparian property owners idicating that they have no objection to the proposed work or that the adjacent riparian property owners have been notified v certified mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by a marine ontractor or other individuals acting as an authorized aeenr on behalf of the applicant. 'his form was sent to you by the following individual or company designated by the applicant as an .uthorized agent., authorized .s Signature Uate �• tr�nrR CAC dame of Individual Applying For Permit: kddress of Properry: Jr (Lot or Street �_ Street or Road) C /� C (City and Counn) l hereby certify that I own propem, adjacent to the above -referenced properr. The individual applying for this perrni as described to me as shown on the attached drawing the development they are proposing. A description or drawing oith dimensions. should be provided with this lever. I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Coastal Management, 12' Cardinal Drive Extension, Wilmington, NC 28405 or tail 910-796-71215 within 10 days of receipt of this notice No response is considered the same as no objection if you have been notified by Certified flail. WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set back minimum distance of 15' from my area of riparian access - unless waived by me. (If you wish to waive th setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. aR . ,. I do not wish to waive the 15' setback requirement. i� • � �uK�t�v I rcrrAKIAN PROPERTY OWNER NOTIFICATION/WAFVER FORM The purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual or individuals listed below. The CAMA General Permit application procedures require that applicants provide the Division of Coastal Management confirmation that a written statement has been obtained signed by the adjacent riparian property owners indicating that then have no objection to the proposed work or that the adjacent riparian property owners have been notified by certified mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by a marine contractor or other individuals acting as an authorized agent on behalf of the applicant. This form was sent to you by the following individual or company designated by the applicant as an authorized agent: A6ent's Signature 2iGc e, Date Name of Individual Applyitra For Permit: ` 5mG Co .address of Property: . .?•/ % 3A -2 J' (Lot or Street 1, Street or Road) J L/L t G /j1 r, < - b (City and Counrv) 't hereby certify that I own property adjacent to the above -referenced properrv. The individual applying for this permi as_described to me as shown on the attached drawing the development they are proposing.:'_ description or draNvi.m with dimensions, should be provided with this letter. �r I have no objections to this proposal. f: you have objections to what is being proposed, please write the Division of Coastal Management, 12 Cardinal Drive Extension. Wilmington, NC 28405 or call 910-796-7215 within 10 days of receipt of this notief fib response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I undlerstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set back minimum distance of 15' from my area of riparian access - unless waived by me. (If you'wish to waive tb 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 +� o Ll Date NCDENR New, C qcu— 1p.XT-E)r 01, �rnRCW+IX� AMD NJQ'.p1AL ?ESCRIA -FA CERTIFIED MAIL -RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM The purpose of this form is to provide proper notice to ,you as an adjacent riparian property owner to the individual or individuals listed below. The CAMA General Permit application procedures require that applicants provide the Division of Coastal Management confirmation that a written statement has been obtained signed by the adjacent riparian property owner indicating that they have no objection to the proposed work or that the adjacent riparian property owners have been notified by certified mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by a marine contractor or other individuals acting as an authorized agent on behalf of the applicant. This form was sent to you by the following individual or company designated by the applicant as an authorized agent' 0 c s Signature Date Name of Individual Applying For Permit: �� "`� C U C_jt/,C,1,�1 Address of Propert:v: 3U Z 7 YA 17' (Lot or Street 47, Street or Road) SVZL/ .< C- /T—Z /'- C (City and County) I hereby certify that I own property adjacent to the above -referenced property. The individual applying for this perm has described to me as shown on the attached drawing the development they are proposing. A description or drawin, 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 Coastal Management, 11 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215 within 10 days of receipt of this notic 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, boat house or boat lift must be set back minimum distance of 15' from my area of riparian access - unless waived by me. (If you wish to waive tl setback, you must initial the appropriate blank below.) y I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. -A &--.V Division of Coastal N19t, Habitat Impact Computer Sheet licant:' ,Q,�,Q CrOl,v�� Permit #:(� M 5 ll cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement id 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 impactamount)temp TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount) Dredge ❑ Fill ❑ Both ElOther ,3j 3 8 ouCJ Dredge ❑ Fill Both ❑ Other ❑ Dredge Fill ❑ Both ❑ Other ❑ I I qO Dredge ❑ Fill XBoth ❑ Other ❑ Dredge ❑ Fill XBoth ❑ Other ❑�J� Dredge ❑ Fill ❑ Both ❑ Other Z5 �� 5 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 ❑ gx 110 - Itio �.� �� = I I ® ,13� 513 iSo .150 S6= 1�to