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Home My WebLink About57415D - HornerICAMA / DREDGE & FILL EN ERAL PERMIT Previous permit # New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued rized by the St ite of North Carolina, Department of Environment and Natural Resources Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC T H l Rules attached. t Name k j 31.1"a �.•) -4V V r A t ✓ Project Location: County VU Y1 S1N I C4, 5 It �. ( i 1 ' i r'. / , Ur. I I It State I. "l ZIP Z K,-3U # lo)3Z3-2Uii Fax #( ) zed Agent f � 6( VfF Yk ,t, AS-� l ? -E i j L_ Crl . CW ❑ EW � PTA ❑ ES ❑ PTS ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A PWS: ❑ FC: yes / no PNA yes Cno Crit.Hab. yes / no if Project/ Activity 'V U J d4-, ock)length Street Address/ State Road/ Lot #(s) Subdivision N City V ej (ux Y�Va (..ice. ZIP U1W Phone # River Basin �XIAA Adj. Wtr. Body G A&( (nat L Closest Maj. Wtr. Body i ww AG ( kln (Scale: ' ■■■■■■■■■■■■■■w■■■■■■■■■■■■■■■■■■I ■■■■■■■■■■■■■w■w■.■■�■•.�■■■■■�1►�l ength ■a■■■■■■■ii■■i■1'i■■■■■�■w■■■■■■■■■ imber ■■■■■■■■■■■■Y■■■■■■■■v■■■■■■■■■■■■■I !g distance offshore ■H■■■■■■■�tl�■■■■■■■■■■■■■■■■■■■I )ax distance ■■■■■■■■■■o■mvm■m■7■■■LZY==:!■■■■■■■■■I ■■■■■■■■■Y■■■■f'r':dl�.l�l■■� 1■N■Y■■■■■■■■■I jbic yards ■■■■■■■■■■■■ ELWU�1111 III oil i�■■■ NONE ■■ !■■■■■■■■wgmE rt■0I0091■ullfm■■■■■■■■■■■I rjulldozing ■■■■■■■■■■■■■■■■■■I I■■■■■■■■■■■■■■■■1 ie Length not sure yes ■■■■■■■■■`�■■■1:'i ■■■■■w■■■■■■IIIY■I N■■■■■■■■■■■■■■■■■■■■■■■La■�i■■■�■■i ■�r.;e�•��N� ■■■■■■■■■■■■■■■■■■■■■■YRol ■iiAttached: ■..■■■t��l■■■■■■�■Iw■■■■�1�■■■■,sue■■I 'ed no IN :�iIYY■tisililiii■■■■:a�'�iir■■■■4�,�i�i■■■111�!'�r'isil xes no IR�i�ili■L/,'�l■�■■■■�■■■�■ram■■■■�i�■I ling permit may besrequired by: ' (((� ❑ See note on �ack regarding River Basin i 11 10.52a Adcock Rentals 919-776-2344 p-1 06/06/2011 13:43 9109609742 WI CONSUMER PRODS PAGE 01 CXRVMR N&9z — RUMP DTMTON OF COASTAL ZVIANAGE&M4T ADJACEiT RMARMN pROp' yO191 Mlt STATEMFI'tT Nw e of property Owner Add= of PropeTt,, Ll rl T aG ea`1'Iry 7 v-G (Lot or Street 8, street or Roma, City Co+mty) A,ppliicmW5pb➢ottc#: lb— 01 Aaatt cjS G}�v�ct: �� i hereby cafd fy lbOt 1 awn prop t:Tty adjec m tD ibe move referenced pmperty- The ita:iridui sppiying for t id pemn has deseiibed to me as A v m ao dte attached &Wwing tit, &mdWtstettt they w- prvp-eWS- A motbo t� ti `A � I hM no objecfio% m tbis praposat. I bz7a obja�otis ffi �tsgrnQosal. uyoo bit obJaetivtar to wbat is bring proposed, ycm must malifT the DivWau or Cm. Mang--e rt (DM in WrWmg wiWa !b;&" of receipt of this ts, iic., Corrapoudaarx sionW be ss*W to 127 Csrmng Dt ive Xvt. Witmingbm, KC 28485-.U49. DC A tepmmtstivu esm dw be eoatacW at M11) 7%-7715. No response is eenunezxu the its �.o obfecdpn 11Im base been not domed by CtrtiScd �Visi4 WAIVER SEC1'TOV I uodecstmd that a pier, dock mooring jxTwgs, beeskwiter. bondmuse, orI i@ nusa be set back a InimiuMm distance of 15' ftm my atu of rww isu access r vbss wrai ved by "- (I€ yot; wish to wrdiveffit Setback, yaa most itriRinl the `5 ` a b1sk belmw-) 1�� I do wish to waive the 15' wt back rogai cffm t. I do notwish to wwmra Litt 15' sct bKk ntg rure prillux Type Irmo Mot or Type 1.55 S• c�►11 R - � 5� Laic �o � Lam. - b6 �Cit7B,- �!Jtll City 1 State I Zip qqQ TekphoaeNumber O —32� ��T�Phoa+eNorrtberkIr r r� .�� Dee Date '3/06/2011 13:43 9108609742 NFI CONSUMER PRODS PAGE 01i Mgr.. CERTIFIED ibIA, L - RETURN RE CE REOUFST• D DIVISION OF COASTAL TAcNAGEMENT ADJACENT RIPARIAN PROPERTY OWNER STATEMENT Address of Property: �� 1 ,1 ��. aGCi�fV •�^ (Lot or Street 0, Street or POad, City dt County) Applicant's phone #:. l l� — h0 Mauling Address: � c�S c� • G rt� 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 we proposing. &Aq1CLrJq1kn a s' ns rou 0 vided yr this otter. l have no objections to this proposal. 1 have objections to this proposal. 1.f you bave objections to what is being proposed, you must notify the Division of Coastal Management (DC4 in writing within 10 days of receipt of this notice. Correspondence sbould be mailed to 127 Cardinal Drive Tar. Wilmington, NC 28405 3W. DCM mpreseAtatives esrn also be contacted at (91U) 796-721.5. No response is c n. a the e n ob ectl n if u have been motif ed b Cer ' cd WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, bostbouse, or 1 ift must be set back a minimum distance of 15, from nW area of riparian access unless waived by me. (If you wish ro waive the setback, you most initial the appropriate blank below.) t/I do wish to waive the 15' setback requirement. I do not wish to waive the 15, sci back requirement (prp pry Ixrfo a n) (Ripaz Ian pro2 1 eryerty Oinformation) f Si lure 5i Print or Type Name print orp au :5c C Mailing Address ailin Address City 1 S ! Zip City State 1 Zip 2 `0 TelephoneNumberrq —3 .3 r �� TelephoneNamber C— -- C— ` \ Date i/10/2011 09:36 9108609742 NFI CONSUMER PRODS PAGE 01/ Nadh Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves perdue .lames K Gregson Dee Freeman Governor Director Secretary AGENT_AUTHORVATION FOSM Name of Property Owner Applying for Permt E k:;F 2A (6�9_ �n4fjf7L Marling Address: /6-s' 5- 02, Phone Number: (/o )s►". cal _ certify that I have authorized (agent) I N &A) Clb'M�� L-Lc- - to act on my behalf, for the purpose of applying for and obtaining all LAMA Permits necessary to install or construct (activity) Iry S ,A j V. j i D*A at (my property located at) j(l=�E Yl;�-- _QCtI aulew _ibQAr.1�. n.dG This certification is valid thru (date) A A . _ /. \/ L 1 Owner Signature V/ r 9 ~ k Data Existing Floating Dock P "0' Off se xisting Dock 0' Division of Coastal Mgt. Habitat Impact Computer Sheet licant: ({Y��►� Permit #: 5�150 -ribe 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 impact amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Feet (Anticipated Tina disturbance. Excludes any restoration and/c temp impact amount) \►� '\\ / W Dredge Fill Both Other ❑ El l `f LJ 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 ❑ LIMITED RECOURSE: This Money Order will not be paid if it has been forged, altered or stolen, and recourse is only against the PERSONAL MONEY ORDER -' endorser. This means that persons receiving this Money Order should accept it only from those known 45to them and against whom they have effective O recourse. NOT VALID OVER $1,000.00 pUB NfHf W ISSUING BRANCH s _. DATE PAY TO TH ORDER OF Wei 1 4 _ DOLLARS BY SIGNING YOU AGREE TO THE TERM •, , ��y W � PURCHASER, SIGNEF yyy� ADDRESS CITY 8 STATE fig 3000 9 S 60 S SII' I:0 S L 40 2 3 6 9i:000 10 l 908000 LIl'