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Home My WebLink About57551D - Howell t�?;•ti.�Y`.u$ZBS.fLl�t�'e'�S��;Jii't�ii?:� 't�^��Li��(?t t, a.-,,, _,.-•��.,��9 �� -�.1 ' y ^ � .�{� �'" QYe? it�:s,�$i8232ct .�Z4L .�a�; Cy.-��-, ;-�Z �f..•t�tir�•'`'Ls -� .:Lyi �ts'a��J J.J �Y�ii.L:� .y e_ ;,^. ',�i t�, V or ADiACENT RIPARIsku PROPERTY OWNER1\107FICATION/ AVER FORM The purpose of this farm is ro provide proper nonce ro you as an adjacenr riparian property owner to the ir4v* individuals listed, below. The LAMA Oeneral Permit application procedures require that applicants provide the) Coastal Management confirmation that a written starement has been obtained signed by the adjacent riparian,P' irick-mnS. that they have no objection to the proposed work gr :hat the adjacent riparian properry owners leave: by certified trait of the proposed work. Often These forms are submitted to the adjacent riparian prcypasy conract,or or ocher individuals acring as an authorized agent on behalf of the applicant. This form was sent to you by the Mowing. individual or company designated by the authorized agent: �,, / _ Authorized Agenr,'PSignarur dame of IndiNridual Applyioa For Pennit:ZX�rd :address of Properr : 44 / T o2, 6 J t"r' U&I 4) (Lot or Street �i_ Street or Road) Ciry and Counr. , jere,by cer<ify that I own propem, adjacent to the above -referenced property. The individual applying for ti is~p g,descrbed to me as shot`m on the attached dralving the deveiourne nt they are oroposing. A descriptiort ordrav 4h-dimensions, should be provided with this lerrer. i have no objections io tis proposal. have obiections—to what is being proposed, please write the Division of Coastal Manfigement, il' a al,Dtive ExFension. Wilmington, NC 7-8405 orcail 910-796-7215 w='thin Zd days of receiptofthis n6tii is s anise is considered the same -as no objector, if you have been notified by Certified Mail. WAIVER SECTION € vu#ermrand that a pier, dock, mooring pilings, break-waten boat house or beat lift roust be slat back ti :.riistancE aP 15� from my area of riparian access -unless jai -red "bv roe, -(If you wish to waive du must initial the appropriate blank below . ) . I do wish to waive the i b setback t�uirement. I do not wish to waive 1 _5' setback requirement. � � Di�ISiO r OF COASTaL'r1ANA. EMENT ADJACENT RIPARIAN PROPERTY OWNER NOTTFICATIONIWAIVER 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 Divisi+ -o€ Coastal Management confirmation that a written statement has been obtained sued by the adjacent riparian property owom indicating that they have no objection to the proposed work or that the adjacent riparian property owners have beend by termed mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by ate 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 t authorized anent: A s Sist<tarure Date 111�1 Name of individual Applying For Permit: 14�4,tg -1 Address of Properr!.-: e� / // o� �� Cites-ov�Ti Oar (Lot or Street =. Streer or Road) (Ciry and Counn•) }iereby certify that i own prop e ty adjacent to the above -referenced property. The individual applying for this,pertn " ' ,described to me as shown on the attached drawing the development they are proposing..4, description or drawirt. dimensions. should be provided with this letter. I have no objections to ibis proposal. "boa. have objections to what is being proposed, please write the Division of Coastal Mana=ement,..12 di a1 Drive Extension. Wilmington, NTC 28405 or call 910- 796-7215 within 10 days of receipt of this notic+ - �o response is considered the same -as no objection if you have been notified by Certified Ylaii. WAIVER SECTION t understand that a pier, dock. mooring pilings, breakwater, boat house or boat lift roust be set back miroma"in distance of 15' from ray area of riparian access - unless waived by me, (If you wish to waive th you must initial the appropriate blank below.) I do wish to jvaive the 15' setback requirement. I do not wish to waive 15' setback requirement. a ,� ,r, :� �as8✓cam// ' �ia�a hdan'ch.1D i dicant: /%OYl I'lowt /Y Permit #: l 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 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) t G% 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ ® GLOBAL EXPRId88" North AmeAcan�Banking Company, MN Im- @'y ORDER 314382427 GEORAI EXPRESS MONEY ORDERS, INC. DIV DF DE CIAI SERVICES. INC Po _"' R-Ell SPRING. MAR —ND .-DT PAY TO THE ORDER OF MONEY CIA- -1 0ERT RELEP@NT i:09 L 2 L5558D: 3 700 3 0,313 2'. 27110 3i2012 15:12 FAX 1j001 r�,�,��r�u3►t� N° 5755 ,I�s..A 1 i;l DRExa "LJL, ►1 ( a GENERAL PERMIT s Previous ptrmlt- aw LIModification ❑Complete Reissue rii�l ltais u�►a) ♦ * * d3lete�pte>riows �lrt►�4tas the 5ta f�f4 olin&, Partment of Environment and Natural Resources pasta limn rcw Corn on In an aria 6~ ylronment;W concern pursuant to I SA NCAC 7 � _ _ D Ru es nQd. Project Location: County _. Street�Adddrress/ State Road/�L,00t #(s) Subdivision City- ZIP, C7 1ad 1 CW DEW r_i PTA I 1 ES I.-IPT5 Phone IF V 9 River Basin D OEA ❑ HHF !-1 IW f7 USA ❑ WA ;�. Adj. Wtr. Body S Lrs. r, PWS: UFC: _ V � Closest Maj. Wtr: Body es no ?NA yes C_'.:�� Crlt.Hab. yes I of Project/ Activity ,✓ (Scale: (ce) length r - I - 1 G I 4 ; n length I i I I I r I i I I r number_,.. head/ h �� j• — — kP�P length Avg distance offdwe ; I ; ; ; i 1 ' } max distance offshore char nol _I i I ! — cubit yards i I ' ramp - ' t 1 •h Buildozing _ 1 1 NWV ; nww.. ' yam. I -r— ! T l p R 2� 2 ' 1 _ I ^T' viding permit may be required by: ^ See note on back its RNer Basin rules Ilt Les/ Spodad Condltlom �.Cti !9/2012 15:11 FAX Q"L'L 'LV$M'a♦ *! *a! VJ *!a(•(♦(va rIh ov//5 RECEIVED )CM WILMINGTON, NC APR 232012 [� {i ii 1_