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Home My WebLink About57369D - KeiferCAMA / DREDGE & FILL 3"ENERAL PERMIT Previous permit# 1Ikw :Modification ❑Complete Reissue El Partial Reissue Date previous permit issued rized by the State of North Carolina, Department of Environment and Natural Resources Zoastal Resources Commission in an area of environmental concern pursuant to 15A NCAC {T� ! 2 U C �� O.Rules attached. it Name_ ,•G !��+- la i`�� Stated_ ZIP `3 3S fax # C—) :ed Agent ; ; ��t:1<, - i , �'°• ` C� �` ❑ CW DEW L:�PTA ❑ ES ❑i PTS ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ WA ❑ PWS: ❑FC: yes PNA es o Ctit Hab es / no Project Location: County Be J NSyj ( cy— Street Address/ State Road/ Lot #(s) . I SL i-NI3 012. Subdivision City ZIP 2c�� Phone # ( ) River Basin I—UA" Adj. Wtr. Body T)/��C y y Closest Maj. Wtr. Body pD',n/�J f Project/ Activity 1..--6 L7'_7' i _ r Ar (Scale: I �,- Zia v ■■#!■■i■■■■■■■■■■■■■■�■■■■■■■■■■■1 �:'�+ilia■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■1 ngth EEMMEEQZMULN,o ::::■MEMO MENNEN ■■I ■■■■■�■■■e* 'a■■■■�■�z��■■i■■■■■■■■1 -distance offshore ■■■■■1ii■■t.'i■I�..��Ii■'lrl�T�■■■■■■�■■■■■■1 x distance offshore_ iannel iii■■iiii�cii� �iii +�i �ii iME IM iii■■ dc yards■■■■3�aaQ� ■■111■■� E�■r!�� :�■■■■■■ ■■■■■ ■■■■■1■d■■■■■iI�C■■■� Ilril'w■■■■■■■■■■■■■ Aldozing ■■■■■11■■I��II.�c� 9 iiiw'I■!I■■■�■■■■■■■■■■■■ ■N■■I�il■■■■■■■■■■N■il��'■■�■■■■■■■■■■■■ not sure yes .not ■■■■■i(jil■■■■■■■■■■■■11[iL■■■■■■■■■■■■■■ ■■■■�i� i■■■■■■■■■■■■t!■■■®■■■■■■■■■■■■ sure yes no • ■■■■■■�i■■ ■Il�i�l��'t'�If7;■■■�■■■■■■■■■�■■ yes no ■■■■■■■■■■■■N■■■■■■■■■�■■ ■■■■■ ■■■ ig permit may be required by: O f1L I SL A�,JJ ❑ See note on back regarding River Basin rt r- ,- O I tyv � o s�En YQ) --`> NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management iael F. Easley, Govemor James H. Gregson, Director WWiam G. Ross Authorized Agent Consent Agreement is hereby authorized to act on my (Printed Norm of AyAnt) 3er to obtain any CAMA permit(s) required for the property fisted below. The authorization is limit, ific activities described in the attached sketch. ATION OF PROJECT: ►PERTY OWNER MAILING ADDRESS: 'HORIZED AGENT MAILING ADDRESS: r 7 PHONE NO. PHONE NO. ZO�— 5113 iature of Prmnerty Owner n4r i;. cu l l I I ; Lorivi No.3277 P. 2 V DMSION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY.OWN-ER STATEMy-- ` Name of Property Owner: eSL�6- 0 F IRCIVE-�ARgzls Addmu of Prope*= 1 3 �, /'5/— ANb- p K 0-► K i S L RA)b (Lot or Street N, Street o, Road, City 8c County) Applicant's phone #��7gf b� Mailing Address: 2 I imrcby catitjr that I owO PmPerty adjacent to the above referenced property. The indiv has didurt! apPh'�8 for t ttscYibed mate as AOWA on the 4 tschod drawinwim,milstg the devclopttteDt they arc Proposing. / I have no objee#i,ons to this proposal. - -f brave objections to this propose If you have oh0"10" W what is beiwg propmed, you mast ■atifj the Divis"of Casaw Mmaggwreu, is w"tlalt witVa 10"a[ me*' of tk ""' Cor"SPoadftoe xbQ9W be nmded to 127 C,ardiW I w4018� NC 2*10S-31l ' DCM rsPru"tad vea era airo be contneted at (9AO) 7W7215. No res" u WATWR SECTION l uudcT$U d that a pier, dock, mooring pilings, breakwater, boetbouse, or lift must be sat back it minimum & 15, frvm my area of riipariart access unless waived by me. (If you wish to waive the setback, you meet iaitb Vpropriate blank below,) I do wish to waive tht IS' set back requirement. I do dot wish to waive the 15' set back requirement, �Yser rmatioa) Periy Ow r atio SigaLe Signatur • I/ I Print or Type Name Print nr Type Name - --�!l I moo$ Marling Addrew � t 3 E Mailinn AAA--- DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER STATEMENT tune of Property Owner: 6-57e-+7'C-7 a F (�ie/✓ - �?A� - idress of Property: 13 �, I SL/�}N n Q A (LDG ff // (Lot or Street 0, Street or Road, City & County) )plicant's phone N: I �a e-(7 Mailing Address: S'/9-tit e- ff weby certify that I own property adjacent to the above referenced property. The individual applying fo s described to we as shown on the attached drawing the development they are proposing. A th dim/aansiaas. must be movided with this letter. I have no objections to this proposal. I Gave objections to this props You Lave objections to ghat is being proposed. you must notify the Division of Coastal Managew wrkift within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardin 'ibtinglon, NC 23403-3845. DCM representatives can also be contacted at (910) 7%-7215. No rem AMMA the aaaat as no oW-Won if you have beegntifkd by Cer0fied Mail, WAIVER SECTION inderstand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum from my area of riparian access unless waived by me. (If you wish to waive the setback, you must im vropriate blaak below.) I do wish to waive the 15' set back requirement. I do not wish to waive the I S' set back regi{ires MOW ignature Li S �e'r? eaAAJ qe Tint or T _ Name Island A Signature Print or Type Name i r 3 c---- IS c�.4.rJr� C Division of Coastal Mgt. Habitat Impact Computer Sheet plicant: tz-Eq�)2J ST�� Permit #: 6 '73bcf scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremer ind in your Habitat code sheet. Atat 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 fin disturbance. Excludes any restoration and. temp impact amount) Dredge ❑ Fill ❑ Both ❑ Other r 141 R Vv Dredge ❑ Fill ❑ Both ❑ Other EJ." 0 L —1 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 ❑ BERNARD SCOTT BURNS PH.(910)754-9740 P.O. BOX 1417 WRIGHTSVILLE BEACH, NC 28480 os;s a 573 8 -6[ lQ DATE PAY TO v i,_, ^ JTHE ORDER OF / $ 9 QO / 0 �N/G LCCCL///S � �C/".�.. State Employees' Credit Union® �AR�� Supply, Nir3 Caro na ,,, 11 MEMO�:253177 491: 861wB 29Sn OS73