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Home My WebLink About56697D - PriceCAMA / 'DREDGE & FILL ` GENERAL PERMIT Previous permit # VNew -- Modification ❑Complete Reissue El Partial Reissue Date previous permit issued ;sized b)ihe State of North Carolina, Department of Environment and Natural Resources Coastal Kasources Commission in an area of environmental concern pursuant to 15A NCAC 2e!!LQ/,!� 0 ZJRules attached. it Name �'o� r t Project Location: County Street Address/ State Road/ Lot #(s) State/C ZIP2 FW 2 Fax # C— ;d Agent 'd lu CW ❑ EW a PTA LiES ElPTS ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ❑ FC: yes / no PNA yes / no Crit.Hab. yes / no Subdivision City. ZIP Phone # () 11 / River Basin Adj. Wtr. Body Cr919b19f b 1?l 1/n? XaT Closest Maj. Wtr. Body/ �✓ �✓ of Project/ Activity Ac,i �(� �k� p,;,�d (Scale: length jad�bprap lengthfNI,G]f�aE■EEO■■■N■NE■NE■■E■OEM■■■N ■■■■HEM R."INl■■ ■■NOm■■■■■■■NEE■ ■■■■■■■■■■NUME%ZWENEfi!!nl-�!!!■■■■■■■■ ■■■■■MM0� WOMMINIMINEEMEN ■1■■■■M■.■■■■■■Ell rWME■■■■■■■■■■■■■■■■ NONE ■■■■■■OMEN vg distance offshore -iax distance . channel ■HENE�NE■NEENEE■NE■■NEE■■NENEENEE■ E®N■�Mii■■E■■��EE■ENEENE■NE■NEON■■■ OMNI EMIN Bulldozing ■■MEMEMIMM■M 1lE■EE?!�l�11MN�.�G►7iElr.�l/EI mom EM ME IL ■E■Eli rIEE■E■■■��E■EEE■■■N5 PIN mom row not sure yes .) gs: not sure yes `' yes no Attached: yes -mo i/ ■O■■Nina ii!NOR ONE on ■■EN■M■MNON ■■NOON■ rlFAMEWIM■EN IENE ■MEMO ■■■OM■EMEENI =ENE= Mw%lilmmmllmmmmmm■ENEE■NMNME NEE■E■■MOM■MM■M■MI ■■■■■■■M■OI ■NEE■■ ■■■■■■■� IEEEENEO■■NE■EEE■NEI ling permit may be required by:n ��S ❑ See note on back regarding River Basin k.#-,d — & c-/i vc sy ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to \ S (dame f Proprty Ovine � r) property located at Ul C' 15 � �' 1 to yl C, -,P ^� (Lot, Block, Road, etc.) on 2Lv-ey- , in ))__ aterbod S �c Il C' _�N.C. y) (Town and/or County) Applicant's phone #cj f -(� j�, &4 Mailing Address: He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. -------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by property owner proposing development) (Information for Property Owner Applying for Permit) Mailing Address (Riparian Property Owner Information) Signature I L.�•..d - �+ e. 1, ✓ ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to O c 's (dame of Pro erty Owner) property located at (Lot, Block, Road, et on / - ! Cal L ra G;�; �� / Y�y , in i,(Waterbody) --�LcN.C. (Town and/or County) Applicant's phone #: Mailing Address: I He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. ------------- - - - - - - ----------- - - - - --------- - ------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by property owner proposing development) ------------------------------ (Information for Property Owner Applying for Permit) (Riparian Property Owner Information) L1 Mailing Address Signature )Gcant:, �20-/ e Permit e: scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremer nd in your Habitat code sheet. TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet (Applied for. (Anticipated final (Applied for. (Anticipated fin. iitat Name DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. Choose One includes any Excludes any total includes Excludes any anticipated restoration any anticipated restoration and, restoration or and/or temp restoration or temp impact temp impacts) impact amount) temp impacts) amount) s L Dredge ❑ Fill$ Both ❑ Other ❑ 1� Dredge ❑ Fill ❑ Both ❑ Othero ■ Complete items 1, 2, and 3. Also complete A. S' nature item 4 if Restricted Delivery is desired. ❑ Agent ■ Print your name and address on the reverse X v `S ❑ Addressee so that we can return the card to you. B. Received by Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the frbnt If space permits. 1. Article Addressed to: Air '4 ��l c�.�, s NL- L/q_5 D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ® Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number (Transfer horn servJce kW7 010 1060 0000 8 4 6 7 9 3 9-5 -- PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 COMPLETE•N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1, 2, and 3. Also complete A Signature item 4 if Restricted Delivery is desired. i Agent ■ Print your name and address on the reverse �� so that we can return the card to you. ❑dre; b)(prated_ ) C. DVelip ■ Attach this card to the back of the mailpiece, 1 or on the front If space permits. r / 1. Article Addressed to: s delivery ress differ4id from item 1 ? ❑ es PRICE DOCKSIDE RESTAURANT INC OPERATING ACCOUNT 9955 NANCE STREET CALABASH, NC 28467 PAY TO THE r j ORDER OF 1 l c .,CAROL10-NA RM FOR �PFq� c a� 11,00008266n' 1:0539021971:71006731L DATE q _) 9, 1'