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Home My WebLink About56595D - Sands;AMA / DREDGE & FILL ENERAL PERMIT Previous permit # Jew, Modification 1. ;Complete Reissue Partial Reissue Date previous permit issued .ed by the State of North Carolina, Department of Environment and Natural Resources Z astal Resources Commission in an area of environmental concern pursuant to 15A NCACIIIII Uattached. Name L. 3 rin � ___. -- Project Location: County F-3e LI IJS1N 101--- Street Address/ State Road/ Lot #(s) 7 i2 )f11 State /' 6 ZIPS- ` _ _ �Q ��1� g t �1 ()(1 Fax # ( _) Subdivision dAgent k.. s ,." - City_ no, ZIP ❑ CW DEW ❑ PTA QES ❑ PTS Phone # ( ) River Basin CAPE, C !�'L ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body W ❑ PWS: ❑ FC: Closest Maj. Wtr. Body es /0 PNA &/no Crit.Hab. yes / no Project/ Activity r/2 j -/� t (Scale: length LfiffhUMAT Oii ilr■�(�■■■ ON MM ■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■: MEN MENMEN■■■■■■■■■: -. ■ EON ■■■■■■EEG M■■rH��- BEEM-MMo■■■■■■■MEN /Ripraplength■- ■■■■■MEO■E■■11■■■■SEE■■ II■■■O■■■■■N distance offshore■■■■■S■■■■■1■■■■■■■1M■■1E■■■■■■■■■■■N ■■M■■■■■■■IN�■■■■■■■■■E■■■■■■■■■■■N distance offshore ■■■■■■ MEMO ■Eli/ii■f " ,�_ ■SEE■■■■■E■■SEMEN � .c yards■/■/I ENE li ■'!��"' m■■■OHO■■■SEC ■■■■■■■■■■■t■■■■EW'IV%��■■ MEN ■■■■■■1 ■■■■■■■■■■■■I■mm_!\ MEMO ■■■■■■■■■■MEM■1 - SSS■MSEOSSS'MiIAMSSSS■■■■■S mom SSSMSol ■O■ME■■!'■�!!!"'E•�tWiililMl■■■■■■■■■■NMI Adozing MOO■■■■I�Miiiz t� V■■'fJ''�ilftLiM M■■■O■O■■1 ■ME■■■r11M■ OM■1 ■■■■■i�i►�O'�IM■ii/M ■■■OSOEM■■1 Length ■■■M■ imp)■■N1■■wr IN■■■■■OOM■1 MEN 0 owbo --z�M...�..�■■O■■I ■■■■M.10 iill■■■■■MEME■■E■E■■ Ism ■■■■■NMI not sure yes . ■■■"u"�Mn17EIN EMS HOEM ■■■M OMNI I: not sure yes n ■■■rOlii■■ NEE ■■■■■■■■■E■■I�a�!!■ ■■■■■■1 1-211111 ■1 . - . ... ■■M■■O■■■■off■�■�0■:0■■�■�■■■■■■■ mom LL� ig permit may be required by: L, ° ❑ See note on back regarding River Basin i f \ �G I L 5C 704" 02/2011 10:23 3368465529 ASHE COUNT`,' SHERIFF PAGE ALT7 V` A NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F. Easley, Govemor James H. Gregson, Director William G. Ross Jr., Secretary Date Applicant: Name Mailing Address��x^ l certify that I have authorized (agent) to act on. lily behalf, for the purpose of applying for and obtaining all CAMA Permits neccssary to install or construct (activity) at (location) This certifi Signature ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/1I00RING PILINGSIBOA TLIFTIBOA THOUSE) I hereby certify that I own property adjacent to �, ; 1 i Ct (1'\ 5Qs n � S 's ,/ _ y (Name of Property Owner) property located at �� Q 0 �5 �= / cc [; �� -� (Lot, Block Road, etc ) on , in Y - Cr ✓ , N.C. (Waterbody)(Town and/or County) He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) I do not wish to waive I do wish to waive that setback requirement. ----------------------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) ------------------------------ (Information for Property Owner/Applicant (Riparian Property Owner Information) Applying for permit) p„bloc D 1 e'f- -6 & T: Oct Is I ao Mailing Address U Signature City/State/Zip Print or Type Nam, ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORING PILINGSBOATL7,IFTBOATHOIISE) ) I hereby certify that I ovum property adjacent to A&.4-0 —S 'n dS 's (Name of Property Owner) property located at (Lot, Block, Road, etc.) on �� , in —lk /GC /fic✓ t , N.C. (Waterbody) (Town and/or County) Applicant's phone Mailing Address: -Fb,�o jC %Z 4 He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) I do not wish to waive ZPZ4 I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) ?rl"4 °�— /Y)r. f )a,rv; n GA f T� 00k Yach� 90 8 (Information for Property Owner Applying for Permit) Mailing Address ,Dk %S � fy-wdP a off lbr7 x 710-4 /VIC-Sfir evF (Riparian Property Owner Information) Signature Division of Coastal Mgt. Habitat Impact Computer Sheet :ant: • W Il-V/ dyVz jfi-f-W-f 11-7/1l )OCRAl,lr # sl�s9S ribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement i in your Habitat code sheet. :at 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 impaactamount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/o temp impact amount) (�-� / Dredge El Fill El Both [IOther[;/✓ b i '(f I `%-' /4:� bW Dredge ❑ Fill ❑ Both ❑ Other 2-1*' 3 Z- Sz, 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 ❑ WILLIAM J. SANDS JUDITH F. SANDS PO BOX 126 JEFFERSON, NC 28640 G 1121 66-211/531 DATE $ a0V D% ' YADKIN 50+ INTEREST CHECKING VALLEY BANK JEFF BON, NC 26N0 t7l- CO 5 3 10 2 L L ?1: 80000 20 ?0 211' L L 2 L