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Home My WebLink About57546D - Sass'CAMA / DREDGE & FILL '3ENERAL PERMIT Previous permit # New .-Modification E]Cornplete Reissue El Partial Reissue Date previous permit issued rized by the State of North Carolina, Department of Environment and Natural Resources -? // 14 -oastal Reso / ,.yrces Commission in an area of I rsuant to 15A NCAC Anvironpenta co -f -2 f r �!qn Du 2e IV 1 7 fie, Rules attached. t Na� �e Project Location: County A Street Address/ State Road/ Lot #(s) State e ZIP Fax # Subdivision :ed Agent_ z City El CW [:41EW PTA 0 OEA El HHF El 1H El PWS: El FC: yes 10 PNA yes/ (9 F Project/ Activity ❑ ES E PTS Phone# (—) River Basin UBA El N/A Adj. Wtr. Body 141WA21- (nat Crit.Hab. yes / no Closest Maj. Wtr. Body C -1e,1V1 �l/ /? (Scale: 114101"KINEWER12d i■■� �ili�■■■■■i FA VIdozing ie Leng �h not sure y not sure ■■■�rr�■■vw■n»■►��+■t�■ ■■■■■u�■■■■■■0■■� 'iurn: n/a yes yes Attached: es y AAWAR&M UAli R-14-2010 0e:52 From: To-910256.3052 P 4 WMERR North Carolina Department of Envlrorlment and Natural Resources Divwnn of Coastal Management .lames H, Gregson Beverly Eaves perdue Director Govemor AGE p�taTWt�RiZATION FaRM Date:./ Name of Property Owner Applying for Permit. owner MaitlAddress' Phone Number Dee Net Sem Namo of Authorized Agent for this Project ,Agent's Malling Address: r 1 NC2W Phone Number (g1p))256'3062 i that i have authorized the agent listed above to act on my behalf, for the Purpose of applying I cent fy y) for and obtaining all LAMA Permits neces arY to ►nstalti or construct the following (act'svit z Z9yA ,my property located) at This cettifi?,ion'va{id thru (d Ee)to �r 12c) yt ner Signature Date DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM Name of individual applying for permit-j F Sys Address of property�urwux-1y 6✓�1•►�c�� 8 I hereby oertity that I own property adjacent to the above referenced property. Thi individual applying for this permit has described to me as shown on the attadied drawing the development they are proposing. A description or drawing, with dimensions should be provided with this letter of notification. o Please initial below if you have no objectiona.awee 946w4r, i have no objections to this proposal. f If you have objections to what is being proposed, please write the Division of Coas Management,127 Cardinal Drive Extension, Wilmington, N. C. 28405 or call 910 .no 3690VAMIn 10 days of receipt of this notice. No response is considered the 176.AK same as no objection if you have been notified by Cerdffed Mail. WAIVER SECTION i understand that a pier, dock, mooring pilings, breakwater,boat house,lift or sandbags must be set back a minimum of 15' from my area of riparian access unless waived by me.(If you wish to waive the setback, you must initial the app7oate blank below.) I DO wish to waive the 15' setback requirement. I DO NOT wish to waive the 15' setback r+equ Mme"t kj-71 1,� jme rhR- �?n j1 s h�Z (`��f1 DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FOP Name of individual applying for permit RaF ;)O> Address of property,) 906-A/J`�l °```� �� /J"/� �� } i hereby certify that I own property adjacent to the above referenced property. 7 individual applying for this permit has described to me as shown on the attach( drawing the development they are proposing. A description or drawing, with dimensions should be provided with this letter of notification. Please initial below if you have no objections. /&,J,,W& AMT,� I have no objections to this proposal. ° 'f '°G-A If you have objections to what is being proposed, please write the Division of Co, Management, 127 Cardinal Drive Extension, Wilmington, N. C. 28405 or call 9' within 10 days of receipt of this notice. No response is considered tt A/<' same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater,boat house,lift or sandbags must be set back a minimum of 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 wish to waive the 15' setback requirement. I DO NOT wish to waive the 15' setback requirement. y � ECEIVE Signature & Date y -U" Nt VV ball t exf" je'^ P. O. Box 865 Wrightsville Beath, N. C. 204M 919/256-3062 its DIVISION OF _ COASTAL MANGM+ RECEIVED OCT 19 2011 DCM WILMINGTON, NC 3z C Division of Coastal mgt Hao itat Impact Computer Sheet ��t hrrtr Zt5 IG+�',V n � C p�ican /� �o �t ASS Permit #: s` te: Scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement nd in your Habitat code sheet. dtat 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) (1 Dredge ❑ Fill ❑ Both ❑ Other X q 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 ❑ F AND S MARINE CONTRACTORS, INC. P.O. BOX 868, TEL. 256-3062 WRIGHTSVILLE BEACH, NC 28480 PAY TO THE / � <.- ORDER OF __ n ly4 11 DAT _ RBC Bank'" RHCBank(USA) FOR ® 6 / ✓ / (1 p ------ II'000 39 L881I' i:0 5 3 L008 50':0 2 7 200 58091I■ $C DC