HomeMy WebLinkAbout57417D - Wodell'CAMA / DREDGE & FILL
3"ENERAL PERMIT Previous permit#
New ❑Modification []Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC » UC
Rules attached.
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tName_ 1, '-Ak'ftA. �"+4j�`Q:�,r Project Location: County o&AJItk
XT I( State ' �r ZIP '21 +1 2-
() Fax # ( ) !1f
ed Agent'
❑ CW [I EW )� PTA DIE S V PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
yes (no) PNA yes K no) Crit.Hab. yes /
' Project/ Activity
Street Address/ State Road/ Lot #(s)
7Z faa- iy bid '-4.
Subdivision r� A
(Qity U � uL �ra+"�C.ti.. ZIP )) '
Pone # (�) - �3River Basin 1.�w k
Adj. Wtr. Body 1 nat r
Closest Maj. Wtr. Body W w
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ck len th
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ig permit may be required by: `x L(,U `�j� �f �(( �1 ❑ See note on back regarding River Basin ru
ail I-F.h (ri--1 All A I], —,I rinj C ,� 111AA (,cJit —f ,AtA. ,I.L --_ . J
-G 11 10::38 FROM,-CHAPM l TO:19197686713
U5 MAIL -, a lV/oµti ra
P.1/1
p,7
DTVISION t?IF COASTAL MA.:NA(;F:MFNT
A1VACEYT RiPARJAN PRo pVRTY OWNxR STA,'MINTRN-r
Name Of Prorerty C vntar..lLl�
Address of Propo:t[v;
(Lot or StrEet W", SUCAt Or R43d,
Applica►tPs pbonc p:,
1 hereby canify djat I own roert xd'acen�r to the � 7
Y 1 above t�fcavwaed prnpettr. 1;'hc indivia= applying fpr this permit
fIQS doscrihnd t0 rae 3S spawn on the xtlnahexl drawing !hc dcValopancr,t they rtn: propocing, w n
wrS� vi *A,S
* ` I have no nbjt+ctloas tp this
op04,,j i have obicctioru to this prOPM1,
If yQy }l8ve Q6nctfonS ro wi►nt is lxiiu� prpp(�yet1, you must mod the Alr1$lan of
ip wtiit2lg thin Q days o� CeoeiPt Of this Mike- Comzpondollce shoulu be tuMe4 to� ?LstA#jlClitl�ft (DCIt'i)
W}fmlAg(on. NC 2840,- a,3 ,;. pC1►�rap C*rdful Drive Ext,
rc&ea.at�vc5 can alto be =Uctca at (910) 796-73I5. No Cespouu la
t su1riU fts x4 If CC1tA .�
o n r;flEa cc_rn�i� y�lt.
WA[VRRS'l~Cn0jV"
uru3crs�gna chat a pier, dock, motat;ag PiliQ" bmakwmter, b aftus1.c, ar lift must be sect 1c a_rr ioimum c�btanc4 of
1ST pri uln ►e Mara Lleof lowriot� aCCC3s w�lvss vrnit•ecl by u�c. Jf}ou wisll to waive tiro scOack, you Inuit initial the
rt�`optiare blau�c Uef�u+,)
I tan wish to waive the
15' tEt Dltek rPQt►lret]trut,
_--- 1 do Not wish to walrc tfrc IS' 3cr bacv mquirc.,n�,nr
` on fp
G
i',►int or7.'ype Nxmc � ` ~�
Mailing Addrors ---Y.-�
City i State 1 Zip
ielol5hi�ttel�lum6tr,� �
Da'c
(RlParixv Property Uwaer rnfoU'rn uon)
Signature
Past or Type Name
Mailing
ing A�clress '"�
City / stela / Z[p
Telephent Numl"
Date
A MAIL
CERTIFIED MAIL RETURir1 RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIP AWAN' PROPERTY OWNER STA'TEN" ..
Q /
flame of Property Owner: y
kddress of Property:
91Q �ZQ �/� Mailing Address:
Applicant's phone It:i
le
Svc z9y6z
r_ _ mot' ermi
I hereby certify that I own property adjacent to the above referenced property.
The Inctiviauai appryn% .V• -•••' r.,...--
has described to me as shown on the attached drawing the development they are proposing_ A description of drawin
with dimensiorfs must be provided with this letter.
I have no objections to this proposal.
I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCW,
in writing within 10 days of receipt of this n ntatives can also be contacted at (910) 9b-721� No responseice. Correspondence should be mailed to 127 Cardinal is
Ex
Wilmington, NC 28405-3840. DCM representatives
considered the same as no objection if -you have bee notified b Certified itiiail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distance 4
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' set back requirement.
'( 7 I do not wish to waive the 15' set back requirement
O Information) (Riparian Property Owner Information)
(Property `A,'r` er 1
_ Signature
e e / Print or Type Name
Print or TYPJ lame
�7--T- Mailing Address
Mailing Address
/.,- / J// -7
G7/ .X 9 X Z
_ . _
ACA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson
Governor Director
AGENT AUTHORIZATION FORM
Date: of 8 J&be to /l
lame of Property Owner Applying for Permit:
'-oge'tt c Z c
)wner's Mailing Address:
' my.513/_'IM& CT
ke&4Awn Al C Z 77/2
'hone Number
Dee Freema
Secretai
Name of Authorized Agent for this project:
Agent's Mailing Address:
/7 O gDeElecvooa nu iyu)
_! u. nfffak W C. "'Ye"
Phone Number �/O S�- 7117(10
certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
or and obtaining all CAMA Permits necessary to install or construct the following (activity):
6
II&W C`Oitl,STXb(C'%7Q/lJ� Si4i/r)!s� '.�/N1Qr'f%C/d� _
;my property located) at 52 `i44M-PAIT Sr. L�GEJ�N TSL E aEAff,/ NG
This certification is valid thru (date)4
Property Owner Signature Date
Division of Coastal Mgt. Habitat Impact Computer Sheet
)licant: wO�dQ� ( I (, p (fi- Permit #:
:e:
>cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd 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/oi
temp impact
amount)
�
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other
l a
a
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 ❑
L4 v- l74- 119 T;;f
Brenda Murra#
MichaefG . Wulm 2877
Ph. 910-754-71 j 66 112/531
1790 DeerruoodTr[N�W
SuppG, NC 28462-3700 �f �fliE
D.1.11. on
B.cM.
BRANCH � iByANKING AND TRUST COMPANY
G,I B B NK BBT BBT.com
':053 10 1 12 11:0005 194 500 13 211'0 2877
mZD0 NBM Berner Sf.d-AG.
KIM ANDERSON-
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailplece,
or on the front if space permits.
1. Article Addressed to:
607
A, -/O,eeic/CL- .SC
2.
PS Form 3811, February 2004
Xsigryt(tu
G❑ Agent
❑ Addressee
B. F�ct�ived by ( Printed am C. Date f li ery
. f m�
D. Is delivery address dill rent from Rem 1? ❑ Y s
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
7 WM MM -J:71p7g4-t:4:
stic Return Receipt
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to: O
'L X?'t1AA
�0 X)X '�IY7
A. Sig
❑ Yes
102595-02-M-1540
;Received
Agent
❑ Addressee
( Prin Na e) C. Date of Delivery
.severy address different from Rem 1? ❑ Yes
If YES, enter delivery address below: ❑ No
o. oervice type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
2. Article Number
(Transfer from service label)
4. Reatrint-i r) ii -- n-
❑ Yes
7010 2780 0000 3712 2538