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Home My WebLink About56669D - WorrellCAMA / DREDGE & FILL 1 E N E RAL PERMIT Previous permit # New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued -ized by the Stag of North Carolina, Department of Environment and Natural Resources ti .oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC attached. t Name 71 i2 t vi 41-1 U' w e e i Project Location: County u wi CIO 2 6. "' % % Street Address/ State Road/ Lot #(s) ID % Sfj.of G� f.e State ZIP_ (336) 512 a - 2,7a7 Fax # ( ) ed Agent P It, F w Via,,., L ❑ CW DEW ❑ PTA DES ❑ PTS ❑ OEA ❑ HHF IH ❑ UBA ❑ N/A ❑ PWS: ❑ FC: yes / o? PHA yes / o, Crit.Hab. yes / no Subdivision city,e9u L„lrN Sees zip 2,ry6. Phone # ( ) nn River Basin Adj. Wtr. Body ee2,✓A1 d7-7/mow (nat,/� Closest Maj. Wtr. Body �jw�"� Project/ Activity �Ae> —, /4 L C"t, (Scale: igth el Riprap length ■■■■■■■■■■■■■■■■■■■■■■■■■n■■■■■■■■■■� distance offshore- ■■■■■■■■■■■■■■■■■■■■■■■ri■■■■■■■■■■� x distance offshore ■■■i■■■■ii■■■■■■■■NU■'i■■w■►WINFUGi■■■■■i ■■■■■■■■■■■■■■EIIE I i■■m i■■■■m■■■■■■I Eic yards ■■■■■■■■■■■■■■`i1I■ �I I■■N IR►7�■■ ■■■■■■I 1p ■■■■■■■■■■■■■■■C4==11J ■■■N INO■■■■■■■■■N ■■■■■■■■■■■■■■■■■■1111 I■■I !■■■■■■■■■■l ■■■■■■■■■■■■■■■■■■■1111■■■■■■■■■■■■■■■I Aldozing ■■■■■■■■■■■■■■■■■■■1111■■■■■■■■■■■■■■■I .M■■■■■■■■■■■■■■r===MMu■■■■■■■■■■■■■■I - ■■■■■■■■■■■■■1 1■■■■ ■■■■■■■■■■■■■1 ■■■■■■■■■■■■■m■l I■w!m(7■ ■■m■■■■■■■■■■■s ■■■■■■■■■■■■■■OINE■■■ ■■■■■■■■■■■■■■e t Length YYYYYYY��YY�� 11��1■�� 8��'■� ■■■■■■■■■■■■■■■■■■■■■■■■11■■■■■■■r■� not sure ■■■■■■■■■■ ■■■■■■■■■■■■■■■■11■■■!_I/IIA■■I yes not sure yes no iurn: n/a yes noiOMMI GiLL�MplMM■11I�■■■■■■■■■■■■■■11■■■IIWMMM■l f■■■■'Aiil■■■■■■■■1'■11■■■F.;%I.WMMMMMRA§ yes nol .: "MNN�KMEMMMMN=MMMM=E11E=MNNMMM1,r.:t' ng permit maybe required by: /7U L Lr 101 ❑ See note on back regarding River Basin n 1 fA NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary Date l Llo A RECEIVED Name of Property Owner Applying for Permit: DCM WILMINGTON, NC -rur-1 hoktdl MAR 17 20i1 Mailing Address: ';w ') ", A�—'Pr I certify that I have authorized (agent) to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) at (my property located at) This certification is valid thru (date) 5 -�� k//) ""� CERTIFIED MAIL — RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER STATEMENT Name of Property Owner: Address of Property: &a6k Lot or Street #, S et or Road, City & County) Applicant's phone #: �0'�3�- o�.�3U Mailing Address: enn)( /W -->gwgges [ hereby certify that I own property adjacent to the above referenced property. The individual applying for this 1 has described to me as shown on the attached drawing the development they are proposing. A description of dra with dimensions, 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 (D( in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Driv( Wilmington, NC 28405-3845. DCM representatives can also be contacted at (910) 796-7215. No response considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION i understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distan 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.) IoX— I do wish to waive the 15' set back requirement. I do not wish to waive the 15' set back requirement. Signature s r, print or Type N k-4 hr Vlailing Address (Riparian Property Owner Information) Signature /r" r'S�J� Print or I ype Name Mailing Address f� bc, �r r ai 6 1 r,n II I licant: P Q� L✓E/ 12 e Permit #: / -vibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement id 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 fina disturbance. Excludes any restoration and/c temp impact amount) .-a 1/ Dredge ❑ Fill ❑ Both ❑ Other 7 % �� •, L 2— 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 ❑ Bank of America ACH RIT 053000196 ALLIED MARINE CONTRACTORS, LLC 08-03 910-367-2159 92 HAROLD CT. HAMPSTEAD, NC 28443 PAY TO THE n f %, n ORDER OF / 6�(f [-, /// $ //III _ V MEMO IK_ ii'004346ii' ':053000 L9D: 000684743738ii' ■ 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: A. Signature Received by ( Printed Name) I C. Date of Delivery D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: B'IIro— ervlce Type Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise l• d Ul' .d ❑Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑Yes 2. Article Number (Transfer from service label) 7010 2780 0003 4072 2463 PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 ■ 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: +Y6� �d r !, C)�3Or) COMPLETE• ON DELIVERY A. Signature X W H Agent ressee B. Receiv y (Printed N ) rate ivery f!'l2r E c v D. Is elivery address d I m item T? ❑ Y If YES, enter delivery ad below:,_ 6 6 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 7 010 1670 0001 1917 12 7 7 (transfer from service 1