HomeMy WebLinkAbout56524D - AtlanticF CAMA / DREDGE & FILL
23ENERAL PERMIT Previous permit#
-iNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
)r4z 0 by the State of North Carolina, Department of Environment and Natural Resources
coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC -f
❑ Rules attached.
it Name , _.. 1 / I t !' �(f f K yft!o ' Project Location: County k t
Street Address/ State Road/ Lot #(s)
19111 -_ State Ne-, ZIP
Fax # ( )
:ed Agent F-�
C CW KEW PTA ❑ ES ❑ PTS
C OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWs: ❑ FQ
yes / e PNA yes /c Crit.Hab. yes / no
Project/ Activity
kllancrh
Subdivision
City
ZIP
Phone # ( ) River �� Basin
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ding permit may be required by: �Gyy� 71 b*11? � $ee note on back regarding River Basin
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DIVISION Of COASTAL MANAGEMENT
ADJAO`ENT RIPARIAN PROPERTY OWNER NO' -1`1 1CATI0"N & WAWEER FORt,
Name of individuai applying fYr permit11
Address of property, b l ,� 1 S �/,�a »mil gL
I hereby certify that I own propel adjacent to the above referenced Property. Tt
individual applying fir his permit has de=rri�d to me as shown on the attache(
drawing the developrnent they are proposing. A description or drawing, witth
dimensions should be provided with this letter of notification.
Please initial below if you have no objections.
I have no object -ions to this proposal.
If you have objections to what is being proposed, please write the Division of Com
Management, 127 Cardinal Drive Extension, Mmington, N. C. 264050 or call 91(
within 10 days of receipt of this notice. No response is considered the
? 96 'Pd same as no o§edion if you have been notified by Certified Mail.
CEIVED --
_MINGTON, NC
0 7 2010
WAIVER SECTION
I understand that a pier, dock, mooring Pilings, breakwater,boat tmu3e,lift or
sandbags must beset 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 1 v' setback requirerntaInt.
I DO NOT wish to waive the 15' setback requirerrie t.
�S� Signature & Date
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FOF
Name of individual applying for permit //I�'�✓ l "��` ��`� ���'`��
�i
Address of property b11�-��1���`�
I hereby certify that I own property adjacent to the above referenced property.
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.
I have no objections to this proposal.
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
.395- within 10 days of receipt of this notice. No response is considered t
nn
f 16 /4 jS 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- E C E I V
�/ DCM WILMINGT
100 wish to waive the 15' setback requirement_
OCT 0 7 2(
I DO NOT wish to waive the 15' setback requirement.
���� � S' AJ
,,2 Signature & Date
R-14-2010 08:52 From: To:9102563062 P.1
;DER Natural Resource
North Garc�iina Department of Environment Ma Management
Djvision of Co
.lames H, Gregson
88vetty Eaves Perdue Director
Govemr
AGENT AtJiW4RtZA71�N CORM
Date; / 3 dM1 D
Name oL"2jg*rn;8rApplY!ng for ermit
Ate
owrters Mailing Address.
a CSC
;✓/,�6L —/—I Ij� L
Phone NumberE-5 $6
Do Free
sea{
Name of Authorized Agent for this project
9/4/
Agent's Malihng Address' rye
&��
x
Phone Number
the purpose o€ appiYln9
1 certify that l have authorized the agent listed above to act on behalf,
e he'€�ooQ ng (ac ivity):
for and obtaining aA GAMA Permits n cefis install or Construct
2�d - j 'g�
(my property located) at
This\\�A n is
s6 91)l b
R�, Date
Owner Signature RECEIVED
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RECEIVED
DCM WILMINGTON, NC
OCT 0 7 2010
Division of Coastal Mgt. Habitat Impact Computer Sleet
dicant:
/e/is/iv
;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/c
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other y
3 3
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 ❑
PAY
TO THE
ORDER OF
F AND S MARINE CONTRACTORS, INC.
P.O. BOX 868, TEL. 256-3062
WRIGHTSVILLE BEACH, NC 28480
38613
- 4 ' i 2 66-85/531
DATE
RBC Bank- DOLLARS
RBC Bank (USA)
ci P'%Sa4,Cn)
FOR Iit��IG' Q l_vu-c
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