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Home My WebLink About56536D - Brown,CAMA / ' DREDGE & FILL "ENERAL PERMIT mew ❑Modification El Complete Reissue ❑Partial Reissue Previous permit # 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 Coles attached. t Name 11N , L- [ f' t S�t iL / 2G?fic✓ •✓ Project Location: County y r✓E ", Le State__ Zip ` ,7p6 (tt)1iG �iJh Fax # (_—) edAgent 67p2191.a1 6aoaN ❑ CW ❑ EW ❑, PTA ❑ ES ❑ PTS ❑OEA ❑HHF =IH FJUBA ❑N/A ❑ PWS: ❑ FC: Street Address/ State Road/ Lot #(s) Subdivision CiZIP�2 ?'Y� Phone # ( ) ^ ^River Basin Z w "3_4 Adj. Wtr. Body CA-'Ot Ot" /`�/ �'�/w (nat k yes Lr'10 PNA yes /,Ca2 Crit.Hab. yes / no Closest Maj. Wtc Body / "A/ Project/ Activity !L P .o L,a C e Z_X ' 5?4', �A� �, • 13.i t',�i� Qq S6% (Scale: -k) length /`JC,C>%/wAc y ■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ igth ■■■■■■■■■■■■■■■■■■I■■■INMENJIM ■■1■ _Aprap length .■■■....■■....■■■■..l.�►.■....■..■■■■■ ■■■■■■■■■■■■■■■■■■■■/i�V■■■■■■■■■■■■■ ■■■■■■■■■■�f■■■■V:■f1/■■■■■■■■■■■■■■■■■ ■■■■■■■■MEN Hc yards MEN JJMWi AQJ■■N■■MEMO■■■ 1p ■■■■■��■■ ■■■■■■■■■`�.I� r■■■■■■■■■■■ ■■■■■■�7L'��■ Es■■■■■ l�� \■■■■■■■■■■■ ■�■�i■■■� �w��i�!�rl�rwl�w��www�w�w� Length ■■■■■■■■■■ 11■ ■■ ■1 ■� ■■ 1■I ®■� 1■I ■ I ■L:■■■■■■ not sure yes n' . ■■■■■■■■■■ 11■t ■■ ■� ■i ■■ t■t ■ ■� 1■i I ■■r�r�■�■■■ not sure es n ■■■■■■■■■n n■ ■■■■�■■■■■■■11■■■■■■■■■ yes wtached: yes ig permit may be required by: /7/0 LC141111 49P,9 L / El note on back regarding River Basin r� c --- � -- c. - -/ o_ X2_ i . <"- - C_ -JL> ,J Holcim 1(4"% 800-845-1120 www.holcim.us Lo rLA A LkJ YU 0 6r' k Of (Information for Property Owner Applying for /Perm it) Mailing Address 207 Pe J/[ditr City/S ate/Zip 5e4,vW ADJACENT RIPARUN PROPERTY OWNER STATEMENT `� � 's I hereby certify that I own property adjacent to j � n G f" y "} (Marne of Properly Owner) property located at �Y oe- Cori. --- (Lot, Block, Road, etc.) a `' / ( ��; � vs tv- G,.. , N.C. on � i yvt a in (Waterbody} (Town and/or County) Applicant's phone ##: fZE -13 Z b Mailing Address: ZP? Gr He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. -------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be fdled in by property owner proposing development) / o C t �/�a _------------ ---- -------- ---------- ------ ------ (Riparian Property Owner Information) \Signature Print or Type Name 4#VV-r ADJACENT RIPARUN PROPERTY OWNER STATEIVIENT I hereby certify that I own property adjacent to er Owner) (tame of Property located at property �'� (Lot, Block, Road, etc. / ( �v ✓ , N.C. r ,y , in �2ur.r w, c on ,CvaJ F �__ (Town and/or Co ty) (Waterbody) cant's hone #: FLG" Mailing Address: y� // N ZG� G'l Appl' � S3Gd v He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. ------- ----------- ----- --------- D- --------------ESGRIP'iION AND/OR DRAWING OF - PROPOSED DEVELOPMENT (To be filled in by property owner proposing development) d r 1.✓.a. el � i i (Information for Property Owner Applying for Permit) Mnilinv Address (Riparian Property Owner Information) —Z.X��Signature NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Dee James H. Gregson Freen Beverly Eaves Perdue Secrei Governor Director AGENT AUTHORIZATION FORM Date: Name of Property Own r Applying for Permit: N e of Authorize ent for this project: Owner' Mail' g Addres Phone Number ig, , 0 Agent's Ma' 'ng Address: Phone Number I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct the following (activity): (my property located) at This certification is valid thru (date) Property Owner Signature Date plicant: L�lr✓� f-C �/ S�P/L ll�/doc✓/`� te: /V3, � Permit #: scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremei ind in your Habitat code sheet. bitat 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 fir disturbance. Excludes any restoration an( temp impact amount) Dredge ❑ Fill Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other Tel 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 ❑ EUNICE FISHER BROWN 3-90 66-7027/2531 5696 NCDL 816935 PH. 828-456-8060 48 BLACKBERRY RIDGE bVAYNESVILLE, NC 28786 IZ 20� PAY THE OR ORDER t (' Y C� A Qj �00 . po 07,E HOMETRUST BANK DOLLARS 12 CLYOE SAVINGS SINCE 1926 fWWW.HOMETRUSTBANKING.COM r `iL1131C) %� FOR I' d0 �l del IJIS� VI 1:2531?02791: 0000323564iin 5696