HomeMy WebLinkAbout55867D - Brown1dAMA / [� DREDGE & FILL
3 EN E RAL PERMIT Previous permit #
4 ew ❑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 I SA NCAC
/ [9%les attached.
it Name /44 of 0 d1 <tiJ1 Li _ Project Location: County �/2 f/.✓S!✓/ C/�
21 .Sf, , Street Address/ State Road/ Lot #(s) 122 ypL,p,
PHA- State ZIP 2 s 6S!
O o7iP Fax # ( )
ed Agent 61 mi� /ydide,•%
CW LAW ❑ PTA ❑-}ES ❑ PTS
OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Subdivision
City //r l d o,-, deocA ZIP 2'701�
Phone # ( ) River Basin L W,., ,
Adj. Wtr. Body Cl. "O ( (na r
C PWS: ❑ FC:
yes kno PNA ye no Crit.Hab. yes / no Closest Maj. Wtr. Body
Project/ Activity�4= z r C- �ti l/l�11 0,4 f/ 1 5 Ally
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ck) length
ngth
tuber
Riprap length SQ /
distance offshore_
x distance offshorei"
cannel
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ip {
se/ Boatlift
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a Length J a ,
not sure yes
64
not sure yes
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um: n/a yes
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no
ktached: yes
no --
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ig permit maybe required by:
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See note on back regarding River Basin ru
Special Conditions, �L L
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-2007 10:02 From: To:8423805
CEIi'fTMD_MAIL - Ra ETUR I R1�CEIPT REQUFSTED
The purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual of
individuals listed below. The CAMA General Permit application ptecedures require that applicants provide the Div],
Coastal Management confirmation that a wrinen statement has been obtained signed by the adjacent riparian property
indicating that they have no objection to the proposed work or that the adjacent riparian property owners have been n
by certified mail of the proposed work. Oftn these forms are submitted to the adjacent riparian property owners by t
contractor or other individuals acting as an authorized agent on behalf of the applicant.
This form was sent to you by the following Individual or company designated by the applicant as as
authorized agent:
Agent's Signature
Name of Individual Applying For Permit: Gl-e,AO&Jb
Address of Property- �8 �l�h. e
( Lot 4or Streeett 0, S eet or R
(City and County)
I hereby certify that i own property adjacent to the above•referenced property. The individual applying for t
has described to me as shown on the attached drawing the development they are proposing. A description of
with dimensions, should be provided with this letter,
I have no objections to this proposal,
If *you have objections to what Is being proposed, please write the Divislun of Coustni Ntanaget
Cardinul Drive Extension, Wilmington, NC 2W5 or call 910-796-7215 within 10 days of receipt oft
No response is considered the same as no objection if you huve been notified by Certified mail.
WAIVER SECTION
1 understand that a pier, dock. mooring pilings. breakwater, boat kouse or bout llR must be
minimum dis-tanee of 15' from my area or riparian access - uttlem waived by me. (if you wish to
setback, you most initial the appropriate blank below.)
i do wish to waive the 1 S' setback requirement.
dicant: G✓A_� E &21�l
e: 'V o
Permit #: J ` t — - 6 2, 46
cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
rid 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)
i2el,
Dredge ❑ Fill 34,Both ❑ Other ❑
S Q
T"G
Dredge ❑ RIIJ4 Both ❑ Other ❑
SQL
S QQ
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 ❑
-03-2007 10:02 From: To:8429806
CER'CIFTED MAIL - RETUR f-REC IPT;REOUESTFn
r tl s r a .. U UiTsimmal
i t' : {, i �� � ► r \ ► \ � a * ►V . FLU
The purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual or
individuals listed below, The LAMA General Permit application preccdures require that applicants provide the Division
Coastal Management confirmation that a written statement has been obtained signed by the adjacent riparian property owl
indicating that they have no objection to the proposed work 1 that the adjacent riparian property owners have been notifi
by certified mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by n ma
contractor or other individuals acting as an authorized agent on behalf of the applicant.
This form wus sent to you by the following Individual or company designated by the applicant as an
authorized agent:
Agent's Signature
Date
Name of Individual Applying For Permit: a AIA
Address of Property- /3 ! k
(Lot or Street 9, Street or Road)
(City and County)
I hereby certify that I own property adjacent to the above -referenced property. The individual applying for this K
has described to me as shown on the attached drawing the development they are proposing. A description or dra
with dimensions, should be provided with this letter.
I have no objections to this proposal,
If you huve objections to what Is being proposed, please write the Divislun of Coustnl Managemen
Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215 within 10 days of receipt of this r
No response is considered the same as no objection ifyou have been notified by Certified Mail.
WAIVER SECTION
1 underttund that a pier, dock. mooring pilings, breakwater. bout house or bout (lf't must be set t
minimum distance or t5' from my area of riparlan access - unless waived by me. (if you wish to wai
setback, you must initial the appropriate blank below.)
I do wish to wnivc the I5' setback requirement.
/1 Z1 I da!al wish to waive the IS' setback requirement. XWA
HOLDEN D
q &
OCK & gU LKDyLKHEgDS
HEg
910- OOROiHy HOLDEN
TONE NCDt 457 6438
1502
SUPPLY CHIMNEY RD SW HERS 5202642:'
NC 28462
JVC
';053142
Harlantl Clarke
j:8p00 is 7 S 301190 3 7
/Zo10, pa
WILOLIFE OMS.
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