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Home My WebLink About55861D - BrownCAMA / L�OREDGE & FILL NERAL PERMIT Previous permit# ew ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued ized 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 U les attached. Namelom Pf a2fic l Project Location: County�q�„i State-57.C- ZIP Z 9S-6 S- (t)-SGDFFax #( ) ed Agent R6 "i'yi P %�% 16' 4, CW P3 $PTA ttE-Sr ❑ PTS OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A PWS: ❑ FC: yes / no PNA yes no Crit.Hab. yes / no Street Address/ State Road/ Lot #(s) 3D Sc-U-,12 Subdivision City �'AA,� rLP BO�c� ZIP Z FyF� Phone # ( ) River Basin Adj. Wtr. Body G✓L✓ (nati Closest Maj. Wtr. Body OfProject/ Activity Reloove /9,n0ocX. /2C4llc veed-i v� /nf)�PrIi9� �2GA9 u�% VV' (Scale: Jock) length rm(s) pier(s) length camber :ad/ Riprap length_ tvg distance offshore nax distance offshore channel yR )i( n :ubic yards_ amp ause/ Boatlift Bulldozing ine Length not sure igs: not sure Drium: n/a r Attached: %c ding permit may be required by: 614i f— r t-12 e go/*C ❑ See note on back regarding River Basin S 1✓ P// fI S �� O 7/iC�il 0 VSpecial Conditions O.f/�.�5 .419.40A W� 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: q3/)J-- Name of Property ow%jner Applying for Permit: Owner's Mailing Address: .PQ Qov S,S— Dee Freeman Secretary Name of Authorized pAgent for this project: Agent's Mailing Address: Phone Number- 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 3 O S c.o� 1 4^ a This certification is valid thru (date) 3JI) 21ke 4ZertyOwner Signature Date ��. 28Vb( DIVISION.OF COASTAL Kk AGINI ENT ADJACE�t-T RVAn,CN PROPERTY ONVXEER/�STATEINMN7 jprr+ea T .131N i/r . 13 I hereby eery that Town propeM adJ&cent to (Name of Property Ow-mer) property located at 7�0 S c 0-H."I S�rR��i' —_ ' (I,ot, $�ociy Rao$ etc) • ;� ,�.. 1.� I.a. ) on (Waterbo ) (Town and/oo L�ty3'S" ,applicant's phone # '�'� ' 8 Mailing Addres: �► .�..-.— i.�. S -Z4 ry He/She has described to me as shown below the developm� hd a is proposing et that location, end Z bave syo objections to the proposal,------^....__-------_W---------��_-^-_-- - — DESC^WTION AND/OR DRAWING OF PROPOSO DEVELOP?YMNT: (Indduidual,proposing development must jW fn description MOW or allach a sits dFawingj C Pr l . if you ha-fe objections.ty wh&t is betty prOpcsed, You amuet notify the D'visiop a Coa3tal Maaag"MIam (DCK In wri w1fl n 10 days of recelpt of this aotice- Ccrraspoadence should be maned to 127 Cardlaal Dora Ext. Wilmington, N DCM r4Qr0entit1v¢8 CAR Abo bo contacted at 010) g96.7"Z�S.r,eAn not4Ged Sr Certffitd iVisii �GNC �-tTD+c.l.�r-1 Ptiut or Type Name Spas c� Mailing Address 2�—)G1aj. Q<- City / State I Zip (Riparian Property Owner Xnformation) sign ze print or `hype Name .qyl e've Mailing Address City/ Sta.ta / zip - d e,/i vC-y ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to 's (Name of Property Owner) property located at (Lot, Block, Road, etc.) on in , N.C. (Waterbody) (Town and/or County) Applicant's phone #: flailing Address: 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 filled in by property owner proposing development) (�� k cif ----------------------------------------- (Information for Property Owner Applying (777T mation) for Permit) Mailing Address Signature icant:f�„� Permit Bribe 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 final disturbance. Excludes any restoration and/c temp impact amount) Dredge Fill ❑ Both ❑ Other ❑ �{S' Dredge ❑ Fill ❑ Both ❑ Other G �� 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 ❑ RONNIE McCRAY, SR. 66-7704/2531 1351 PH. 910-287-6191 Golden Circle 9225 OCEAN HWY. W Z d CALABASH, NC 28467-2111 DATE L ^� nevTn /l�/ !//�� $ 06 THHEEOORR EVOIr /�s��✓ _ LA�� Pit- �V DOLLARS a o,,,,,m- 9 State Em to eesCredit Union® Supply, North Carolina 81 i:2S3L77049i:086LEI L99S72110 13SL